Jitesh Dhingra, MD, FRCEM, on the advantages of PSMA-PET in prostate cancer

In this video, Jitesh Dhingra, MD, FRCEM, outlines advantages of prostate-specific membrane antigen (PSMA)-PET imaging compared with conventional imaging methods. Dhingra is an attending nuclear medicine physician at Allegheny Health Network in Pittsburgh, Pennsylvania.

Transcription:

What are the specific advantages of PSMA-PET imaging over conventional imaging methods in the diagnosis and staging of prostate cancer?

This is a very exciting time for nuclear medicine and molecular medicine. Basically, PSMA stands for prostate-specific membrane antigen. When we are using PSMA, we are actually able to image specific cells which should have prostate cancer in them, under the camera. This is basically where PSMA imaging is superseding any other imaging modality like CT or MRI, because we are at the molecular level, figuring out where the prostate cancer cells are, and ideally, molecular medicine usually precedes radiology. So whenever you have prostate cancer cells enough to express PSMA, you start seeing it, but you may not even see a CT or MRI abnormality at that time. There have been many studies done about sensitivity and specificity comparisons between PSMA and PSMA-PET/CT and MRI, and they have come to a conclusion that utility of PSMA-PET/CT and MRI usually come and meet together in numbers, but PSMA is superseding MRI in many other areas. For example, like when we are using PSMA-PET/CT for patients with the recurrent prostate cancers...the sensitivity of PSMA is around about 86% with the PSA level of above 2 nanograms per ml, but above 5, the sensitivity actually goes higher and is like 97%. The specificity, on the other hand, for recurrent disease and prostate cancer is pretty high. It is in the ranges of 95% to 97% in multiple studies. It's difficult to give a number because there are so many studies that have been done, but the numbers are pretty reassuring with the sensitivity and specificity of about 90% in recurrent prostate cancers. Overall summary sensitivity and specificity of PSMA in patients with initial staging as well as recurrent disease is again in the range of 85% to 90%, which is again a pretty good number, and it's pretty comparative to MRI.

This transcript was AI generated and edited by human editors for clarity.