Dr Ravi on Barriers to PSMA-PET in mHSPC

“More and more, I'm seeing PSMA-PET availability increasing. It's available at community sites, not just academic centers, and it's available globally.”

Praful Ravi, MB, BChir, MRCP, the medical director of GU Theranostics and a physician at Dana-Farber Cancer Institute as well as an assistant professor of medicine at Harvard Medical School, discussed potential barriers to widespread adoption of prostate-specific membrane antigen (PSMA)-PET imaging in metastatic hormone-sensitive prostate cancer.

The availability of PSMA-PET has expanded dramatically over the past several years, reducing what was once considered a major barrier to its widespread clinical use, Ravi began. Although PSMA-PET was introduced into routine practice in countries such as Australia nearly a decade ago, adoption in the United States and many other regions accelerated only within the past 5 to 7 years, he noted. During that early period, limited access raised concerns about whether the technology could be broadly implemented in clinical practice, he said.

Today, those concerns are steadily diminishing as PSMA-PET becomes increasingly accessible across a wide range of practice settings, Ravi explained. Rather than being confined to major academic medical centers, the technology is now available in many community-based sites and has gained broad international adoption, he noted. In fact, access to PSMA-PET may be more readily available in some middle-income countries, including Brazil, India, and China, than in certain parts of the United States, he added. This global expansion reflects growing recognition of the clinical value of PSMA-PET for prostate cancer diagnosis, staging, and treatment planning, he said.

PSMA-PET is now routinely incorporated into the management of many patients with prostate cancer, both at the time of initial staging and during restaging after treatment, Ravi said. Although logistical challenges remain, particularly because PET scanners are less numerous than conventional CT or bone scan equipment, these limitations are expected to lessen as health care systems continue to invest in imaging infrastructure, he said.

Importantly, the need for expanded PET imaging extends beyond prostate cancer, Ravi said. The emergence of theranostic approaches across multiple solid tumors is increasing demand for advanced molecular imaging, making additional PET scanner capacity a priority for hospitals and health care systems worldwide, he said. As these investments continue, access to PSMA-PET is expected to improve further, allowing more patients to benefit from its diagnostic and therapeutic applications, he concluded.