Opinion

Video

Expert on sensitivity and specificity of PSMA-PET in prostate cancer

Key Takeaways

  • PSMA-PET imaging surpasses other modalities in detecting recurrent prostate cancer, especially in patients with low PSA levels post-prostatectomy.
  • It effectively identifies lesions at a molecular level, even when MRI fails, particularly for PSA levels below 1 ng/mL.
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In this video, Jitesh Dhingra, MD, FRCEM, discusses the sensitivity and specificity of prostate-specific membrane antigen (PSMA)-PET imaging in prostate cancer. Dhingra is an attending nuclear medicine physician at Allegheny Health Network in Pittsburgh, Pennsylvania.

Transcription:

How sensitive and specific is PSMA-PET in detecting recurrent prostate cancer, particularly in patients with a rising PSA level but negative conventional imaging?

This is basically where PSMA-PET imaging supersedes any other modality. When we are treating prostate cancer, some patients get radiation, some patients get prostatectomy. In patients with prostatectomy, there are different cut-off levels for PSMA positivity with a PSA level. In patients who have had a prostatectomy, they usually have a low PSA level. They have a PSA below 1 ng/mL. Now in these patients, detecting an MRI abnormality becomes a challenge, and this is where PSMA-PET is basically [superior]. [That is] because even at molecular level, at a PSA of less than 1, PSMA-PET is able to detect lesions, which MRI may be missing at this point of time, and that's basically where many studies have been done, and they have come to an algorithm where the sensitivity of PSMA-PET with the PSA level of less than 1, is somewhere in the range of 60% and in PSA above 2, the sensitivity is almost in the range of 95% to 97%, so that means that above 2 and between 2 to 5, a PSA level can be detected with positive PSMA imaging, which may be missed on MRI.

This transcript was AI generated and edited by human editors for clarity.

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