Phillip J. Koo, MD, presented “PSMA PET Imaging: A Primer for the Urologist or Oncologist” during the 30th Annual Perspectives in Urology: Point-Counterpoint, on March 10, 2023, at Humphreys Half Moon Inn, San Diego, California.
How to cite: Koo, Phillip J. “PSMA PET Imaging: A Primer for the Urologist or Oncologist.” March 10, 2023. Accessed May 2024. https://grandroundsinurology.com/testosterone-update-on-oral-products/
PSMA PET Imaging: A Primer for the Urologist or Oncologist – Summary
Phillip J. Koo, MD, 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 how technicians window, fuse, and send images can affect what a practitioner sees. Dr. Koo recommends that practitioners avoid sole reliance on 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 30th Annual Perspectives in Urology: Point Counterpoint conference: Presented by Program Chair and Grand Rounds in Urology Editor-in-Chief E. David Crawford, MD, this conference brought together leading experts in urology, medical oncology, and radiation oncology to discuss and debate the latest topics in genitourinary cancers, primarily prostate cancer and bladder cancer. This interactive conference offered topical lectures, pro/con debates, interesting-case presentations, interactive panel discussions, and interactive audience and faculty networking.
