How do you approach a prostate cancer patient with oligomet disease on PSMA PET?

I think there is a spectrum of 'PSMA-PET Avid lesion suspicious for metastasis'. In some locations, such as ribs, I worry more about false positives. For lesions with PET avidity without CT correlate, I worry about false positives and may advocate for a biopsy if it will change the treatment plan. S...

I would try to biopsy the site to prove metastases. Always a good idea to prove the first metastasis with a biopsy. Assuming it is proven or I am convinced it is real, such a patient is not someone who would have qualified for studies showing a benefit to SBRT (SABR-COMET, STOMP, ORIOLE). So, I woul...