ADOPTION OF PSMA-PET IMAGING FOR PROSTATE CANCER WITHIN A LARGE INTEGRATED HEALTH SYSTEM, 2021-2024
Author(s)
Michael R. McGovern, PharmD1, Timothy Reynolds, PharmD2, Linda Chen, PharmD1, Da Sol Kim, PharmD3, Paul Godley, PharmD4;
1Baylor Scott & White Health, Round Rock, TX, USA, 2Baylor Scott & White Health in Partnership with the University of Texas at Austin, Temple, TX, USA, 3Baylor Scott & White Health, Novi, MI, USA, 4Baylor Scott and White Health, Temple, TX, USA
1Baylor Scott & White Health, Round Rock, TX, USA, 2Baylor Scott & White Health in Partnership with the University of Texas at Austin, Temple, TX, USA, 3Baylor Scott & White Health, Novi, MI, USA, 4Baylor Scott and White Health, Temple, TX, USA
OBJECTIVES: Prostate-specific membrane antigen positron emission tomography (PSMA-PET) offers superior sensitivity for detecting prostate cancer compared with conventional imaging and was incorporated into NCCN guidelines in 2021. However, real-world adoption patterns remain poorly characterized. This study evaluates PSMA-PET utilization, temporal trends, and predictors of use within a large integrated health system in Texas.
METHODS: This retrospective cohort study linked institutional tumor registry data with electronic health records. Adult males diagnosed with prostate cancer between 2021-2024 were included. The primary outcome was PSMA-PET utilization rate and yearly trend over time. Baseline demographic and clinical characteristics were compared between patients who received PSMA-PET versus those who did not using chi-square tests and t-tests. Multivariable logistic regression assessed demographic, clinical, and facility-level predictors of PSMA-PET use. Cochran-Armitage testing evaluated temporal trends.
RESULTS: Among 2903 patients, 635 (21.9%) received PSMA-PET. Utilization increased significantly from 10.0% in 2021 to 39.4% in 2024 (p<0.001 for trend). Patients diagnosed in 2024 had significantly higher odds of receiving PSMA-PET compared with 2021 (OR=5.31; 95% CI: 3.90-7.31).
In multivariable analysis, metastatic disease (AJCC stages 4a-4b; OR=3.17, 95% CI: 2.26-4.44, p<0.001) and higher PSA at diagnosis (10-20 ng/mL, >=20 ng/mL; both p<0.001 vs <10 ng/mL) were associated with increased odds of PSMA-PET testing. No significant differences were observed by race, age, ethnicity, or insurance status. Substantial facility-level variation was identified, with two sites accounting for 83% of all PSMA-PET scans.
CONCLUSIONS: PSMA-PET adoption increased nearly four-fold, with utilization concentrated among patients with advanced disease and elevated PSA at diagnosis. The absence of demographic-based disparities is encouraging. These findings suggest that PSMA-PET is being adopted in a pattern consistent with clinical practice trends, with use increasing over time and aligning with disease severity.
METHODS: This retrospective cohort study linked institutional tumor registry data with electronic health records. Adult males diagnosed with prostate cancer between 2021-2024 were included. The primary outcome was PSMA-PET utilization rate and yearly trend over time. Baseline demographic and clinical characteristics were compared between patients who received PSMA-PET versus those who did not using chi-square tests and t-tests. Multivariable logistic regression assessed demographic, clinical, and facility-level predictors of PSMA-PET use. Cochran-Armitage testing evaluated temporal trends.
RESULTS: Among 2903 patients, 635 (21.9%) received PSMA-PET. Utilization increased significantly from 10.0% in 2021 to 39.4% in 2024 (p<0.001 for trend). Patients diagnosed in 2024 had significantly higher odds of receiving PSMA-PET compared with 2021 (OR=5.31; 95% CI: 3.90-7.31).
In multivariable analysis, metastatic disease (AJCC stages 4a-4b; OR=3.17, 95% CI: 2.26-4.44, p<0.001) and higher PSA at diagnosis (10-20 ng/mL, >=20 ng/mL; both p<0.001 vs <10 ng/mL) were associated with increased odds of PSMA-PET testing. No significant differences were observed by race, age, ethnicity, or insurance status. Substantial facility-level variation was identified, with two sites accounting for 83% of all PSMA-PET scans.
CONCLUSIONS: PSMA-PET adoption increased nearly four-fold, with utilization concentrated among patients with advanced disease and elevated PSA at diagnosis. The absence of demographic-based disparities is encouraging. These findings suggest that PSMA-PET is being adopted in a pattern consistent with clinical practice trends, with use increasing over time and aligning with disease severity.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
MT4
Topic
Medical Technologies
Disease
SDC: Oncology