Molecular Imaging

How to cite: Hofman, M. “Molecular Imaging.” September 15, 2025. Accessed Oct 2026. https://grandroundsinurology.com/molecular-imaging-2/

Summary

Professor Michael Hofman, MBBS, FRACP, FAANMS, FICIS, GAICD, Peter MacCallum Cancer Centre, Melbourne, Australia, explains how prostate-specific membrane antigen (PSMA) positron emission tomography (PET) provides superior diagnostic accuracy compared with conventional imaging modalities and significantly influences treatment decisions. He emphasizes findings from the ProPSMA trial, which demonstrate that PSMA PET outperforms computed tomography (CT) and bone scans in staging prostate cancer while reducing radiation dose and diagnostic uncertainty. Professor Hofman describes how PSMA PET streamlines staging by offering a single, more reliable imaging approach.

He highlights the PRIMARY trial, which evaluates the combination of PSMA PET with multiparametric magnetic resonance imaging (MRI). Results indicate that this dual-modality approach improves detection of clinically significant prostate cancer, and the PRIMARY score standardizes reporting for PSMA PET interpretation. Professor Hofman introduces the PRIMARY2 trial, which investigates whether PSMA PET can help avoid unnecessary biopsies by refining patient selection.

The presentation also explores global initiatives to develop standardized interpretation criteria, including PROMISE2 and PSMA-RADS, which enhance consistency and reproducibility across institutions. In addition, Professor Hofman notes the potential role of artificial intelligence and deep learning tools in improving diagnostic accuracy and integrating imaging into broader clinical workflows.

Professor Hofman asserts that molecular imaging is reshaping prostate cancer care by improving staging, guiding treatment planning, and supporting precision oncology. He underscores the importance of continued clinical validation and international collaboration to optimize patient outcomes.

The Global Summit on Precision Diagnosis and Treatment of Prostate Cancer is a unique multi-disciplinary forum organized to inform the key health care stakeholders about the emerging advances in clinical case and research and create a consensus-based vision for the future of precision care and educational and research strategy for its realization. The mission of the Summit is to fill the currently existing gap between the key experts of in vivo imaging, the world authorities in the in vitro fluid- and tissue-based molecular diagnostics, including genomics, and thought leaders in the development of novel observation strategies (e.g., active surveillance, or AS) and therapeutic interventions.