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PEER-TO-PEER CLINICAL CONVERSATIONS |
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| PROMISE Criteria: Enhanced Survival Prediction in Prostate Cancer with PSMA PET |
Wolfgang Fendler, MD
Phillip Koo interviews Wolfgang Fendler about advancements in PSMA PET imaging and its prognostic capabilities. Dr. Fendler highlights that the PROMISE criteria, developed for standardized PSMA PET reporting, now show significant prognostic value in predicting overall survival in prostate cancer across all stages. |
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| Comparing PSMA Ligands for Prostate Cancer Imaging |
| Michael Hofman, MBBS, FRACP, FAANMS, FICIS, GAICD |
| Alicia Morgans discusses advances in prostate cancer imaging and theranostics with Michael Hofman. Dr. Hofman emphasizes the growing variety of PSMA ligands for PET-CT imaging and treatment, comparing their subtle differences and implications for clinical practice. |
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| Molecular Imaging for Prostate Cancer: When and Which Agents |
| Delphine L. Chen, MD |
| Delphine Chen discusses the pivotal role of molecular imaging in prostate cancer care, specifically focusing on PSMA-PET. She emphasized its applications in initial staging, detecting biochemically recurrent disease, and guiding patient selection for PSMA-targeted therapy like Lu-177 PSMA-617. Dr. Chen highlighted the clinical benefits and evolving criteria for therapy eligibility, underscoring improvements in PSMA PET access while addressing challenges such as cost and reimbursement. |
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| Alternative PSMA Ligands for Diagnostics and Treatment – Are They Interchangeable? |
| Michael Hofman, MBBS, FRACP, FAANMS, FICIS, GAICD |
| Michael Hofman presented at APCCC 2024 on the interchangeability of alternative PSMA ligands for diagnostics and treatment in prostate cancer. He highlighted that while 68Ga-PSMA-11 and 18F-DCFPyL are considered equivalent with similar organ biodistribution, other agents like 18F-PSMArh7.3 and 18F-PSMA-1007 have distinct characteristics such as benign bone uptake and varying levels of experience and evidence. |
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| Do the Differences in PET Agents Matter? |
| Wolfgang Fendler, MD |
| Wolfgang Fendler discusses the diversity of PSMA PET agents and their logistical, clinical, and interpretive implications. He emphasized that while various radiotracers like 68Ga-PSMA-11 and 18F-PSMA-1007 demonstrate high concordance in lesion detection, their specific physiological distributions and detection capabilities should be understood to optimize clinical use and interpretation in prostate cancer imaging. |
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| 18F-DCFPyL PET/MRI Radiomics for Intraprostatic Prostate Cancer Detection and Metastases Prediction Using Whole-Gland Segmentation
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| Seyed Ali Mirshahvalad, MD, MPH, FEBNM
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| Seyed Ali Mirshahvalad presents the findings on 18F-DCFPyL PET/MRI radiomics for prostate cancer detection and metastasis prediction using whole-gland segmentation. The study included 103 therapy-naïve patients, demonstrating that a hybrid PET/MRI radiomics model combining whole-gland T2-weighted MRI with 18F-DCFPyL PET outperformed clinical models in predicting clinically significant prostate cancer.
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| Willingness of Patients with Biochemically Recurrent Prostate Cancer with Positive 18F-DCFPyL PET/CT PSMA to Monitor Without Treatment |
| Monique Williams, MS, PMP |
| Monique Williams presents findings on the willingness of patients with biochemically recurrent prostate cancer detected via positive 18F-DCFPyL PET/CT PSMA to monitor without immediate treatment. The study, involving 86 patients, revealed that 87% of those with PSMA-positive biochemical recurrence opted for monitoring until the next scan, highlighting a significant patient preference for surveillance over immediate intervention in the absence of survival benefit data. |
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| 68Ga-PSMA-11 PET/CT for Baseline Staging of High-Risk Prostate Cancer: Associations Between Clinical Risk Factors, Metastases and Imaging Parameters |
| Gary Cook, MD |
| Gary Cook presented findings on the use of 68Ga-PSMA-11 PET/CT for baseline staging in high-risk prostate cancer. A retrospective analysis of 525 patients showed that 22.1% had evidence of metastatic disease. Factors such as PSA ≥20 ng/ml, ISUP grade ≥3, and ≥cT3a stage were significantly associated with increased metastatic risk. The study highlighted that the risk of metastasis increased with the number of these risk factors present, reaching 43.5% when all factors were present. |
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