PSMA-PET Staging

This study examined how well a type of medical scan called PSMA-PET can predict survival outcomes in men with prostate cancer. PSMA-PET has become an essential tool for diagnosing and staging prostate cancer since it was introduced in 2012. To make the scan results easier to understand and use, researchers created a standardized reporting system called PROMIS. In this study, scientists tested how accurate PROMIS-based PSMA-PET predictions (called PPP nomograms) were compared with older, well-known clinical tools used to predict patient outcomes.

The study used data from over 2,400 men with prostate cancer who had undergone PSMA-PET scans at four hospitals in Germany between 2014 and 2021. About 37% of these patients had died by the time the data was analyzed in 2023, with an average follow-up of about 4.5 years. The researchers created two different types of PPP prediction tools—one based on numbers from the scan (quantitative) and one based on visual assessments (visual). They used statistical models to determine which features observed in PSMA-PET scans were most useful in predicting survival, including the presence of lymph node or distant metastases, the tumor size, and tumor activity on the scan. Both types of PPP tools performed well. The new tools were just as good or even better than existing clinical risk scores; they were more straightforward and more broadly effective.

Lancet Oncology. PMID: 39089299