David Margel, MD, PhD

David Margel, MD, PhD, explores the integration of multi-modality imaging, specifically combining MRI with PET (positron emission tomography), to enhance the detection of clinically significant prostate cancer (csPC).

Dr, Margel explains that MRI provides detailed anatomical information and is widely used for localizing suspicious lesions within the prostate gland; however, MRI alone may have limitations in accurately distinguishing aggressive cancers from indolent ones. PET imaging, on the other hand, offers functional insights by detecting metabolic activity within tissues. Radiotracers like 18F-fluorodeoxyglucose (FDG) or prostate-specific tracers such as 68Ga-PSMA are utilized to target specific molecular markers associated with prostate cancer cells.

The combination of MRI and PET leverages the strengths of both modalities: MRI for precise anatomical localization and PET for functional characterization based on metabolic activity. This synergistic approach improves the accuracy of prostate cancer detection, particularly in identifying csPC that may be missed by either modality alone.

Dr. Margel emphasizes the clinical implications of multi-modality imaging in guiding treatment decisions. By accurately identifying and characterizing csPC, clinicians can tailor personalized treatment plans, including targeted biopsies, focal therapies, or systemic treatments. This approach minimizes overtreatment of indolent disease while ensuring aggressive cancers are appropriately managed.