PSMA PET/CT doubles prostate cancer detection in men with inconclusive MRI scans

A PSMA PET/CT scan can double the detection rate for prostate cancer in men whose MRI was inconclusive. Image generated by WIX AI

CANCER DIGEST – Oct. 18, 2026 – A small study combining two diagnostic imaging techniques found the combination doubled the detection rate for prostate cancer without the need for invasive needle biopsy.

Led by Andrea Farolfi, MD at the Azienda Ospedaliero-University of Bologna, Italy, the single-center study looked at combining PSMA PET and CT scanning to see if they could improve rates of prostate cancer detection in men whose MRI images were negative or inconclusive, but still had high risk factors for the disease. Their findings were published in the Sept. 2026 Journal of Nuclear Medicine.

In the study, 63 men with negative or inconclusive MRI scans underwent Ga-PSMA-11 PET/CT imaging followed by PET fusion-guided prostate biopsy.

Needle biopsy involves inserting needles into the prostate to take tissue samples that are examined by a pathologist under microscope looking for cancerous cells. 

Prostate Specific Membrane Antigen (PSMA) PET/CT-guided targeted biopsy uses molecular imaging with tracer element, in this case Gallium Ga 68 or 68Ga–PSMA-11, which is a radioactive tracer injected intravenously that attaches to prostate cancer cells in the body and emit positrons that the PET scanner picks up to generate a highly detained map of where the cancer is located.

The results using PSMA PET/CT showed that cancer was present in 25 of 26 men who were ultimately diagnosed with clinically significant prostate cancer. The PSMA PET/CT-targeted biopsy detected significant cancer in 37 percent of the men in the study, compared to 21 percent of men using needle biopsy alone. Combining the two approaches using the imaging biopsy and the needle biopsy increased the rate of significant cancer detection to 41 percent.

“Our findings suggest that PSMA PET/CT could provide an additional tool for identifying men who remain at risk despite non-diagnostic MRI findings,” said Farolfi in a press release, "and for directing the biopsy toward the most suspicious area. If confirmed in larger studies, this approach could make the diagnostic pathway more accurate and personalized.” 

Sources: Society of Nuclear Medicine and Molecular Imaging press release, and the Journal of Nuclear Medicine