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Researchers caution test could wrongly indicate metastasis

Some Iowa men with prostate cancer may undergo prostate-specific membrane antigen positron emission tomography imaging to determine whether the cancer has metastasized. While this is a popular test, a study that appeared in the September issue of The Journal of Nuclear Medicine cautions that it may misidentify benign tissue, leading to a misdiagnosis.

The test works by identifying the enzyme PSMA. While it is highly expressive in prostate cancer cells and its presence may indicate metastasis, there can also be heightened PSMA expression in benign tissues including the bowels, salivary glands and kidneys. Earlier studies have indicated that this misdiagnosis could occur and could lead to the treatment being changed unnecessarily.

This study examined the records of more than 400 patients. Its focus was on coeliac, cervical and sacral ganglia. Researchers said that despite the limitations of the test, it should not be abandoned altogether. Instead, PET results should be studied in conjunction with lesion configuration and localization.

Many medical tests and treatments include side effects, so when they are used, it is important that the benefits outweigh any negative physical or psychological outcomes. A misdiagnosis can not only mean unnecessary treatment and testing but also switching course to a different type of treatment that does not effectively address the person's actual condition. This can negatively affect a patient's health and could even be fatal. People who believe they have been the victims of medical malpractice or whose loved ones have may want to consult an attorney to discuss what recourse they might have and what the next steps might be.

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