Experts say one radiotracer outperforms all others when it comes to detecting prostate cancer
When it comes to detecting prostate cancer, not all radiotracers are created equal, according to a new comparative analysis.
Rates of prostate cancer diagnoses have been on the rise over the last two decades and it is now the second most common cancer among men. With the increase in cases, medical experts have dedicated countless hours to researching the most effective ways to diagnose and manage the disease. Imaging has played a key role in this.
Today, multiparametric MRI is considered the standard for diagnosing, staging and managing treatment options for prostate cancer. Though the modality is known to be accurate, it is not perfect, and when used to guide biopsy decisions, nearly 10% of cases are misclassified with mpMRI.
In recent years, PET/CT, often used to check for prostate cancer recurrence, has emerged as an accurate alternative to mpMRI for initial diagnoses. PET imaging makes use of radiotracers that improve the localization of intraprostatic lesions. There are several radiotracers specifically designed to identify prostate cancer, but experts now have reason to believe there is one that is superior the others at both the patient and the lesion level.
These experts shared their findings recently in Academic Radiology.
“Positron emission tomography/computed tomography is an important modality for the diagnosis of prostate cancer (PCa), yet the choice of radiotracers has not been clearly defined,” Jianfeng Wang, with the Department of Urology at The First Hospital of China Medical University, and colleagues noted. “As more novel radiotracers emerge, determining the optimal choice for diagnosing PCa has become of significant clinical importance. Due to the lack of direct comparisons among different imaging modalities, we conducted a network meta-analysis to synthesize information from both direct and indirect comparisons.”
The group’s meta-analysis included research on a total of nine radiotracers: 18F-DCFBC, 18F-FACBC, 68Ga-RM26, 68Ga-PSMA-617, 18F-PSMA-1007, 68Ga-PSMA-11, 18F-DCFPyL, 18F-FCH, and 68Ga-RM2. Comparisons of each tracer’s performance were made at both the patient and the lesion level, with these measurements used to rank the top three diagnostic methods.
At the patient level, the three best methods were 18F-PSMA-1007, 68Ga-PSMA-11 and 18F-DCFPyL. At the lesion level, the three best methods were nearly identical, with 18F-PSMA-1007 providing the most optimal results, followed by 18F-DCFPyL and 68Ga-PSMA-11. But overall, 18F-PSMA-1007 offered the highest accuracy at both the patient and lesion level. This radiotracer also outperformed mpMRI, the group noted.
This could be due, at least in part, to 18F-labeled radiotracers having lower positron energy, which results in better spatial resolution.
“Benefiting from its superior energy characteristics, and its non-urinary excretion pathway, it overcomes some practical limitations of 68Ga labeled PSMA-targeting tracers,” the authors explained.
The team only had a limited number of studies that utilized 18F-PSMA-1007, however, so they cautioned that more research specific to its use is needed before more definitive conclusions can be made.
Learn more about the team’s findings here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.