The discussion highlights key insights regarding the biodistribution of PSMA tracers in imaging, particularly for prostate cancer care. Dr. Ghesani emphasizes the patterns of tracer uptake, which are crucial for planning lutetium-177 PSMA therapy and anticipating side effects. He notes the physiological uptake in organs like salivary glands, liver, spleen, and kidneys, as well as excretion routes.
Dr. Yonover raises concerns about interpreting physiological uptake in ganglia, which can lead to false positives, stressing that PSMA PET imaging shows expression levels rather than directly indicating cancer presence. He points out that some advanced cancers might lose PSMA expression completely.
Dr. Mendel agrees, advocating for clinicians to analyze images directly instead of relying solely on reports. He mentions discovering unexpected high-grade lesions even in patients under active surveillance, indicating that the use of PSMA PET is expanding.
Dr. Yonover argues for the necessity of PSMA PET imaging before prostatectomy to prevent unnecessary surgeries in patients with undetected metastasis. Dr. Ghesani contributes technical insights regarding interpretation challenges, particularly regarding ganglion uptake and ureteral activity. He advises using varied imaging planes to avoid misdiagnosis.
The panel will further explore “Variation in PSMA PET Adoption for Prostate Cancer Care,” touching on how differences in practice settings affect the integration of this imaging technology and its impact on patient discussions.
