In what situations would a standard FDG PET/CT be useful in the evaluation of high risk prostate cancer?

With the advent of PSMA PET/CT, this is my study of choice for high risk prostate cancer. Are there scenarios where standard FDG PET is useful? For example, Gleason 5, dedifferentiated tumors, or those with an intraductal component?

4 Answers

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Radiation Oncology

Answered on

Overall, my impression is that the use of FDG PET for this purpose is limited. If interested, below is my rationale as summarized in the Conclusion.

As mentioned, PSMA PET/CT is considered by many to be the current best standard of care for the staging evaluation of high-risk prostate cancer, and it is one staging option currently endorsed by the NCCN. It has been shown to outperform conventional staging (CT, Tc99m Bone Scan) in the proPSMA randomized trial by demonstrating better sensitivity wit...

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Radiation Oncology · Cedars-Sinai Medical Center

Answered on

I would also consider an FDG PET/CT in addition to a PSMA PET/CT for nodal and distant staging work-up of a prostate adenocarcinoma with neuroendocrine differentiation.

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Radiation Oncology · University of Florida

Answered on

Mostly to identify positive nodes

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Radiation Oncology · Allegheny General Hospital-Western Pennsylvania Hospital

Answered on

I’ve found it useful for ductal histology.

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