Adding PSMA PET/CT to MRI-US Fusion Biopsy Boosts Cancer Detection

A prospective, single-center paired diagnostic study of 308 biopsy-naive men compared tri-modal PSMA PET/CT-MRI-US fusion biopsy with standard MRI-US fusion biopsy and systematic biopsy. The study reported that tri-modal fusion detected 4.9% more clinically significant prostate cancer than MRI-US fusion biopsy, with the largest gains in PSMA-positive lesions under 10 mm and PI-RADS 4 lesions; a PSMA-derived risk score showed high discrimination and, in simulation, could have avoided about 42% of biopsies while missing 2.3% of significant cancers. The authors state these findings require multicenter validation before clinical adoption.

Most relevant for: Biopsy-naive men undergoing prostate cancer diagnostic workup with MRI-US fusion biopsy, particularly those with PI-RADS 4 lesions or small PSMA-positive lesions.

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