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How do you interpret PSMA/PET with focal prostate activity after XRT currently on ADT with stable PSA?

Pretreatment PSA 25.3 with Gleason 4+3=7 and MRI suspicious for ECE. Eight months after pelvic nodal and prostate XRT to 79 Gy, PSA is 5.02 (down from 5.61 at 4 months.) PSMA PET showed focal prostate activity only.
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Radiation Oncology
Answered on

The most concerning element of the case presented is that the patient’s PSA continues to be ≈ 5 while on ADT with presumably castrate levels of testosterone, which should be verified. The current PSA is one order of magnitude greater than would be expected from the effect of ADT alone possibly indic...

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