Rates of PSMA PET Staging and Positivity in Newly Diagnosed Prostate Cancer in a National Health Care System.

Miller SR, Gonzalez RT, Jackson WC, Caram MEV, Tsao PA, Stensland K, Shah Y, Wale D, Wong KK, Viglianti BL, Elliott D, Caverly T, Hofer TP, Saini S, Green MD, Schipper M, Dess RT, Bryant AK. Rates of PSMA PET Staging and Positivity in Newly Diagnosed Prostate Cancer in a National Health Care System. Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 2025 Jan 3; 66(1):75-83.

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information vaww.hsrd.research.va.gov/dimensions/

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.    Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions

Search for Abstract from PubMed

---

Abstract:

Prostate-specific membrane antigen (PSMA) PET was approved by the U.S. Food and Drug Administration in 2020 for the staging of newly diagnosed prostate cancer, yet rates of adoption and real-world positivity rates are unknown. We characterized patients undergoing PSMA PET staging and describe positive findings in a large national cohort. We identified all newly diagnosed prostate cancer patients in the national Veterans Health Administration from June 2020 to August 2023. Demographics, staging imaging reports, and cancer-related information were obtained from electronic medical record data. To assess positive findings, we chart-reviewed 1,994 patients ( = 657 low to intermediate risk) with staging PSMA PET reports available. Among 31,838 patients with newly diagnosed prostate cancer, 4,538 (14%) underwent PSMA staging. Use of PSMA staging increased rapidly from near 0 in early 2021 to approximately 70% of patients with high- or very-high-risk disease by August 2023. Among patients who were N0/M0 by conventional imaging, PSMA PET positivity rates (N1 or M1) were 5.9% for favorable intermediate risk, 8.2% for unfavorable intermediate risk, 14% for high risk, and 34% for very high risk. PSMA PET staging for newly diagnosed prostate cancer increased rapidly in the Veterans Health Administration. Positivity rates were less than 10% in this large intermediate-risk cohort. These data confirm the utility of PSMA PET staging in high-risk disease and suggest that additional study is needed to refine patient selection in intermediate-risk disease.