Clinical Reliability of PSMA PET in Advanced Prostate Cancer

In this episode, ‘Clinical Reliability of PSMA PET in Advanced Prostate Cancer,’ expert faculty examine the real-world reliability of PSMA PET imaging in evaluating tumor burden and disease extent in advanced prostate cancer. Clinicians highlight its high specificity—generally around 90%—while acknowledging limitations in detecting microscopic disease. Differences in study endpoints and validation methods across clinical trials are discussed, underscoring the importance of understanding how “true positive” lesions are defined. The conversation also reviews normal physiologic agent distribution and subtle differences between agents, including findings from a phase 4 study comparing urinary radioactivity and detection rates at low PSA levels. Finally, panelists discuss how increasing confidence in PSMA PET has led to earlier imaging in biochemical recurrence, sometimes before traditional PSA thresholds are reached, particularly when results may alter salvage therapy decisions.

The next episode in this series, ‘Integrating PSMA PET into Advanced Prostate Cancer Care,’ features the panelists discussing practical insights on integrating PSMA PET into prostate cancer care, emphasizing its impact on staging, recurrence evaluation, and radioligand therapy planning. The panel also highlights the importance of multidisciplinary interpretation, awareness of imaging pitfalls, and clear communication to support patient-centered decision-making.