We undertook a head-to-head comparison of PSMA-targeted <sup>18</sup>F-DCFPyL PET to Na<sup>18</sup>F PET to determine which modality was more sensitive for the detection of lesions suspicious for bone metastases in a group of patients with metastatic PCa.
The typical and predictable patterns of spread in prostate cancer are still more prevalent, such as spread to pelvic lymph nodes and bone metastasis, but different patterns of disease spread are becoming more commonly recognized with higher reliability because PSMA imaging allows detection of more typical and atypical lesions than conventional imaging.
Agreement between PSMA PET/CT and PSMA-PET/MR was very good for intra-prostatic PSMA-avid foci (K = 0.85) and pelvic lymph nodes (K = 0.98), good for PSMA-avid bone metastases (K = 0.76) and fair for prostatic capsular invasion (K = 0.25) and seminal vesicle involvement (K = 0.31).
Local pelvic lymph node recurrence was detected on F-fluciclovine versus Ga-PSMA-11 in 46.6% versus 50%, in extrapelvic lymph node metastases in 41.4% versus 51.7% and in bone metastases in 25.9% versus 36.2%.
A systematic review and meta-analysis to compare the diagnostic performance of prostate-specific membrane antigen (PSMA)-PET/CT, choline-PET/CT, Sodium Fluoride (NaF) PET/CT, MRI, and bone scintigraphy (BS) in detecting bone metastases in patients with prostate cancer.
Clinicians reporting F-PSMA-1007 PET/CT should be aware of this potential pitfall, especially in nontypical trauma pattern (eg, solitary osseous lesion) mimicking bone metastases.
<sup>68</sup>Ga-PSMA-PET/CT in comparison with <sup>18</sup>F-fluoride-PET/CT and whole-body MRI for the detection of bone metastases in patients with prostate cancer: a prospective diagnostic accuracy study.
Of these, 50 lesions (11%) were only detectable on PET but not on conventional CT. PET-positive/CT-negative bone metastases demonstrated a significantly lower PSMA uptake compared to PET-positive/CT-positive bone lesions (p < 0.05).
[<sup>68</sup>Ga]PSMA PET/CT is an invaluable imaging modality in the assessment of primary high-risk PCa with great potential for the detection of lymph node spread and bone metastases that would impact the management plan.
There are many options of treating BM, such as chemotherapy, immunotherapy, external beam radiotherapy, bone modifying agents and recently prostate-specific membrane antigen (PSMA) targeted therapies.
In this retrospective study, prostate-specific membrane antigen PET/computed tomography was found to be superior to planar bone scintigraphy in the detection of bone metastases.
RM2 PET revealed two additional lesions indicative for bone metastases in two patients with multiple PSMA-positive bone metastases, which had no therapeutic consequence.
Prostate cancer patients with known bone metastases underwent PSMA-targeted PET/CT (<sup>18</sup>F-DCFBC or <sup>18</sup>F-DCFPyL) and <sup>18</sup>F-NaF PET/CT.
The objective of this study was to evaluate the rate of detection of bone metastases obtained with the prostate-specific membrane antigen (PSMA)-targeting tracer <sup>99m</sup>Tc-MIP-1427, as opposed to conventional bone scanning with <sup>99m</sup>Tc-methylene diphosphonate (<sup>99m</sup>Tc-MDP), in a collective of patients with known advanced-stage osseous metastasized prostate cancer.
Comparison of [<sup>68</sup>Ga]Ga-PSMA-11 PET/CT with [<sup>18</sup>F]NaF PET/CT in the evaluation of bone metastases in metastatic prostate cancer patients prior to radionuclide therapy.
The diagnostic performance of DW<sub>600</sub>-MRI was significantly lower than that of <sup>68</sup>Ga-PSMA PET/CT and <sup>18</sup>NaF PET/CT for diagnosing bone metastases (p < 0.01), and no significant difference in the AUC was seen between <sup>68</sup>Ga-PSMA PET/CT and <sup>18</sup>NaF PET/CT (p = 0.65).
We present images of Ga-PSMA PET/CT and parameters of response of a 75-year-old heavily pretreated metastatic castration refractory prostate cancer patient with extended bone metastases, showing an extraordinary biochemical response in PSA-levels concordant to SUV decline in bone metastases.