Best Imaging For Recurrent & Metastatic PCa


Brothers, I am lining things up for a future cyberknife treatment and believe that the centerpiece to a successful outcome is the best imaging possible that clearly shows the tumor location plus any junior bandits that may be lurking elsewhere. Here is a link to an article I pulled from Renal and Urology that discusses the various imaging technologies out there and their particular strengths and weaknesses.

There's a lot to choose from and I would appreciate any insights that you all might have.

So from your perspective what imaging was done prior to your cyberknife treatment, what was your PSA at the time of the imaging, and did it adequately support the treatment?

Thanks guys. Holiday season is fast approaching and I hope nobody is too stressed out from the planning and preparations.







  • VascodaGama
    VascodaGama Member Posts: 3,668 Member
    It is not the machine alone that makes the difference


    I have commented in your previous thread regarding this newer phase in your journey. In my post to Tdoyle I also comment about PET/CT exams. It is not the machine alone that makes the difference but the radiotracers used and the experience of the radiologist in interpreting the films. For instance, the PET/CT (18)F-FDG is not the most suitable for low grade Gleason cases. Some tracers require cyclotrons as some of these got short half-life.


    I recommend you to investigate details among the various clinics (cyclotron availability) including the radiopharmaceuticals giving preferences to PSMA pathways. Some are better to certain types of tissues (soft/bone) and some are better in low rate Gleason types (micrometastases). SUV is the marker used by the radiologists to judge what is seen. By experience they discard positive (high SUV) areas where PCa would have low probabilities for existence, such as the liver and kidneys in localized cases (T3 M0). Your present and past status and findings must be considered in the final judgment. All the data should be passed to the radiologist doing the exam.

    Your link is great as it correlates the results from several exams based on experiences. I would request your oncologist for guidance in requesting consultations with the famous experienced clinics/radiologists, probably some of those listed in the article that served as references for the authors of the link (both urologists).

    I will be curious about your investigations and conclusions.

    Best wishes,