Should we apply PSMA PET: yes or no?

BJMO - 2019, issue Special, march 2019

C. Artigas MD, prof. dr. Piet Dirix


PSMA is a type II transmembrane glycoprotein that is highly expressed in almost all prostate cancer (PCa) cells, with only 5–10% of primary PCa not having PSMA expression. The recent development of radiotracers directed against PSMA has taken things to a new level. There is now a solid body of evidence for the performance of 68Ga-PSMA PET/CT in secondary staging (i.e. at PSA rise after primary treatment), with an ability to accurately detect small volume disease at far lower serum PSA levels than with bone scan or even choline PET/CT. As a result, the use of 68Ga-PSMA PET/CT as a diagnostic adjunct is becoming increasingly mainstream. In addition to this, radioligand therapy is emerging as a new therapeutic strategy in PCa. In the final presentation of the 2019 annual BMUC meeting, dr. Carlos Artigas discussed the potential of PSMA-PET in staging and assessing biochemical recurrence in prostate cancer (PCa) patients after which dr. Piet Dirix listed up some critical notes with respect to the use of PSMA in the evaluation of biochemical recurrence.

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