An advanced imaging method shows promise to improve the diagnosis of prostate cancer

A trial conducted at the University Hospital Bonn in Germany has been testing the benefit of a scanning method known as PSMA-PET/CT to help target where to take biopsy samples. According to the study, interim results reveal that when used alongside standard imaging techniques, the additional scans might help clinicians make improved decisions about subsequent courses of treatment.

The researchers note that the comparisons to the standard scans alone, when PSMA-PET/CT was used, clinicians changed how they might treat a patient with clinically significant prostate cancer in 19% of cases.

“The normal standard of care, which is an MRI scan and then a biopsy, is already good at detecting prostate cancer, but we wanted to see if PSMA-PET/CT could offer additional information to help with treatment plans,” says Philipp Krausewitz, MD, a urologist at University Hospital Bonn who led the study. “It appears to be having an impact in high-risk patients, but we also saw false positives in 6% of patients that meant we needed further investigations. The question we are considering is whether the additional diagnostics are worthwhile.”

The study, known as the DEPROMP trial, recruited around 200 men to take part since March of 2021. The researchers hope to have 230 patients enrolled by the end of the trial. The preliminary results used data from 219 men who all underwent MRI, PSMA-PET/CT and biopsy.

Their scans were then randomly looked at by two separate teams of urologists—one was given the results from the MRI, PSMA-PET/CT and biopsy, while the other group were given the results without the PSMA-PET/CT data. The researchers then compared how the two teams would choose to proceed with treatment based on the information they had.

As an example, the researchers explained that the clinicians might choose to do surgery to remove the cancer or give the patient chemotherapy. But it is not yet clear how these decisions might ultimately affect patient outcomes as it can take years and even decades for cancer to return if treated correctly, according to the researchers.

“We are seeing a change in cancer detection and management plans in these early results, but we have to wait to see if the final results reflect this,” says Krausewitz. “PSMA-PET/CT is not yet available everywhere as it is expensive, so it is important we understand how it can be effectively used. In the meantime, PSMA-PET/CT could be considered a solution for selected challenging diagnostic cases or those where MRI cannot be done.”