Prof Stricker and Louise Emmett have been instrumental in beginning a choline PET scan imaging which allows patients to find microscopic disease in lymph glands beyond the prostate.
This has been very helpful in people where the PSA starts rising after surgery or radiotherapy to locate the problem so that we can target it and it has also been very useful in high-risk patients prior to their therapy to help planning.
Another modality of PET scanning called PSMA scanning is to be introduced at St Vincent’s. Initially, this will be in a trial setting where patients will be allowed to have PSMA scanning and choline scanning to compare the accuracy between the two. To date, there are no definitive trials comparing these two modalities and it is quite possible that each one has a role and this role will be defined more clearly when the two are compared. This will continue to have an impact on improving the care of patients with slightly more advanced cancer by being able to localise where the cancer has spread to when the cancer is only millimetres in size. This will plan surgery and radiotherapy. It is hoped that the trial will commence in November 2014 and should be completed within three months and then this modality will be available on a routine basis.
Prof Stricker is extremely excited by these developments and it is highly likely that an even more accurate MRI scan using ultra-small particles of iron oxide may even improve the accuracy of assessment even more. This particular trial is scheduled to occur in 2015.