Seduction by Sensitivity: Reality, Illusion, or Delusion? The Challenge of Assessing Outcomes after PSMA Imaging Selection of Patients for Treatment

Risk of metastatic disease on 68gallium‐prostate‐specific membrane antigen positron emission tomography/computed tomography scan for primary staging of 1253 men at the diagnosis of prostate cancer

“…Current European Association of Urology (EAU) guidelines recommend multiparametric MRI (mpMRI) for local staging and at least a cross‐sectional abdominopelvic imaging with bone scan for predominantly Gleason grade 4 intermediate‐ and high‐risk prostate cancer . Currently, the clinical benefit of detecting earlier metastasis in the primary setting with new staging radiology techniques, such as 68 Ga‐PSMA PET/CT, remains unclear .…”

Prostate specific membrane antigen (PSMA) and Prostate Cancer Staging: is our current conventional staging obsolete?

“…The extent of prostate cancer (PC) with imaging is crucial for therapeutic decision-making, particularly in patients suffering from high-risk localized PC or at risk of extended disease (1). In addition, adequate staging and tailored stratification might lead to a positive impact on the natural evolution of the disease, particularly nodal staging (1)(2)(3)(4)(5).…”

Clinical perspectives of PSMA PET/MRI for prostate cancer

“…Despite these promising results on the clinical impact of changing management based on PSMA PET evaluation of BCR, improvement in long-term outcomes must be demonstrated to confirm that this transformational molecular imaging technique is useful in clinical practice. As recently discussed in an editorial article published in the Journal of Nuclear Medicine 48 , the major challenge oncologists face in managing PCa is identifying which patients harbor significant and nonsignificant recurrence. Current treatment options have rather low success in curing patients, and avoiding toxicity and promoting quality of life are fundamental objectives in treatment selection.…”