Radiation Therapy Planning Using Advanced Imaging – Pearls and Pitfalls
Sean P. Collins, MD, PhD, shares POSLUMA, a new PSMA-specific PET imaging agent approved in May 2023 for prostate cancer.
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Novel Targeted Therapies
Daniel P. Petrylak, MD, presents a detailed 9-minute discussion on novel targeted therapies for prostate cancer.
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Transforming Prostate Cancer Care – The Emerging Role of Radio-Ligand Therapies
Ilya Gipp, MD, PhD, explores the transformative potential of radioligand therapies in prostate cancer care.
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Transperineal vs Transrectal Biopsy Clinical Trials: Mo’ Data Mo’ Problems
Arvin K. George, MD, delves into the nuances of prostate cancer biopsy techniques, focusing on the comparison between transperineal and transrectal approaches.
In this 14-minute presentation, Dr. George shares that transperineal and transrectal biopsies demonstrate equivalent cancer detection rates, particularly for clinically significant prostate cancer. However, some retrospective data suggest potential advantages of transperineal biopsy in specific anatomical areas, with notable studies emphasizing the reduced risk of infections with transperineal biopsy. Dr. George also discusses a decreased need for antibiotics and the use of local anesthesia in a transperineal approach.
Further, Dr. George reflects on the implications for clinical practice, antibiotic stewardship, and cost-effectiveness for transperineal and transrectal approaches. His talk provides a comprehensive synthesis of current evidence, encouraging a balanced and thoughtful approach to biopsy method selection.
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PSMA PET for Preoperative Planning of Prostate Cancer: Nodes, Nerves and Margins
James Wysock, MD, MS, highlights the transformative role of novel imaging techniques, particularly PSMA PET and MRI, in improving prostate cancer diagnosis, staging, and management.
In this 14-minute presentation, Dr. Wysock explains the combination of PSMA PET and MRI significantly improves the detection of extraprostatic extension and seminal vesicle invasion compared to conventional imaging.
Meta-analyses confirm PSMA PET’s superior accuracy, particularly its high negative predictive value. This suggests that some intermediate-risk men with negative scans might safely omit extended lymph node dissection. This evidence raises important discussions about refining surgical planning and patient consent to balance risks and outcomes.
Wysock addresses emerging data supporting direct prostatectomy based on highly suspicious PSMA PET findings, bypassing biopsies. While controversial, this approach underscores the potential for imaging advancements to redefine standard workflows, especially as artificial intelligence enhances interpretation and decision-making.
Dr. Wysock emphasizes that while PSMA PET and MRI improve staging and management, these tools are still primarily validated in high-risk populations, with sensitivity challenges in lower-risk groups. The evolving role of advanced imaging, coupled with ongoing technological progress, promises to reshape prostate cancer treatment pathways.
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