
Selecting candidates for radioligand therapy requires more than a positive PSMA scan, and the panel details how tracer avidity, disease volume, and sequencing with hormonal therapy affect outcomes.
Mendel is a radiation oncologist with Rio Grande Urology in El Paso, Texas.

Selecting candidates for radioligand therapy requires more than a positive PSMA scan, and the panel details how tracer avidity, disease volume, and sequencing with hormonal therapy affect outcomes.

A high-risk, newly diagnosed patient's PSMA PET results reshape surgical planning, nerve-sparing decisions, and the choice between surgery and radiation for definitive local therapy.

A rising PSA after treatment discontinuation prompts a PSMA PET that reveals a solitary rib lesion, testing how much confidence clinicians place in a single indeterminate finding.

Adoption of PSMA PET still varies by practice setting, and the panel discusses how visualized disease reshapes conversations with patients accustomed to tracking PSA values alone.

Physiologic PSMA uptake in ganglia, ureters, and other normal structures can mimic disease, and the panel walks through the anatomic pitfalls that most often mislead inexperienced readers.

An indeterminate bone lesion forces clinicians to weigh pretest probability, tracer type, and biopsy risk before committing to a diagnosis, with serial scanning often settling the question over time.

Radiotracer choice, cyclotron versus generator supply chains, and shifting reimbursement policy all shape which patients can access PSMA PET, according to two physicians who built imaging capacity directly into their practices.

Molecular imaging has displaced conventional CT and bone scans as the first-line staging tool in prostate cancer, but a radiation oncologist and a urologist explain where conventional imaging still holds value.

"It's been a very exciting time for the radioligand space," says J. Travis Mendel, MD.