Phillip J. Koo, MD, presented “PSMA PET Imaging: A Primer for the Urologist or Oncologist​” during the 30th Annual Perspectives in Urology: Point Counterpoint (PCP30) conference on March 11, 2023 in San Diego, California.

How to cite: Koo, Phillip J. PSMA PET Imaging: A Primer for the Urologist or Oncologist.” March 11, 2023. Accessed Jun 2024. https://grandroundsinurology.com/psma-pet-imaging-a-primer-for-the-urologist-or-oncologist/

PSMA PET Imaging: A Primer for the Urologist or Oncologist – 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 30th Annual Perspectives in Urology: Point Counterpoint

The Perspectives in Urology: Point Counterpoint (PCP) conference brings together leading specialists in urology, medical oncology, and radiation oncology to engage in dynamic discussions on the latest men’s health, general urology, and genitourinary cancer topics. Among the featured urologic subjects are lower urinary tract symptoms, localized and advanced prostate cancer, bladder cancer and immunotherapy, upper tract cancer management, renal cell carcinoma, and MRI and imaging. The conference’s format includes debates, point-counterpoint discussion panels, interactive audience response technology, and unique-case presentations. Under the leadership of co-chairs E. David Crawford, MD, and Manoj J. Monga, MD, FACS, the 30th iteration of PCP took place March 10-12, 2023 in San Diego, California.

To view more educational presentations from PCP 30, visit our collection page.