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Peer-reviewedCC BY 4.0Journal of Nuclear Medicine

PSMA PET Imaging for Prostate Cancer Recurrence After Minimally Invasive Focal Therapy: A Single-Center Retrospective Study

  • Mahbod Jafarvand1
  • Andrea Farolfi1,2
  • Riccardo Mei2
  • Loic Djaileb1,3
  • Matthias Benz1,4
  • Alex Chung4
  • Wayne Brisbane5
  • Leonard Marks5
  • Tristan Grogan6
  • Andrei Gafita1,7
  • Lela Theus1
  • Andrew T. Nguyen1
2 more authors
  • Johannes Czernin1
  • Jeremie Calais1
7 affiliations
  1. 1Ahmanson Translational Theranostics Division, Department of Nuclear Medicine and Theranostics, UCLA, Los Angeles, California
  2. 2Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
  3. 3Nuclear Medicine Department, LRB, Université. Grenoble Alpes, INSERM, CHU Grenoble Alpes, Grenoble, France
  4. 4Department of Radiological Sciences, UCLA, Los Angeles, California
  5. 5Department of Urology, David Geffen School of Medicine, UCLA, Los Angeles, California
  6. 6Department of Medicine Statistics Core, David Geffen School of Medicine, UCLA, Los Angeles, California; and
  7. 7Division of Nuclear Medicine and Molecular Imaging, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Abstract

Prostate-specific membrane antigen (PSMA)–targeted PET/CT (PSMA PET/CT) has become the first-line imaging modality used for staging and restaging prostate cancer. Its utility after minimally invasive focal therapy (high-intensity focused ultrasound, laser ablation, cryoablation) remains unclear. This study evaluated PSMA PET/CT for detecting and localizing recurrence after focal therapy. Methods: This retrospective single-center study included patients with prior focal therapy for prostate cancer who underwent 68Ga-PSMA-11 PET/CT for suspected recurrence between 2016 and 2023 without intervening treatment. Three masked readers analyzed whole-body PET/CT images using a per-region (prostate, pelvic nodes, distant metastases) majority rule for per-patient positivity. Interreader agreement was determined using Fleiss κ. In a subcohort of 39 patients with both MRI and biopsy results available within 3 mo of PSMA PET/CT, per-patient and per-segment (12 prostate segments) accuracy was assessed. One masked reader evaluated PET/CT at 60 min (whole-body) and 90 min (pelvic) postinjection, and one prostate MRI expert independently read the MRI scans. Biopsy pathology-confirmed clinically significant prostate cancer, defined as International Society of Urological Pathology grade 2 or greater, served as the reference standard. Results: In total, 112 patients were included. PSMA PET/CT showed 82% positivity for intraprostatic recurrence, 15% for pelvic nodes, and 9% for distant metastases. Interreader agreement was moderate (κ = 0.4; 95% CI, 0.32–0.54). In the subcohort, per-patient sensitivity was 85% for PET vs. 82% for MRI. All cases with an SUVmax of 10 or greater had an ISUP grade group of 3 or greater. Conclusion: PSMA PET/CT effectively localizes prostate cancer recurrence after focal therapy, outperforming MRI on sensitivity.

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Cite

BibTeXRIS
BibTeX
@article{jafarvand2026psma,
  title = {{PSMA PET Imaging for Prostate Cancer Recurrence After Minimally Invasive Focal Therapy: A Single-Center Retrospective Study}},
  author = {Mahbod Jafarvand and Andrea Farolfi and Riccardo Mei and Loic Djaileb and Matthias Benz and Alex Chung and Wayne Brisbane and Leonard Marks and Tristan Grogan and Andrei Gafita and Lela Theus and Andrew T. Nguyen and Johannes Czernin and Jeremie Calais},
  journal = {Journal of Nuclear Medicine},
  year = {2026},
  month = nov,
  doi = {10.2967/jnumed.125.271556},
  url = {https://doi.org/10.2967/jnumed.125.271556},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - PSMA PET Imaging for Prostate Cancer Recurrence After Minimally Invasive Focal Therapy: A Single-Center Retrospective Study
AU  - Mahbod Jafarvand
AU  - Andrea Farolfi
AU  - Riccardo Mei
AU  - Loic Djaileb
AU  - Matthias Benz
AU  - Alex Chung
AU  - Wayne Brisbane
AU  - Leonard Marks
AU  - Tristan Grogan
AU  - Andrei Gafita
AU  - Lela Theus
AU  - Andrew T. Nguyen
AU  - Johannes Czernin
AU  - Jeremie Calais
PY  - 2026
DA  - 2026/11/03
JO  - Journal of Nuclear Medicine
DO  - 10.2967/jnumed.125.271556
UR  - https://doi.org/10.2967/jnumed.125.271556
AB  - Prostate-specific membrane antigen (PSMA)–targeted PET/CT (PSMA PET/CT) has become the first-line imaging modality used for staging and restaging prostate cancer. Its utility after minimally invasive focal therapy (high-intensity focused ultrasound, laser ablation, cryoablation) remains unclear. This study evaluated PSMA PET/CT for detecting and localizing recurrence after focal therapy. Methods: This retrospective single-center study included patients with prior focal therapy for prostate cancer who underwent 68Ga-PSMA-11 PET/CT for suspected recurrence between 2016 and 2023 without intervening treatment. Three masked readers analyzed whole-body PET/CT images using a per-region (prostate, pelvic nodes, distant metastases) majority rule for per-patient positivity. Interreader agreement was determined using Fleiss κ. In a subcohort of 39 patients with both MRI and biopsy results available within 3 mo of PSMA PET/CT, per-patient and per-segment (12 prostate segments) accuracy was assessed. One masked reader evaluated PET/CT at 60 min (whole-body) and 90 min (pelvic) postinjection, and one prostate MRI expert independently read the MRI scans. Biopsy pathology-confirmed clinically significant prostate cancer, defined as International Society of Urological Pathology grade 2 or greater, served as the reference standard. Results: In total, 112 patients were included. PSMA PET/CT showed 82% positivity for intraprostatic recurrence, 15% for pelvic nodes, and 9% for distant metastases. Interreader agreement was moderate (κ = 0.4; 95% CI, 0.32–0.54). In the subcohort, per-patient sensitivity was 85% for PET vs. 82% for MRI. All cases with an SUVmax of 10 or greater had an ISUP grade group of 3 or greater. Conclusion: PSMA PET/CT effectively localizes prostate cancer recurrence after focal therapy, outperforming MRI on sensitivity.
SN  - 0161-5505
SN  - 1535-5667
ER  -