Are prostate PET scans (axumin, PSMA, etc.) still useful for patients on androgen suppression therapy?
Is there any information on how ADT affects the test operating characteristics?
Answer from: Radiation Oncologist at Community Practice
The detection rate with this radioisotope is a function of PSA level with sensitivity improving with increased level of PSA. I don't think androgen ablation by itself would affect detection rate unless disease is under control with the therapyThis is good review article in PRO comparing sensitivity ...
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Radiation Oncologist at Mountain Radiation Oncology Any documented benefit to earlier detection (other...
Radiation Oncologist at Varian Medical Systems/Allegheny health network It changes management with the hope that it may ch...
Answer from: Radiation Oncologist at Academic Institution
The effect of ADT on PSMA expression, which would impact PSMA PET imaging, is a complicated and evolving topic, currently under investigation. It seems that ADT initially increases PSMA expression. But later, ADT decreases PSMA expression (please see some references below), and PSMA may be increase...
Answer from: Radiation Oncologist at Community Practice
The performance of Axumin scans is likely affected by ADT. Below, you can learn about the relationship between the LAT1 transporter and Fluciclovine, and the regulatory effects of androgen suppression. As such, it’s probably unreliable after ADT has been started.
http://www.blueearthdia...
Answer from: Radiation Oncologist at Academic Institution
As initial or relapse staging, ADT likely suppresses uptake of tracers and will lead to false negative staging scans. On the other hand, if patients become castrate resistant, there may be a change in the inhibitory effect that ADT has on tumor uptake of tracer. There is a nice review last year in E...
Any documented benefit to earlier detection (other...
It changes management with the hope that it may ch...