As a clinician involved with PC for 3+ decades, it is clear that pre-RP and pre-RT nomograms and neural net calculations can often predict who will have so-called PSA recurrence (PSAR). And post-RP, the use of ultrasensitive PSA obtained ≈ 5 weeks post op & monthly thereafter (if ≥ 0.01) can provide info for PSA kinetics. Expert review of Gleason score at RP & IHC (Immunohistochemistry) of PC at RP especially for PSMA, should be helpful in further/future evaluation of the value of 68Ga-PSMA-11 PET/CT even at PSA levels of < 0.35. All of these issues & the value of various radioligands need clarification so that we clinicians can hone in on the best imaging tools. Is 68Ga-PSMA-11 PET/CT as good, better or inferior to 18F-DCFBC ?

Will any of these PET/CT or PET/MRI ever be compared to Combidex-Enhanced MRI (CEM) re nodal accuracy with anatomic pathology and clinical follow-up to know if assessments of positive vs negative findings are correct? It would be nice to get some clarity rather than more controversy. Is any of this possible in your realm of research?

Stephen B. Strum, MD, FACP

Medical Oncologist specializing in PC

Member of ASCO, AUA, ASTRO