The group unanimously agreed that progression to metastatic disease is a seminal event for patient management. NGI techniques are able to detect previously undetectable metastases, which could redefine the phases of prostate cancer progression. Hence, earlier treatment, either systemic or locally directed, may positively alter patient outcomes.
The RADAR III Group recommends NGI techniques for select patients suspected of disease progression based on laboratory (biomarker) values, comorbidities, and symptoms. Currently, 18F-fluciclovine and 68Gallium (Ga) PSMA PET/CT are the NGI agents with a favorable combination of availability, specificity, and sensitivity. There is ongoing research for additional NGI technologies, which may offer improved diagnostic accuracy and therapeutic options. As NGI techniques evolve and presumably result in improved global accessibility, a clinician’s ability to detect micrometastases may be enhanced for both decision-making and patient outcomes.
Authors: E. David Crawford, Phillip J. Koo, Neal Shore, Susan F. Slovin, Raoul S. Concepcion, Stephen J. Freedland, Leonard G. Gomella, Lawrence Karsh, Thomas E. Keane, Paul Maroni, David Penson, Daniel P. Petrylak, Ashley Ross, Vlad Mouraviev, Robert E. Reiter, Chaitanya Divgi, Evan Y. Yu Prostate Cancer Radiographic Assessments for Detection of Advanced Recurrence (RADAR III) Group
Crawford, E. David et al. A Clinician’s Guide to Next Generation Imaging in Patients With Advanced Prostate Cancer (Prostate Cancer Radiographic Assessments for Detection of Advanced Recurrence [RADAR] III). The Journal of Urology
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