Brian T. Helfand, MD, PhD, presented “Next Generation Imaging for Localization of Recurrent Prostate Cancer” during the 31st International Prostate Cancer Update in July 2021 in Snowbird, Utah.
How to cite: Helfand, Brian T. “Next Generation Imaging for Localization of Recurrent Prostate Cancer.” July 2021. Accessed Dec 2023. https://grandroundsinurology.com/next-generation-imaging-for-localization-of-recurrent-prostate-cancer/
Next Generation Imaging for Localization of Recurrent Prostate Cancer – Summary
Brian T. Helfand, MD, PhD, Chief of the Division of Urology and the Ronald L. Chez Family and Richard Melman Family Endowed Chair at NorthShore University HealthSystem in Evanston, Illinois, discusses the efficacy of next generation imaging options for localization of recurrent prostate cancer. He states that conventional imaging is consistently lacking in the sensitivity necessary to localize recurrence in patients with PSA levels below 10 ng/ml and that waiting for PSA levels to become this high produces worse oncologic outcomes in patients. Dr. Helfand suggests that next generation imaging is superior to conventional imaging due to the ability of MRI and PET CT scans to produce more accurate results at lower PSA levels. He then looks at the different available next generation imaging agents, focusing on choline C-11, fluciclovine, gallium, and DCFPyl, and expresses a need to understand how these agents compare to one another. Dr. Helfand reviews data on choline C-11 PET imaging which shows positive scans in 36% of patients at PSA levels below 1 ng/ml. He then discusses data from the LOCATE trial showing a 30% detection rate at 0 to 0.5 ng/ml, and evidence of PSMA having a 57.89% detection rate at 0.2 to 0.5 ng/ml. Dr. Helfand shows comparative data of the agents wherein PSMA has a better detection rate than choline C-11 of 86% vs. 70%, respectively, and a better detection rate than fluciclovine of 80% vs. 62%, respectively. He concludes that all next generation imaging options are superior to conventional imaging but more data is needed on how they improve oncological outcomes and on situational use of imaging agents.
About The 31st Annual International Prostate Cancer Update:
The International Prostate Cancer Update (IPCU), founded in 1990, is a multi-day CME conference focused on prostate cancer treatment updates with expert, international faculty. It is led by expert physicians and is designed for urologists, medical oncologists, radiation oncologists, and other healthcare professionals involved in the diagnosis and treatment of prostate cancer. Dr. Helfand delivered this educational activity during the 31st iteration of the meeting in July 2021 in Snowbird, Utah.