How do you interpret isolated PSMA-hypermetabolic sites in a patient with prostate cancer with no pelvic or RP LN uptake?

How do you discern false-positive PSMA PET sites? Is it typical to find metastatic disease without prior pelvic or RP node involvement?

Answer from: Medical Oncologist at Community Practice

The issue of false-positive PSMA scans is a vexed one, and we are still learning how to handle this optimally. My general approach is to think about the clinical context, level of risk, and whether an early diagnostic pick-up will actually make a clinical difference. For example, in a patient with...

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Radiation Oncologist at University of Arkansas for Medical Sciences
I've recently encountered a variation on this them...

Radiation Oncologist at Beth Israel Deaconess Medical Center/Harvard Medical School
With a grain of salt- especially ribs without CT f...

Answer from: Radiation Oncologist at Community Practice

There's no rule that prostate cancer (or any cancer) has to involve lymph nodes before other metastatic disease. Bone-only metastatic disease is exceedingly common early in the course of mCSPC.Be wary of other mimics with high native PSMA expression. The following paper is a good review:de Galiza Ba...

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How do you interpret isolated PSMA-hypermetabolic sites in a patient with prostate cancer with no pelvic or RP LN uptake?

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