Inside PSMA PET Frameworks | Podcast

Parihar-Let's get started with the first question.There are so many PSMA PET interpretation criteria and frameworks around here.What gap in understanding or clinical practice were you trying to address?Dr. Alberto Vargas-Yeah, thank you for that question.It's very important.The first thing to say is that with the clinical use of PSMA PET being so relatively new here in the US, the first FDA approval was in 2021, it's kind of a young test and therefore there's a learning curve in the interpretation and in the reporting.In addition to that, the fact that there are so many diTerent frameworks for reporting the PETs, it's kind of made it diTicult to attempt to follow them in a natural and easy way in clinical practice.So the gap we were trying to address was primarily trying to see A, what our baseline is, are they being used, which framework is being used, and then maybe trying to shed light on potential reasons for why they were not being used and if there could be anything done to resolve that.Dr. Ashwin Singh Parihar-That's a great point and thanks for that clarification.So how would you summarize the fundamental diTerences between the major PSMA PET scoring systems that you talked about in the paper and including on how and where to use those frameworks?Dr. Sungmin Woo-Well, that's a very interesting question and something that you would want to really understand before utilizing any of these scoring systems and interpretation frameworks.I don't think there's one good way to summarize or in one sentence, I can't really put it in a nutshell, so maybe we'll focus on like one of the points or diTerences that we highlighted between two of the systems and scoring systems that we put out on the article.Those two in particular are, so the first one is PSMA RADS and second is the PROMIS framework.So the PSMA RADS is one scoring system that mainly focuses on individual lesions.Now that doesn't necessarily mean you can only use it when there is one lesion in a patient, but the scoring is basically trying to assess the likelihood if a certain lesion is mystatic from prostate cancer or if it's benign.And then you would have diTerent ways to follow up on those or management guidelines.In comparison with PSMA RADS, the PROMIS, which is now in its version two, is more of a umbrella interpretation framework, which really consists of many, many elements, starting from the primary