Addressing Knowledge Gaps and Clinical Challenges of PSMA PET in Prostate Cancer
More than three years after the first FDA approval of a PSMA radiotracer for detecting prostate cancer (PCa), we are seeing an evolution and maturation of use in the clinic. The availability of PSMA PET with different tracers enables us to detect lesions that conventional imaging misses, identify disease recurrence at very low (<0.5 ng/mL) PSA levels, and distinguish between benign and malignant tissue.1-3 In some countries and regions, PSMA PET is now standard practice for initial PCa staging, treatment planning, and monitoring treatment response. However, questions persist about how to manage patients in the PSMA PET era, particularly because registrational trials of current therapies predated the widespread availability of PSMA PET and therefore used only conventional imaging (i.e., CT, bone scan). Here, I discuss current knowledge gaps pertaining to the use of PSMA PET in various scenarios and how we can best steward this resource.
An Update on Radiographic Imaging for Detecting and Staging Prostate Cancer, Evaluating Treatment Response, and as a Prognostic and Predictive Biomarker
Effective prostate cancer treatment relies on accurate disease detection and staging. For this reason, recent improvements in localized and whole-body imaging will transform management. The discussion regarding localized disease continues to focus on prostate MRI. For metastatic disease, there is a palpable excitement following the U.S. Food and Drug Administration (FDA) approval of PSMA PET diagnostic agents. These technologies are clearly disruptive. However, this disruption will lead to better informed treatment decisions and ultimately, better outcomes. This article provides an update on radiographic imaging for detecting and staging prostate cancer, evaluating treatment response, and as a prognostic and predictive biomarker.
UroToday Launches Society of Nuclear Medicine and Molecular Imaging (SNMMI) Video Channel
“By academic freedom, I understand the right to search for truth and to publish and teach what one holds to be true. This right implies also a duty: one must not conceal any part of what one has recognized to be true. It is evident that any restriction on academic freedom acts in such a way as to hamper the dissemination of knowledge among the people and thereby impedes national judgment and action.” -Albert Einstein
The field of nuclear medicine has seen a resurgence in relevance especially in the area of prostate cancer imaging and therapy. Dr. Evan Yu adeptly summarizes the promising potential of PSMA radioligand therapies in his October 2018 post in the Clinical Trials section of UroToday. We look forward to seeing his future article regarding diagnostic trials evaluating various PSMA targeted agents.
Technology and Imaging: “Ask Not What Radiology Can Do, But What It Should Do!”
Each year, over 54,000 people assemble in Chicago on the Sunday following Thanksgiving to attend the Radiological Society of North America Annual Meeting (RSNA), which is consistently one of the largest medical meetings in the world. The 103rd Annual Meeting recently concluded and was a great chance to reflect on 2017, while taking a peek at 2018 and beyond. The hot topic this year was artificial intelligence (AI) and machine learning. Though the idea of AI instills fear in many, it is clear that opportunities abound. Beyond any concerns, we must remain focused on how we utilize these technologies to meaningfully improve the delivery of healthcare for an individual as well as a broader population.
Stepping into the Light: "Radiologist Dies Upon Immediate Exposure to Sunlight.”
“We can’t believe it, he left us far too young,” explained family medicine physician Miranda Sawyer, scrolling through X-rays as “Jack would’ve wanted.” She continued. “His bright and shining face always kept us smiling. I mean that metaphorically, of course. It’s always dark in Radiology. You could never see him.” For reasons unclear, Jack Lambert stepped outside at approximately 2:19 PM when the glowing orb known as the sun was still present.
Welcome to the new Imaging Center of Excellence (Imaging CoE) on UroToday.com. As a practicing radiologist and nuclear medicine physician, the content on this website has been extremely useful as a tool to learn about clinical urology and urologic oncology. By gaining a deeper understanding of the daily challenges and advancements in the urologic sciences, I have been able to tailor my practice to better meet the needs of my urology and oncology colleagues. With the creation of a new dedicated section on imaging and nuclear medicine therapies, we hope to expand the scope of this resource and build a multi-disciplinary, content driven destination for all topics related to GU radiology and nuclear medicine.
