Scans That Make Prostate Cancer Cells 'Glow' Can Eliminate Invasive Biopsies

Scans that make prostate cancer cells ‘glow’ can eliminate the need for invasive biopsies—and they are already available in Australia and Europe.

The state of the art imaging test uses a molecule that binds to prostate cancer cells, causing them to “light up in a remarkable way”—appearing as bright spots in the scanning image.

The process could safely halve the number of men who need to undergo a biopsy for suspected prostate cancer following inconclusive results from an MRI scan, said the Australian scientists.

Their PSMA PET/CT scan identifies the more aggressive prostate cancer cells, which are potentially harmful and may need treatment—and could help reduce the risk of over-diagnosis by determining which cancers are low-risk and will never cause harm.

“It’s rare to see such strong imaging that could be so powerful in the clinic,” said Dr. James Buteau , a nuclear medicine physician at the Peter MacCallum Cancer Centre in Melbourne who led the trial in coordination with St Vincent’s Hospital in Sydney.

A common cause of cancer deaths in men, about 1-in 8 males receive a prostate cancer diagnosis, and they usually undergo an MRI scan to look for abnormal growths.

If MRI results are suspicious or inconclusive, patients usually undergo a biopsy that takes small pieces of prostate tissue and looks for cancer cells, but the invasive procedure can be uncomfortable and sometimes worrying for patients, and is also associated with side effects.

“Incorporating this testing into clinical care could help to address the major challenge of prostate cancer over-diagnosis, which leads to at best unnecessary and at worst harmful treatment for cancers that would never cause any harm.”

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The Primary2 trial recruited men considered at higher risk of prostate cancer—such as having a strong family history—and randomly assigned them to get either a standard biopsy or a PSMA PET/CT scan.

Primary2 found that PSMA PET/CT scanning could identify people who either did not have cancer, or whose cancer was so low-risk or slow-growing it would likely never cause harm.

Those patients did not need a biopsy, while patients with a ‘positive result’ for cancer according to the PSMA PET/CT scan had a biopsy.