Introduction to PSMA PET in Prostate Cancer

In this introductory video, Dr. Louis Mazzarelli, Director of Molecular Imaging at Lawrence Memorial and Westerly Hospitals, launches a three-part case series focused on the clinical application of PSMA PET imaging in prostate cancer. He begins by reviewing the epidemiology of prostate cancer and the growing need for precise imaging tools to guide diagnosis, staging, and treatment in a large and expanding patient population.

Dr. Mazzarelli outlines the evolution of molecular imaging in prostate cancer, including bone scintigraphy, sodium fluoride PET, and metabolic tracers, highlighting their diagnostic value as well as their limitations in disease specificity and localization. He then introduces prostate-specific membrane antigen (PSMA) as a major advance in prostate cancer imaging, emphasizing its high expression in prostate cancer cells, particularly in advanced and castration-resistant disease.

The video explains how PSMA PET has transformed clinical workflows by enabling earlier detection, more accurate staging, and whole-body disease assessment in a single examination. Dr. Mazzarelli discusses key clinical indications, including initial staging, biochemical recurrence, re-staging, and therapy planning, and reviews current guideline endorsements from organizations such as the NCCN, SNMMI, and ACR.

Additional topics include PSMA PET bio-distribution, radiation dose considerations, interpretation principles, and commonly used FDA-approved PSMA radiotracers. The introduction sets the stage for subsequent case-based discussions that demonstrate how PSMA PET directly impacts management decisions, radiation planning, and systemic therapy selection, offering both clinicians and patients insight into precision imaging in prostate cancer care.