{"entity":{"id":"paper-propsma-hofman-lancet-2020","kind":"paper","name":"proPSMA: PSMA PET-CT versus conventional imaging for staging high-risk prostate cancer","aka":[],"tldr":"PSMA PET-CT was 27 percentage points more accurate than CT and bone scan for finding spread in men with high-risk prostate cancer before treatment, with less radiation and more influence on management, and it has replaced conventional imaging where available.","summary":"Randomised multicentre trial of 302 men with high-risk localised prostate cancer randomised to conventional imaging (CT and bone scan) or gallium-68 PSMA PET-CT for staging, with crossover imaging to define a reference standard.\n\nAccuracy was 92 percent for PSMA PET-CT against 65 percent for conventional imaging, with higher sensitivity (85 versus 38 percent) and specificity, fewer equivocal results, lower radiation dose and more frequent management change.","asOf":"2026-09-17","links":[{"label":"Lancet 2020","url":"https://doi.org/10.1016/S0140-6736(20)30314-7"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/32209449/"}],"tags":[],"related":["prostate-roadmap"],"cancers":["prostate-bcr","prostate-high-risk","prostate"],"sections":[],"technologies":["psma-pet","pet-ct"],"targets":["psma"],"drugs":[],"companies":[],"institutions":[],"pathways":["prostate-cancer-signalling"],"terms":["theranostics"],"trials":["propsma"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["lancet"],"dependsOn":[],"notes":[],"journal":"The Lancet","year":2020,"doi":"10.1016/S0140-6736(20)30314-7","pmid":"32209449","authors":"Hofman MS, Lawrentschuk N, Francis RJ, et al.","paperType":"rct","findings":["Accuracy 92 percent vs 65 percent (27 percent absolute difference).","Sensitivity 85 percent vs 38 percent; specificity 98 percent vs 91 percent."],"whatItMeans":"PSMA PET-CT is the preferred staging investigation for high-risk prostate cancer and for biochemical recurrence, though most treatment trials were designed with conventional imaging.","caveats":["Reference standard relied partly on imaging follow-up rather than histology.","Detecting more disease does not by itself prove better outcomes."],"changedPractice":true,"participants":302},"route":"/key-papers/paper-propsma-hofman-lancet-2020/","neighbours":{"roadmap":[{"id":"prostate-roadmap","kind":"roadmap","name":"Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch","route":"/roadmaps/prostate-roadmap/"}],"cancer":[{"id":"prostate-bcr","kind":"cancer","name":"Biochemical recurrence of prostate cancer","route":"/cancers/prostate-bcr/"},{"id":"prostate-high-risk","kind":"cancer","name":"Localised prostate cancer, high and very high risk","route":"/cancers/prostate-high-risk/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"technology":[{"id":"pet-ct","kind":"technology","name":"PET/CT","route":"/technologies/pet-ct/"},{"id":"psma-pet","kind":"technology","name":"PSMA PET","route":"/technologies/psma-pet/"}],"target":[{"id":"psma","kind":"target","name":"PSMA","route":"/targets/psma/"}],"pathway":[{"id":"prostate-cancer-signalling","kind":"pathway","name":"Prostate cancer (KEGG map)","route":"/pathways/prostate-cancer-signalling/"}],"term":[{"id":"theranostics","kind":"term","name":"Theranostics","route":"/terms/theranostics/"}],"trial":[{"id":"propsma","kind":"trial","name":"proPSMA","route":"/trials/propsma/"}],"journal":[{"id":"lancet","kind":"journal","name":"The Lancet","route":"/journals/lancet/"}],"biomarker":[{"id":"psma-pet-expression","kind":"biomarker","name":"PSMA expression by PET (PSMA-positive)","route":"/biomarkers/psma-pet-expression/"}]}}