18F-PSMA-PET/CT beats multiparametric MRI in staging high-risk and intermediate-risk prostate cancers.

Mookerji N et al. conducted a phase 2 prospective study to assess the accuracy of fluorine-18 PSMA-1007 PET/CT (PET/CT-PSMA) compared to multiparametric MRI in staging intermediate-risk and high-risk prostate cancers. The study was conducted at two tertiary care hospitals in Alberta, Canada, in patients with intermediate or high-risk (histopathologically-confirmed prostate cancer) within 2 weeks before radical prostatectomy.

Of 150 eligible men, 134 underwent radical prostatectomy. PSMA PET outperformed MRI in identifying:

• the final tumor stage (45% vs 28%; P = .003)
• dominant nodule (94% vs 83%; P = .01)
• laterality (64% vs 44%; P = .001)
• extracapsular extension (75% vs 63%; P = .01).

There was no significant difference for seminal vesicle invasion (91% vs 85%; P = .07).

JAMA Oncol. doi:10.1001/jamaoncol.2024.3196

?