Catching the worm.
This patterns of recurrence study describes what we can expect with getting an early PSMA restaging scan upon biochemical recurrence following definitive prostate radiation with androgen deprivation therapy (ADT). Among 114 men (69% high-risk) with a median PSA of 4.7 following definitive radiation with ADT, 91% had focal uptake appreciated on PSMA scan. Sensitivities were 75% among those with a PSA ≤2 (n=16), 89% with a PSA≤10 (n=83), and 100% with a PSA >10 (n=29). Supporting a paradigm of early PSMA scanning, the authors reported how many cases were potentially amenable to focal ablative therapy to all sites of disease (defining this as 5 or less discrete lesions), which was the case for 67% of cases at a PSA ≤2 ng/mL but only 38% at a PSA >10. | Maitre, Radiother Oncol 2022