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| Response and Progression Criteria for PSMA PET: Imaging Prostate Cancer Outcomes |
| Wolfgang Fendler, MD |
| Oliver Sartor and Wolfgang Fendler explore the evolving role of PSMA PET imaging in assessing treatment response and progression in prostate cancer. Dr. Fendler outlines two key assessment approaches: the PPP criteria for early-stage disease focusing on lesion numbers, and the RECIP criteria for advanced disease examining tumor volume changes. |
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PSMA PET in Prostate Cancer: Balancing Sensitivity and Clinical Relevance
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Ravi Madan, MD
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| Oliver Sartor discusses with Ravi Madan the implications of using PSMA PET scans in metastatic castration-resistant prostate cancer. Dr. Madan highlights concerns about prematurely changing treatments based on PSMA PET findings without established criteria for progression.
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| Staging High-Risk Prostate Cancer with PSMA PET: Strengths and Pitfalls |
| Irene Burger, Prof Dr. Med |
| Irene Burger discusses the significant impact of PSMA PET in diagnosing high-risk localized prostate cancer. Dr. Burger describes the rapid adoption of this technology in Switzerland, emphasizing its enhanced sensitivity over traditional imaging since its integration in 2016. |
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| The Role of PSMA PET in CRPC Patients |
| Wolfgang Fendler, MD |
| Wolfgang Fendler's presentation at PSMA PET and RLT 2024 highlighted the pivotal role of PSMA PET/CT in diagnosing and managing metastatic castration-resistant prostate cancer (mCRPC) and non-metastatic CRPC (nmCRPC). PSMA PET demonstrated superior accuracy over conventional imaging, detecting metastases in over half of nmCRPC patients and revealing prognostic markers like PSMA avidity and disease volume, which correlate with survival outcomes. |
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| Combining PSMA-PET and PROMISE to Re-Define Disease Stage and Risk in Patients with Prostate Cancer: A Multicentre Retrospective Study - Beyond the Abstract
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| Madeleine J. Karpinski MSc & Wolfgang P. Fendler MD
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| A multicenter retrospective study has validated PSMA-PET and the PROMISE framework as novel prognostic tools in prostate cancer, establishing nomograms to predict overall survival across disease stages. These tools outperform traditional risk scores in staging accuracy but are not yet optimized for individualized patient counseling. Ongoing research, including the PROMISE-PET Registry Study, aims to enhance these predictive models further. |
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| Second Version of the Prostate Cancer Molecular Imaging Standardized Evaluation Framework Including Response Evaluation for Clinical Trials (PROMISE V2) - Beyond the Abstract
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| Robert Seifert MD, Matthias Eiber MD, PhD, and Wolfgang P. Fendler MD
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| The PROMISE V2 framework enhances the evaluation of PSMA-PET imaging for prostate cancer, addressing the need for standardized treatment response assessment alongside staging. Building on the original miTNM framework, PROMISE V2 introduces a harmonized system that integrates qualitative and quantitative findings into a streamlined reporting template. This advancement supports the design of prospective clinical trials and routine care, emphasizing PSMA-PET's role as a superior imaging modality for staging and response evaluation in prostate cancer management. |
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| Evaluation of Response to 177Lu-PSMA-617 by Site-Specific Disease in Metastatic Castrate-Resistant Prostate Cancer
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| Mohamed E. Ahmed, MD
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| Mohamed Ahmed presented a study evaluating site-specific responses to 177Lu-PSMA-617 in metastatic castration-resistant prostate cancer. Among 273 patients treated at the Mayo Clinic, 76 had either bone-only (52 patients) or lymph node-only (24 patients) disease. Key findings included better treatment responses in the lymph node-only group, characterized by higher PSA50 response rates (54% vs. 33%) and lower post-treatment PSA levels (median 0.9 ng/ml vs. 8.1 ng/ml).
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| Prostate Cancer Working Group 4 Preliminary Criteria Using Serial PSMA PET/CT for Response Evaluation: Analysis from the PRINCE Trial
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| Michael S. Hofman, MBBS (Hons), FRACP, FAANMS
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| Michael Hofman presents preliminary criteria from the Prostate Cancer Working Group 4 (PCWG4) for assessing treatment responses using serial PSMA PET/CT scans. The study, based on data from the PRINCE trial, showed substantial agreement among nuclear medicine experts in categorizing responses and demonstrated that PCWG4 criteria identified disease progression earlier than traditional PCWG3 methods, correlating strongly with overall survival. The findings underscore the potential of PCWG4 criteria to refine response evaluation in clinical trials, with further validation in larger cohorts underway.
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| Development of a Visually Calculated SUVmean (HIT Score) on Screening PSMA PET/CT to Predict Treatment Response to 177Lu-PSMA Therapy: Comparison with Quantitative SUVmean and Patient Outcomes - Beyond the Abstract |
| Mina Swiha, MD, PhD |
| The study led by Dr. Mina Swiha from St. Vincent Hospital in Sydney explored the development of a visually calculated SUVmean, termed the "HIT Score," on PSMA PET/CT for predicting treatment response to 177Lu-PSMA therapy. This visually assessed method offers an alternative to traditional quantitative SUVmean metrics, which require specialized software. The HIT Score aims to simplify the prediction process for therapeutic suitability while maintaining accuracy in correlating with patient outcomes and response to therapy. Further research comparing its reliability against conventional quantitative methods was emphasized to validate its clinical utility. |
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