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Abstract #2290

18F-DCFPyL PSMA PET/MRI improves detection of clinically significant prostate cancer in men on active surveillance: Results from a Phase II trial

Shane A. Wells1, Edward M. Lawrence2, Marcello Bigarella3, Jens Eickhoff4, David F. Jarrard3, and Steve Y Cho2
1University of Michigan, Ann Arbor, MI, United States, 2Radiology, University of Wisconsin, Madison, WI, United States, 3Urology, University of Wisconsin, Madison, WI, United States, 4University of Wisconsin, Madison, WI, United States

Synopsis

Keywords: Prostate, PET/MR, PSMA, prostate cancer, active surveillance, 18F-DCFPyL

Motivation: High interobserver variability and low-to-moderate sensitivity and specificity for detecting clinically significant prostate cancer (PC) limit the utility multiparametric MRI (mpMRI) in men with PC on active surveillance (AS).

Goal(s): To determine the diagnostic accuracy of 18F-DCFPyL PSMA-PET/MRI compared to mpMRI in men with PC on AS.

Approach: Prospective diagnostic trial of 100 men with PC on AS. PI-RADS ≥3 and Likert ≥3 lesions, identified by experienced, blinded radiologists and nuclear medicine physicians, respectively, were targeted for PSMA PET/MRI-US fusion biopsy by an experienced urologic oncologist.

Results: PSMA PET/MRI improves detection of csPC in men on AS while maintaining high negative predictive value.

Impact: Imaging and clinical predictive models that include PSMA PET/MRI may identify low and intermediate-risk men who could potentially avoid prostate biopsy and coincident morbidity, as well as increase the detection rates of csPC missed by MRI-biopsy alone.

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