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NCI Expert Stresses Importance of Multimodal Imaging in Prostate Cancer

Brandon Scalea
Published: Thursday, Sep 06, 2018

Peter L. Choyke, MD, FACP

Peter L. Choyke, MD, FACP

Multimodality imaging holds the keys to providing personalized therapy to patients with prostate cancer, said Peter L. Choyke, MD, FACP.

, Choyke discussed the clinical implications of emerging technologies for prostate cancer imaging.

OncLive: What newer technologies are you excited about?

Choyke: Our team at the NCI developed a method of fusing MR images with ultrasound images so that we could do fusion biopsies of prostate cancer. It has really taken off. There are now a lot of people doing it, and we are really gratified by that. That is a fusion of MRI and ultrasound. We then moved on to looking at PET scans, particularly one that targets prostate-specific membrane antigen (PSMA), which is found in more aggressive cases of prostate cancer. It is very specific.

We are finding out a lot of new things about prostate cancer because this is a changing picture of the disease. We are combining some of the traditional PET imaging like 18F-sodium fluoride bone scans with PSMA. We are finding some interesting things there. It is combining different methods together to figure out what's going on and guide management of patients.

What is the rationale for combining these technologies?

There was this widespread idea that doctors were either just MRI specialists or they were PET specialists. Now, we view it as whatever the best tool is to handle that particular problem is the way to go. For example, I started out as an MRI specialist, but I quickly realized there were limitations to what an MRI can do. Particularly, an MRI lacks specificity. We could see lesions, but we could not see whether they were cancerous or not. PET offers specificity, but the anatomy is not that good. You get the anatomy from the MRI and the sensitivity from the PET, and those 2 things go together very nicely.
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