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Opinion|Videos|April 11, 2025

PSMA PET Imaging in Biochemical Recurrence: Clinical Approaches and Data-Driven Decisions

Author(s)Jason Efstathiou, MD, DPhil, FASTRO, FACRO, Brandon Mancini, MD, MBA, FACRO , Comron Hassanzadeh, MD, MPH

Panelists discuss how PSMA PET imaging plays a crucial role in detecting biochemical recurrence of prostate cancer, offering superior sensitivity and specificity compared with conventional imaging methods. In clinical practice, PSMA PET is typically ordered when there is a rise in prostate-specific antigen (PSA) levels post treatment, indicating potential recurrence. The imaging results significantly influence treatment decisions such as distinguishing between localized salvage therapy and systemic treatments. Pivotal trials have demonstrated the efficacy of various tracers.

Episodes in this series

4 experts in this video

EP. 1 The Evolving Role of PSMA PET in Prostate Cancer Imaging and Management

4 experts in this video

EP. 2 PSMA PET Imaging Agents: Image Quality and Diagnostic Performance

4 experts in this video

EP. 3 Selecting the Optimal PSMA PET Imaging Agent: Clinical Considerations and Data-Driven Decisions

4 experts in this video

EP. 4 Imaging Quality in Prostate Cancer: Impact on Treatment Decision-Making

4 experts in this video

EP. 5 PSMA PET Imaging in Prostate Cancer Staging: Guiding Initial Diagnosis and Treatment Decisions

4 experts in this video

EP. 6 PSMA PET Imaging in Biochemical Recurrence: Clinical Approaches and Data-Driven Decisions

4 experts in this video

EP. 7 Role of PSMA PET Imaging in Guiding Surgical Treatment Decisions in Prostate Cancer

4 experts in this video

EP. 8 Leveraging PSMA PET Imaging in Posttreatment Response Assessment: Evolving Practices and Data Insights

4 experts in this video

EP. 9 Utilizing PSMA PET Imaging in Metastatic Prostate Cancer to Guide Treatment Strategies

4 experts in this video

EP. 10 Case Discussion: Integrating PSMA PET for Focal Boost Optimization

4 experts in this video

EP. 11 Evaluating the Role of Cu-PSMA PET Imaging in Prostate Cancer

4 experts in this video

EP. 12 Key Takeaways and Future Perspectives: PSMA PET Imaging in Prostate Cancer

Video content above is prompted by the following:

Briefly discuss the role of PSMA PET imaging in assessing for biochemical recurrence and how imaging guides treatment decisions in this setting.
What is your typical approach when monitoring for biochemical recurrence in this setting?
When do you typically order PSMA PET imaging when monitoring for disease recurrence?
How does PSMA PET imaging guide your treatment decisions in this setting?
What do available data from pivotal trials demonstrate, and how do these findings inform your decisions in this setting?
- LOCATE – Axumin (fluciclovine F18). Andriole et al. J Urol. 2019.
- PSMA-BCR – Illuccix (gallium Ga68 gozetotide). Calais et al. J Nucl Med. 2018.
- CONDOR – Pylarify (piflufolastat F18). Morris et al. Clin Cancer Res. 2021.
- SPOTLIGHT – Posluma (flotufolastat F18). Jani et al. J Urol. 2023.

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