Dr Koo on PSMA PET Imaging in Prostate Cancer

Phillip J. Koo, MD, is the Chief of Diagnostic Imaging at the Banner MD Anderson Cancer Center in Phoenix, Arizona, discusses the use of prostate–specific membrane antigen (PSMA) PET imaging in prostate cancer, including its potential use for patient selection for radiopharmaceuticals.

Koo stresses the need for a nuanced approach to utilizing PSMA PET imaging, cautioning against its indiscriminate application across all clinical scenarios for patients with prostate cancer, including treatment response assessment. Although PSMA PET imaging is a valuable diagnostic modality, Koo advocates for judicious utilization, emphasizing the necessity of aligning its deployment with scenarios where it offers maximal clinical benefit. He cautions against over-reliance on PSMA PET, noting the importance of adhering to established appropriate use criteria set forth by various medical societies.

Additionally, Koo highlights a common pitfall in the adoption of novel technologies—namely, the tendency to overuse them due to perceived superiority. Advocating for balance, Koo explains the need for evidence-based approaches, urging clinicians to exercise prudence in incorporating PSMA PET scans into routine clinical practice.

Furthermore, Koo discusses the evolving landscape of radioligand therapy in prostate cancer, noting a shift in clinical trials investigating their use earlier into treatment regimens, including pre-chemotherapy and potentially in hormone-sensitive settings.

Ongoing trials are underway to explore the utility of PSMA PET imaging to better select patients for these therapies, Koo explains. These trials encompass prospective, retrospective, and real-world evidence investigations, aiming to optimize patient selection strategies and maximize the clinical impact of PSMA PET technology, Koo concludes.