Utility of F-DCFPyL PET for local staging for high or very high risk prostate cancer for patients undergoing radical prostatectomy.
[PURPOSE] PSMA PET offers the potential for improved local staging prior to radical prostatectomy (RP).
- p-value P = 0.07
- p-value P = 0.045
- Sensitivity 65.8%
- Specificity 80%
APA
Li EV, Schaeffer EM, et al. (2025). Utility of F-DCFPyL PET for local staging for high or very high risk prostate cancer for patients undergoing radical prostatectomy.. European journal of nuclear medicine and molecular imaging, 52(7), 2335-2342. https://doi.org/10.1007/s00259-025-07133-1
MLA
Li EV, et al.. "Utility of F-DCFPyL PET for local staging for high or very high risk prostate cancer for patients undergoing radical prostatectomy.." European journal of nuclear medicine and molecular imaging, vol. 52, no. 7, 2025, pp. 2335-2342.
PMID
39928105
Abstract
[PURPOSE] PSMA PET offers the potential for improved local staging prior to radical prostatectomy (RP). We evaluated PSMA PET versus mpMRI for local and nodal staging for patients with localized NCCN high or very high risk prostate cancer undergoing RP.
[METHODS] A prospective single center pilot study was conducted from 9/2018 to 6/2022. Patients underwent both mpMRI and F-DCFPyL PSMA PET with limited MRI sequences, followed by RP with pelvic lymphadenectomy. Patient and side-specific performance of mpMRI and PSMA PET were compared to RP histopathological standard of truth for extraprostatic extension (EPE), seminal vesicle invasion (SVI), and lymph node involvement (LNI).
[RESULTS] At RP, 79% (38/48) had EPE, 31% had SVI, and 31% had LNI. At the patient level for EPE, PSMA PET had similar sensitivity (65.8% vs. 84.2%, respectively, P = 0.07) but higher specificity (80% vs. 40%, P = 0.045) compared to mpMRI, respectively. For SVI, PSMA PET had lower sensitivity (62.5% vs. 87.5%, P = 0.046) and similar specificity (87.5% vs. 90.6%, P = 0.56). For side-specific LNI, PSMA PET had higher sensitivity (50% vs. 25%, P = 0.03) and similar specificity (96.1% vs. 94.7%, P = 0.71) compared to mpMRI.
[CONCLUSION] PSMA PET offers higher specificity for EPE and higher sensitivity for LNI compared to mpMRI. PSMA PET may improve overall surgical planning, and may be combined with diagnostic mpMRI and clinicopathological variables through nomograms to further predict EPE, SVI, or LNI.
[CLINICAL TRIAL REGISTRATION] NCT03392181 https://clinicaltrials.gov/study/NCT03392181 .
[METHODS] A prospective single center pilot study was conducted from 9/2018 to 6/2022. Patients underwent both mpMRI and F-DCFPyL PSMA PET with limited MRI sequences, followed by RP with pelvic lymphadenectomy. Patient and side-specific performance of mpMRI and PSMA PET were compared to RP histopathological standard of truth for extraprostatic extension (EPE), seminal vesicle invasion (SVI), and lymph node involvement (LNI).
[RESULTS] At RP, 79% (38/48) had EPE, 31% had SVI, and 31% had LNI. At the patient level for EPE, PSMA PET had similar sensitivity (65.8% vs. 84.2%, respectively, P = 0.07) but higher specificity (80% vs. 40%, P = 0.045) compared to mpMRI, respectively. For SVI, PSMA PET had lower sensitivity (62.5% vs. 87.5%, P = 0.046) and similar specificity (87.5% vs. 90.6%, P = 0.56). For side-specific LNI, PSMA PET had higher sensitivity (50% vs. 25%, P = 0.03) and similar specificity (96.1% vs. 94.7%, P = 0.71) compared to mpMRI.
[CONCLUSION] PSMA PET offers higher specificity for EPE and higher sensitivity for LNI compared to mpMRI. PSMA PET may improve overall surgical planning, and may be combined with diagnostic mpMRI and clinicopathological variables through nomograms to further predict EPE, SVI, or LNI.
[CLINICAL TRIAL REGISTRATION] NCT03392181 https://clinicaltrials.gov/study/NCT03392181 .
MeSH Terms
Aged; Humans; Male; Middle Aged; Lysine; Multiparametric Magnetic Resonance Imaging; Neoplasm Staging; Pilot Projects; Positron-Emission Tomography; Prospective Studies; Prostatectomy; Prostatic Neoplasms; Urea