The Continuum of Metastatic Prostate Cancer: Interpreting PSMA PET Findings in Recurrent Prostate Cancer

Adam M. Kase, Winston Tan, John A. Copland, Hancheng Cai, Ephraim E. Parent, Ravi A. Madan

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Conventional imaging has been the standard imaging modality for assessing prostate cancer recurrence and is utilized to determine treatment response to therapy. Molecular imaging with PSMA PET–CT has proven to be more accurate, sensitive, and specific at identifying pelvic or distant metastatic disease, resulting in earlier diagnosis of advanced disease. Since advanced disease may not be seen on conventional imaging, due to its lower sensitivity, but can be identified by molecular imaging, this reveals that metastatic prostate cancer occurs on a continuum from negative PSMA PET–CT and negative conventional imaging to positive PSMA PET–CT and positive conventional imaging. Understanding this continuum, the accuracy of these modalities, and treatment related outcomes based on imaging, will allow the clinician to counsel patients on management. This review will highlight the differences in conventional and molecular imaging in prostate cancer and how PSMA PET–CT can be used for the management of prostate cancer patients in different clinical scenarios, while providing cautionary notes for overtreatment.

Original languageEnglish (US)
Article number1361
JournalCancers
Volume14
Issue number6
DOIs
StatePublished - Mar 1 2022
Externally publishedYes

Keywords

  • Biochemical recurrent prostate cancer
  • Conventional imaging
  • Metastatic prostate cancer
  • Molecular imaging
  • PSMA PET–CT
  • Recurrent prostate cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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