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. 2019 Aug 5;7(8):85. doi: 10.3390/medsci7080085

Table 2.

Summary of indications, contraindications, and limitations.

mpMRI PSMA PET
Indications Active surveillance
Loco-regional and distant metastatic disease staging: Primary and Secondary Loco-regional and distant metastatic disease staging: Primary and Secondary
Clarification of indeterminant lesions on conventional imaging Clarification of indeterminant lesions on conventional imaging
Negative TRUS biopsy and clinical suspicious for undetected prostate cancer Negative TRUS biopsy and/or mpMRI, and clinical suspicious for undetected prostate cancer
Assessment of BCR near bladder neck To determine suitability/treatment response for PSMA targeted theranostic treatment
Treatment planning—respectability/risk of positive margin
Contra-Indications or Not Recommended for Interpretation Aneurysm clip
Embolization coil
Implanted cardiac device
Inner ear implant
Intracranial shunt
Metal prosthesis
Neuro/biostimulator
Ocular metallic foreign body
Claustrophobia
Contrast allergy Contrast allergy
Unable to lie down Unable to lie down
Use in Special Circumstances Contraindicated to prostate biopsy (Coagulopathy, rectal pathology, anterior-perineal resection, immunocompromisation) Contraindicated to prostate biopsy (Coagulopathy, rectal pathology, anterior-perineal resection, immunocompromisation)
Renal impairment
Limitations to Interpretation of Images Haemorrhage
Prostatitis
Fibrosis
Atrophy
Radiotherapy
Hormonal therapy
Renal impairment
Prosthesis
Local recurrence near bladder neck or a metastatic deposit near bladder.
Non-PSMA producing tumour including aggressive tumours such as small cell, neuroendocrine and ductal carcinoma types.
Physiological expression in lacrimal or salivary glands, liver, spleen, kidneys, small bowel and ganglia.
Benign and malignant tumours with neovascularisation.