Phillip J. Koo, MD presented “PSMA PET Imaging” during the 33rd International Prostate Cancer Update on January 24, 2023, in Vail, Colorado.
How to cite: Koo, Phillip J. “PSMA PET Imaging.” January 24, 2023. Accessed Aug 2024. https://grandroundsinurology.com/psma-pet-imaging/
PSMA PET Imaging – Summary
Phillip J. Koo, MD, Division Chief of Diagnostic Imaging and Northwest Region Oncology Physician Executive of Oncology at the Banner MD Anderson Cancer Center in Phoenix, Arizona, presents a primer for urologists and oncologists on prostate-specific membrane antigen (PSMA)-positron emission tomography (PET) imaging. Dr. Koo asserts that PSMA-PET is rapidly becoming a modern-day practice. He explains that not all hotspots shown on these scans are necessarily prostate cancer; sharing research demonstrating PSMA-PET images, including normal images and other findings, that are not prostate cancer. If a practitioner is uncertain, magnetic resonance imaging (MRI) can be performed. Dr. Koo highlights solitary rib lesions, which can present a challenge to clinicians due to a high proportion of false positives on the PSMA-PET scan. He then emphasizes that what is seen on the scan is only half the story, explaining that how technicians window, fuse, and send images can affect what a practitioner sees. Dr. Koo recommends that practitioners avoid sole reliance on the fused images. Practitioners should reach out to radiologists in order to gain clinical context and the opportunity to educate and learn from those experts. He then addresses variability in standard uptake value (SUV) and cites a study on the repeatability of SUV in oncologic 18F-FDG PET, concluding that practitioners should be very careful with SUV numbers and take them in context. Dr. Koo shares a scoring system for various PSMA-PET findings and calls this a clear, standardized way for practitioners to communicate with referring physicians. Finally, Dr. Koo addresses RADAR VI and VII as well as procedure guidelines for PSMA-PET.
About The 33rd 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. The 33rd iteration of the meeting occurred January 22-25, 2023 in Vail, Colorado. To view more educational presentations from IPCU 33, visit our collection page.
ABOUT THE AUTHOR
Phillip J. Koo, MD, is the Chief of Diagnostic Imaging at the Banner MD Anderson Cancer Center in Phoenix, Arizona. Prior to this, he was Chief of Nuclear Medicine and Associate Professor of Radiology at the University of Colorado School of Medicine in Aurora, Colorado. He completed his fellowship at the Harvard Medical School Joint Program in Nuclear Medicine in Boston, Massachusetts. Dr. Koo is a diplomate of both the American Board of Radiology (ABR) and American Board of Nuclear Medicine(ABNM).
