Prostate-specific membrane antigen PET-CT before radical treatment
Mené sur 302 patients atteints d'un cancer de la prostate à haut risque de récidive, cet essai multicentrique compare la performance, du point de vue de la précision, de la sensibilité et de la spécificité, d'une tomographie numérique à émission de positrons à base du traceur "68Ga-PSMA-11" et d'une tomographie numérique conventionnelle pour détecter, avant un traitement chirurgical ou une radiothérapie, des métastases ganglionnaires pelviennes ou des métastases distantes
Michael Hofman and colleagues should be congratulated for their study reported in The Lancet, in which men (median age 68·1 years [IQR 63·0–73·5]) with high-risk prostate cancer were randomly assigned to standard imaging (CT and bone scan) or gallium-68 prostate-specific membrane antigen (PSMA) PET-CT. The study had a crossover design, in which men with no more than two unequivocal distant metastases on first-line imaging had second-line imaging from the alternate group. The primary outcome was accuracy of first-line imaging for identifying either pelvic nodal or distant-metastatic disease. PSMA PET-CT had a 27% (95% CI 23–31; p<0·001) greater accuracy than conventional imaging (92% [88–95] vs 65% [60–69]).
The Lancet , commentaire, 2019