ArticleEuropean radiology2025
Discordance between prostate MRI and PSMA-PET/CT: the next big challenge for primary prostate tumor assessment?
Article in European radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Safety and patient-reported outcomes of multimodal PSMA PET/MRI-guided prostate biopsy: results from the prospective multicenter DEPROMP trial.World journal of urology · 2026Trial
- Limited incremental prognostic value of pretreatment MRI andAbdominal radiology (New York) · 2026Article
- Tri-modal PSMA PET/CT-MRI-US fusion biopsy for clinically significant prostate cancer: a prospective paired diagnostic study.European journal of nuclear medicine and molecular imaging · 2026Article
- PSMA PET: the answer to MRI-occult prostate cancer… or another mirage?European radiology · 2026Review
- Is PSMA PET/CT the answer to MRI-occult prostate cancer? Yes, but with strings attached.European radiology · 2026Article
- Not always a perfect match: discrepancies between PSMA PET/CT and MRI in prostate cancer diagnosis and staging.Abdominal radiology (New York) · 2026Review
- Low-PSMA hormone-sensitive prostate cancer: a distinct clinical and molecular state.Molecular medicine (Cambridge, Mass.) · 2026Article
- Integrating Multiparametric MRI and PSMA PET Imaging in Prostate Cancer: Toward a Unified Diagnostic and Risk-Stratification Paradigm.Medicina (Kaunas, Lithuania) · 2026Review
- Navigating discordant findings in multimodality imaging of prostate cancer in the MRI and PSMA-PET era.La Radiologia medica · 2026Review
- Dose Intensification to the Dominant Intraprostatic Lesion During Prostate Stereotactic Body Radiation Therapy Delivered on a Magnetic Resonance Imaging Linear Accelerator: Feasibility and Early Clinical Outcomes.Advances in radiation oncology · 2025Article
- A New Challenge in Prostate Cancer: Assessing Discrepant Results from Prostate MRI and PSMA PET/CT.Radiology. Imaging cancer · 2025Article
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10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesAn increasing number of patients with prostate cancer (PCa) undergo assessment with magnetic resonance imaging (MRI) and prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA-PET/CT). This offers comprehensive multimodality staging but can lead to discrepancies. The objective was to assess the rates and types of discordance between MRI and PSMA-PET/CT for primary PCa assessment. MATERIALS AND
methodsConsecutive men diagnosed with intermediate and high-risk PCa who underwent MRI and PSMA-PET/CT in 2021-2023 were retrospectively included. MRI and PSMA-PET/CT were interpreted using PI-RADS v2.1 and PRIMARY scores. Discordances between the two imaging modalities were categorized as "minor" (larger or additional lesion seen on one modality) or "major" (positive on only one modality or different index lesions between MRI and PSMA-PET/CT) and reconciled using radical prostatectomy or biopsy specimens.
resultsThree hundred and nine men (median age 69 years, interquartile range (IQR) 64-75) were included. Most had Gleason Grade Group ≥ 3 PCa (70.9% (219/309)). Median PSA was 9.0 ng/mL (IQR 5.6-13.6). MRI and PSMA-PET/CT were concordant in 157/309 (50.8%) and discordant in 152/309 (49.1%) patients; with 39/152 (25.7%) major and 113/152 (74.3%) minor discordances. Of 27 patients with lesions only seen on MRI, 85.2% (23/27) were clinically significant PCa (csPCa). Of 23 patients with lesions only seen on PSMA-PET/CT, 78.3% (18/23) were csPCa. Altogether, lesions seen on only one modality were csPCa in 80.0% (36/45).
conclusionMRI and PSMA-PET/CT were discordant in half of patients for primary PCa evaluation, with major discrepancies seen in roughly one out of eight patients. KEY POINTS: Question While both MRI and PSMA-PET/CT can be used for primary tumor assessment, the discordances between them are not well established. Findings MRI and PSMA-PET/CT were discordant in about half of the patients. Most prostate lesions seen on only one modality were significant cancer. Clinical relevance MRI and PSMA-PET/CT are often discordant for assessing the primary prostate tumor. Using both modalities for primary prostate tumor evaluation can provide complementary information that may substantially impact treatment planning.
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