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Integration of PSMA-targeted PET imaging into the armamentarium for detecting clinically significant prostate cancer

Meyer, Alexa R.a; Joice, Gregory A.a; Allaf, Mohamad E.a; Rowe, Steven P.a,b; Gorin, Michael A.a,b

doi: 10.1097/MOU.0000000000000549
FOCAL THERAPY OF PROSTATE AND KIDNEY CANCER: Edited by Jean de la Rosette and Thomas J. Polascik

Purpose of review To explore the current state of using prostate-specific membrane antigen (PSMA)-targeted PET imaging to aid in the diagnosis of clinically significant prostate cancer.

Recent findings Prostate-specific antigen screening remains controversial, as it is associated with the underdetection of clinically significant prostate cancer as well as the overdetection and subsequent overtreatment of clinically insignificant disease. A diagnostic test that can accurately assess the presence of clinically significant prostate cancer and avoid detection of low-risk tumors is needed. Multiparametric magnetic resonance imaging (mpMRI) can aid in the detection of clinically significant prostate cancer and can be used with fusion-based biopsy platforms to target biopsies to specific lesions. However, there are several limitations of mpMRI including a modest negative predictive value for high-grade cancer. PSMA-targeted PET imaging has shown promise as a noninvasive test to aid in the detection of clinically significant prostate cancer while providing anatomical information to guide targeted biopsies. PSMA-targeted PET in combination with mpMRI offers a higher degree of diagnostic accuracy for imaging localized prostate cancer than either modality alone.

Summary PSMA-targeted PET imaging can aid in the identification of men with clinically significant prostate cancer. Further research is needed to determine the full potential of PSMA-targeted imaging in both the detection and treatment of localized prostate cancer.

aThe James Buchanan Brady Urological Institute and Department of Urology,

bThe Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Correspondence to Michael A. Gorin, MD, The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Park 213, Baltimore, MD 21287, USA. Tel: +1 410 502 7710; fax: +1 410 502 7711; e-mail: mgorin1@jhmi.edu

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