Thomas Hope, MD, an associate professor of radiology and director of Molecular Therapy for the Molecular Imaging and Therapeutics Clinical Section of the Department of Radiology and Biomedical Imaging at the University of California, San Francisco (UCSF), discusses challenges with 68Ga-PSMA-11 PET in men with intermediate- or high-risk prostate cancer.

Topline results of a multicenter, single​-arm trial presented during the 

 showed a 40% sensitivity rate and high specificity with 68Ga-PSMA-11 PET in detecting pelvic nodal metastases at the time of radical prostatectomy in this patient population, says Hope. ​As the primary end point was a sensitivity rate of around 65%, these measures were lower than expected.

Despite this, the study was not a failure​, explains Hope. ​Instead, it may be an indication of how this test functions. The results also illustrate how difficult small nodal metastasis is to identify.

According to current data, PSMA-11 PET appears to be markedly better compared with standard conventional imaging such as CT, MRIs, and bone scans, Hope concludes

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Thomas Hope, MD, discusses challenges with 68Ga-PSMA-11 PET in men with intermediate- or high-risk prostate cancer.

Dr. Hope on Challenges With 68Ga-PSMA-11 PET in Prostate Cancer 

Thomas A. Hope, MD, an associate professor of radiology and director of molecular therapy for the Molecular Imaging and Therapeutics Clinical Section of the Department of Radiology and Biomedical Imaging at the University of California, San Francisco, discusses the positive findings from a phase 3 imaging study, which utilized 68Ga-PSMA-11 PET in the detection of pelvic nodal metastasis (N1) in men with intermediate- or high-risk prostate cancer.

Topline results from the multicenter, single-arm, open-label, prospective, clinical study, which were presented at the 

, focused on the sensitivity and specificity of 68Ga-PSMA-11 PET in the detection of N1 disease compared with pelvic lymph node dissection histopathology prior to radical prostatectomy, says Hope.

A total of 277 patients underwent radical prostatectomy; of those, 75 patients (27%) had N1 disease per histopathology at the time of surgery. Among the 75 patients, 30 tested positive through the PSMA PET; 10 were found to be false positives that were negative on pathology, but positive on PSMA. These findings translated to a sensitivity of 40% and a specificity of 95%, concludes Hope.

Thomas A. Hope, MD, discusses the positive findings from a phase 3 imaging study, which utilized 68Ga-PSMA-11 PET in the detection of pelvic nodal metastasis in men with intermediate- or high-risk prostate cancer.

Dr. Hope on the Effectiveness of 68Ga-PSMA-11 PET in Prostate Cancer

Thomas Hope, MD, assistant professor of abdominal imaging and nuclear medicine at University of California, San Francisco, (UCSF) discusses the detection sensitivity of PSMA-PET scanning.

Prostate-specific membrane antigen (PSMA)-PET is an imaging study agent that localizes the tumor in about 1 hour. PSMA-PET has a high detection sensitivity and can detect subcentimeter sites in patients that would never have been found otherwise.

Retrospective data, especially from Europe and Australia, indicates how many biochemically recurrent patients have a PSMA avid node. Most of the data show that with a PSMA of <1, you can see a recurrence site in about 60% to 70% of patients, which is better than conventional imaging, such as CT or MRI. Researchers at UCSF recently completed a prospective, FDA-registration phase II/III trial that could be potentially completed by end of 2017.

Thomas Hope, MD, assistant professor of abdominal imaging and nuclear medicine at University of California, San Francisco, discusses the detection sensitivity of PSMA-PET scanning.

Thomas A. Hope, MD

Articles

Dr. Hope on Challenges With 68Ga-PSMA-11 PET in Prostate Cancer

Dr. Hope on the Effectiveness of 68Ga-PSMA-11 PET in Prostate Cancer

Dr. Hope on the Detection Sensitivity of PSMA-PET Scanning