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Imaging Sensitive Imaging Test Can Be ‘Game Changer’ for Men with High-Risk Prostate Cancer STORY HIGHLIGHTS PET/CT with gallium-68-labeled prostate- specific membrane antigen as the tracer is more sensitive and specific than any other prostate-cancer imaging test. While other PET/CT methods typically need a PSA of approximately 5 ng/ml for the site of recurrence to be detectable, the new PSMA test can detect a PSA as low as 0.5 ng/ml. A new imaging test now offered at UCLA and a handful of other centers in the U.S. is a potential “game changer” for men with newly diagnosed prostate cancer that has high-risk features, as well as for men who experience a recurrence after their primary prostate-cancer treatment. PET/CT with gallium-68-labeled prostate- specific membrane antigen (PSMA) as the tracer is more sensitive and specific than any other prostate-cancer imaging test, says Robert Reiter, MD, who is working closely with UCLA nuclear-medicine experts to provide the test to appropriate patients and study its impact. It fills an important need by identifying cancers that often are missed by conventional PET scans and pinpointing their location. “This is the most sensitive and specific prostate- cancer imaging test to date,” says Dr. Reiter, the Bing Professor of Urologic Oncology and director of the Prostate Cancer Program in the UCLA Department of Urology. “It can detect a Photo: Superstock higher percentage of lesions — even those that are very small — anywhere in the body, with 95 percent-or-higher accuracy.” Johannes Czernin, MD, chief of UCLA’s Ahmanson Translational Imaging Division, notes that the PSMA test accurately detects metastatic disease in normal-sized lymph nodes, setting it apart from existing technologies. With other PET/CT methods, Dr. Czernin explains, patients typically need a PSA of approximately 5 ng/ml for the site of recurrence to be detectable. With the new PSMA test, the lesions can be detectable with a PSA as low as 0.5 ng/ml. “We can find it sooner and with much greater reliability. “We rarely get false positives with this test,” Dr. Czernin says. “This means that for patients with slowly rising PSA levels after surgery or radiation treatment, we know where the elevated PSA is coming from and can treat the site of recurrence.” The PSMA imaging test, developed by researchers in Germany, uses a peptide that binds to prostate-specific membrane antigen on prostate-cancer cells, whereas most PET imaging approaches use a radioactively labeled sugar. The specificity with which the peptide in the PMSA test reaches its target sets it apart from previous tests, Dr. Czernin says. The test is approved at UCLA for men whose PSA is rising after definitive prostate-cancer treatment with surgery or radiation, and for men with newly diagnosed prostate cancer who have high-risk disease, as defined by a Gleason score of 4 plus 3 or higher, or an extremely elevated PSA. UCLAHEALTH.ORG 1-844-4UCLADR (1-844-482-5237)