Interpreting PSMA PET Imaging in Prostate Cancer

This episode, titled ‘InterpretingPSMA PET Imaging in Prostate Cancer’ features multidisciplinary panelists discussing the following question:

1. How do you approach clinical decision-making when PSMA PET imaging reveals indeterminate or borderline findings, and how do you balance early detection with the risk of overtreatment in advanced prostate cancer?

In this segment, the panel explores real-world challenges in interpreting advanced imaging, particularly PSMA PET, in patients with advanced prostate cancer. Faculty discuss situations in which imaging findings are equivocal, discordant, or difficult to biopsy, and how these uncertainties influence decisions around treatment intensity, surveillance, and timing of repeat imaging. The conversation highlights the evolving learning curve with PSMA PET interpretation, including false positives and non–prostate cancer findings, as well as the role of clinical context and multidisciplinary input. The panel also examines selective use of FDG PET in cases with atypical disease biology, such as genomically aggressive or AR-indifferent tumors where PSA may not reliably reflect disease burden.

In the next episode, ‘Treatment Patterns in Advanced Prostate Cancer from Monotherapy to Treatment Intensification’, panelists highlight on real-world trends showing increased use of doublet and triplet therapy in advanced prostate cancer, alongside persistent gaps in treatment intensification and genomic testing. The panel stresses the importance of education and multidisciplinary engagement to translate emerging evidence into routine practice.