Since our preliminary report in 2018,4 it was clear that 68Ga-PSMA PET/CT could well identify intraprostatic cancer foci with high sensitivity, and thanks to the use of semiquantitative parameters (i.e. SUVmax and SUVratio-to-background), it could provide optimal cut-off points better highlighting the presence of clinically significant PCa. The final results of our trial obtained in 97 patients, and recently published in European Urology Focus,5 not only proved the high diagnostic accuracy of PSMA PET/CT prior to fusion biopsy but allowed us to identify exactly those 25% of patients with clinically significant PCa (GS ≥ 7) missed by previous mpMRI. This could be possible after applying the optimal cut-off points for SUVmax (>5.4) and SUVratio-to-background (>2.2). The overall diagnostic accuracy reached was 90% for SUVratio.
Written by: Egesta Lopci, MD, PhD, Nuclear Medicine Department, Humanitas Clinical and Research Hospital - IRCCS, Milan, Italy
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