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This prospective study captured outcomes for 74 men receiving dual-tracer PET staging upon biochemical recurrence following definitive radiation or prostatectomy for prostate cancer. All patients had to have a PSA <2 on androgen deprivation therapy (ADT). The two tracers were standard FDG as well as the totally en vogue PSMA, the dual approach used to capture metastatic heterogeneity. Overall, 54 patients had radiographically detectable mets, of which 17 were seen via FDG-PET alone. There was no detectable difference in mets-free survival between those receiving ablative radiation to all visible mets versus those who had no visible mets. There was, however, a striking difference in mets-free survival between those receiving ablative radiation versus those who remained on ADT alone (HR 8.78). | Pan, Eur Urol Oncol 2022