In what situations would a standard FDG PET/CT be useful in the evaluation of high risk prostate cancer?

With the advent of PSMA PET/CT, this is my study of choice for high risk prostate cancer. Are there scenarios where standard FDG PET is useful? For example, Gleason 5, dedifferentiated tumors, or those with an intraductal component?

Answer from: Radiation Oncologist at Academic Institution

Overall, my impression is that the use of FDG PET for this purpose is limited. If interested, below is my rationale as summarized in the Conclusion.As mentioned, PSMA PET/CT is considered by many to be the current best standard of care for the staging evaluation of high-risk prostate cancer, an...

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Radiation Oncologist at OSF HealthCare Cancer Institute
Great write-up. Thanks

Answer from: Radiation Oncologist at Academic Institution

I would also consider an FDG PET/CT in addition to a PSMA PET/CT for nodal and distant staging work-up of a prostate adenocarcinoma with neuroendocrine differentiation.

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Radiation Oncologist at Lafayette Radiation Center
Late stage heavily treated when suspect NE differe...

Answer from: Radiation Oncologist at Academic Institution

Mostly to identify positive nodes

Answer from: Radiation Oncologist at Community Practice

I’ve found it useful for ductal histology.

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In what situations would a standard FDG PET/CT be useful in the evaluation of high risk prostate cancer?

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