Important considerations on the case according to Nicolas Mottet
The new EAU 2019 PCa guidelines recommend to perform prostate-specific membrane antigen (PSMA) positron emission tomography (PET) computed tomography (CT) in case PSA > 0.2 ng/ml, if the results will influence subsequent treatment decisions. (strength of recommendation: weak).
In case of PSA only recurrence, imaging is only of value if it leads to a treatment change and therefore to a better outcome. In practice, limited data are available regarding the outcome based on imaging at relapse. Precise detection and location of local recurrences after RP will be needed but not until it has been proven that stereotaxic boost to the recurrence site during salvage RT improves the patient outcome which, so far, remains investigational.
Want to challenge me? I’m happy to discuss these data in more detail during PROSCA on 23-24 October in Paris!