James Wysock, MD, MS, presented “PSMA PET for Preoperative Planning of Prostate Cancer: Nodes, Nerves and Margins” during the 2024 Frontiers in Oncologic Prostate Care and Ablative Local Therapy symposium on October 17, 2024, in San Diego, California.
>
How to cite: Wysock, James. “PSMA PET for Preoperative Planning of Prostate Cancer: Nodes, Nerves and Margins.” October, 2024. Accessed Mar 2025. https://grandroundsinurology.com/psma-pet-for-preoperative-planning-of-prostate-cancer-nodes-nerves-and-margins/
PSMA PET for Preoperative Planning of Prostate Cancer: Nodes, Nerves and Margins – Summary
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.
Frontiers in Oncologic Prostate Care and Ablative Local Therapy (FOCAL) is an outstanding program on prostate imaging, transperineal interventions, and ablative treatments for prostate cancer and benign prostatic hyperplasia. Bringing together community-based, academic, and industry partners, FOCAL offers lectures by world-renowned faculty and hands-on training workshops on in-office transperineal interventions, fusion-guided prostate ablation and state-of-the-art BPH management with novel technologies.
ABOUT THE AUTHOR
James S. Wysock, MD, MSc, is an Assistant Professor of Urology at NYU Langone Health and Division Chief of Urology at Bellevue Hospital Center in New York City. He received his undergraduate degree in Chemical Engineering from the University of Illinois- Urbana Champaign and his medical degree from Northwestern University Feinberg School of Medicine. He completed his internship and residency training in urology at New York-Presbyterian Hospital in the Brady Department of Urology at Weill Cornell Medical College. He then completed his fellowship in urologic oncology and robotic surgery at NYU Langone, where he also obtained a Master’s of Clinical Investigation.
At NYU Langone Health and Bellevue Hospital, Dr. Wysock provides clinical services for the diagnosis and management of the breadth of urologic malignancies. His clinical research efforts focus on image-guided prostate cancer diagnosis and treatment, including MRI-US fusion biopsy and partial gland prostate ablation techniques.
