July 10, 2023 Radparts 0

Cutting-edge technology and nuclear medicine are massively improving prostate cancer treatments, especially over the past two decades. Before 2000, prostate cancer was detected through manual palpation, a Prostate-Specific Antigen (PSA) blood test, and an ultrasound. Notably, prostate cancer is not visible in ultrasounds, so urologists would have to sample random prostate areas to discover the cancer. 

In the early 2000s, prostate MRI emerged and progressed through the 2010s. This technology allowed radiologists to discover whether prostate tumors were present. 

Brett Mollard, MD, a diagnostic radiologist in Michigan, said, “They could now see and target the tumors rather than randomly sampling the prostate and hoping to biopsy the tumor. We’re actively witnessing a second revolution thanks to new imaging agents, known as radiotracers or radiopharmaceuticals, for PET.”

In 2012, Positron Emission Technology (PET) radiotracers received approval, with better ones emerging in 2016. In 2021, Prostate-Specific Membrane Antigen (PSMA) was introduced, which helped to diagnose with lightning speed compared to previous methods. 

Andres Correa, MD, assistant professor at Fox Chase Cancer Center in Philadelphia, said, “While MRI has significantly reduced the rate of negative biopsies and the diagnosis of low-risk prostate cancer, the imaging modality remains limited. Up to 50 percent of patients with prostate imaging-reporting and data system (PI-RADS) 4 and 25 percent of patients with PI-RADS 5 will have benign findings on targeted biopsy. I believe that the incorporation of PSMA agents into MRI screening will allow us to better define patients who need a prostate biopsy and further reduce the number of unnecessary prostate biopsies.” 

Avenda Health’s new AI-backed prostate cancer technology, cleared by the FDA, is emerging in Los Angeles with promising results. Using machine learning, the Unfold AI platform gives physicians the most accurate picture of prostate cancer to date. 

Wayne Brisbane, MD, assistant professor of urology at UCLA Health, said, “With a wide breadth of ablative options available, Unfold AI represents the first technology to improve tumor localization and patient selection. I am hopeful that Unfold AI will be intraprostatic staging what prostate-specific membrane antigen PET/CT has been for extraprostatic staging. Additionally, there are potential applications for surgery, radiation therapy, and patient decision-making.”

Mollard said, “Prostate cancer treatment is already at a great place, especially for local and regional disease, where five-year survival rates are already over 98 percent. Over the next 10 years, I think the focus will remain on earlier and more accurate diagnosis/detection and discovering new drugs to treat metastatic prostate cancer.”  

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