A two-centre prospective cohort phase III study of 18F-PSMA-1007 PET/CT imaging in specific patient populations:
- Adults patients (≥18 years old) with a history of radical prostatectomy for treatment of prostate cancer, and a serum prostate specific antigen (PSA) ≥ 0.2 mcg/L
- Adult patients with a history of radiotherapy, cryotherapy, or brachytherapy for treatment of prostate cancer, and a serum PSA progressively rising to ≥ 2 mcg/L (minimum two samples) OR a serum PSA doubling time of < 9 months
- Adult patients with a history of biopsy-proven prostate cancer and high-risk features for metastatic disease prior to treatment with radical prostatectomy, radiotherapy, cryotherapy, or brachytherapy. High-risk features include a Gleason score ≥ 7, serum PSA ≥ 20 mcg/L, OR minimum clinical T-stage T2c
- Adult patients who do not meet criteria 1-3 but in whom a 18F-PDAM-1007 PET/CT scan is expected to provide clinical benefit as determined by a Urologist, Radiation Oncologist, Medical Oncologist, or Nuclear Medicine physician (licensed in Alberta)
The safety of the investigational 18F-PSMA-1007 tracer will be evaluated in 3 ways:
- The participant will be screened for adverse effects immediately post-injection
- The participant will be screened for adverse effects immediately after the scan (approximately 2.5 hours after tracer injection)
- The participant will be provided an information sheet and contact information for self-reporting of any delayed adverse events (1-7 days post injection)
The incidence of and activity of non-specific bone lesions will be quantified and evaluated as follows:
- All lesions categorized as non-specific bone lesions (PSMA-1007 SUVmax > 2.5 but no corresponding lesion on CT) will be recorded
- The SUVmax and anatomic location will be recorded for each lesion (max 5 per participant)
- Recorded lesions will be evaluated a minimum of 1 year post-scan to determine whether they are benign or malignant based on previously published reference standard criteria (Arnfield et al., 2021)
- Equivocal lesions will be considered unevaluable and will be excluded from assessment of accuracy