This is from an American urological paper, albeit from a small cohort, which shows that the Choline PET scan is not as effective as the PET-PSMA scan (which is more expensive and more difficult to get). No surprise there then.
Management of oligometastatic prostate cancer now includes consideration of stereotactic body radiation therapy (SBRT), although identification of areas of disease remains challenging. In this retrospective study, the authors compared oncologic outcomes in patients with oligo-recurrent prostate cancer (<3 lesions) undergoing SBRT for lesions identified by 18F-choline PET/CT and 68Ga-PSMA PET/CT. A total of 88 patients were included, equally divided between the two imaging modalities. Although not statistically significant, the disease-free survival rate was 63.6% in the PSMA PET group compared with 34% in the choline PET group. The rate of androgen deprivation therapy administration, however, was significantly higher in the choline PET arm, which was attributable to the increased incidence of polymetastatic disease.
- These retrospective data suggest that PSMA PET–guided SBRT may offer longer time to recurrence. The patients in the PSMA arm of the study had lower PSA, which may imply that PSMA PET can detect disease progression earlier. Randomized studies should be performed.
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