0d01f32c04e1da3bb327f48808eca0bc 322597.pdf aa98e19262264d41bd5c92778d88080d24df0733 322597.pdf 138665582175859a18138b874a0d2070964b6af1846dadf9ee9b9332a38272e7 322597.pdf Title: Impact of PSMA-PET/CT on Radiotherapy Decisions: Is There a Clinical Benefit? Subject: Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA-PET/CT) has emerged as a game-changing imaging modality in prostate cancer, offering superior sensitivity and specificity compared to conventional imaging techniques. Its increasing adoption has significantly influenced radiotherapy decision-making, yet its true clinical impact remains under investigation. This narrative review explores the role of PSMA-PET/CT in guiding radiotherapy decisions across different clinical scenarios, from primary treatment planning to biochemical recurrence and oligometastatic disease. We assess its impact on target delineation, treatment modifications, and overall patient management while addressing existing knowledge gaps. Keywords: PSMA; prostate cancer; radiotherapy; biochemical recurrence; metastasis-directed therapy; salvage radiotherapy; androgen deprivation therapy; target volume delineation; PET-based treatment planning Author: Elías Gomis-Sellés, Antonio Maldonado, Miren Gaztañaga, Victoria Vera, Odile Ajulia, Gemma Sancho, Shankar Siva, Fernando Lopez-Campos and Felipe Couñago Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Thu Apr 17 14:24:44 2025 CEST ModDate: Thu Apr 17 14:31:02 2025 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 24 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 2292557 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- QQPPXH+URWPalladioL-Roma Type 1 Custom yes yes yes 10 0 MODRND+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 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yes yes yes 248 0 BCDJEE+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 254 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-12-04 04:07:10 CET RepresentationInformation: 322597.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-12-03 12:44:49 CET Size: 2292557 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 640 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: PSMA-PET/CT Radiotracers in Clinical Practice Destination: section.2 Item: Title: Image Interpretation and Response Evaluation Destination: section.3 Children: Item: Title: The Role of PSMA-PET/CT in Radiotherapy Planning Destination: subsection.3.1 Item: Title: PSMA-PET/CT in Salvage Radiotherapy Destination: subsection.3.2 Item: Title: PSMA-PET/CT Imaging for Treatment of Oligometastatic Disease Destination: subsection.3.3 Item: Title: PSMA-PET/CT in Biochemical Recurrence (BCR) Destination: section.4 Children: Item: Title: Local Recurrence Destination: subsection.4.1 Item: Title: PSMA-PET/CT in Metachronous Oligometastatic Disease and MDT Destination: subsection.4.2 Item: Title: PSMA-PET/CT in the Scenario of Castration-Resistant Disease Destination: section.5 Children: Item: Title: Selection of Oligometastatic Patients Who May Benefit from Metastasis-Directed Therapy Destination: subsection.5.1 Item: Title: Monitoring Disease Response to Systemic Therapy Destination: subsection.5.2 Item: Title: Selection of Optimal Treatment Candidates for PSMA-Targeted Radioligand Therapy (PSMA-RLT) Destination: subsection.5.3 Item: Title: Current Trials Destination: section.6 Children: Item: Title: Post-Prostatectomy Radiotherapy Destination: subsection.6.1 Item: Title: Oligometastases Destination: subsection.6.2 Item: Title: Future Directions Destination: subsection.6.3 Item: Title: Conclusions Destination: section.7 Item: Title: References Destination: section.8 Info: Title: Impact of PSMA-PET/CT on Radiotherapy Decisions: Is There a Clinical Benefit? Author: Elías Gomis-Sellés, Antonio Maldonado, Miren Gaztañaga, Victoria Vera, Odile Ajulia, Gemma Sancho, Shankar Siva, Fernando Lopez-Campos and Felipe Couñago Subject: Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA-PET/CT) has emerged as a game-changing imaging modality in prostate cancer, offering superior sensitivity and specificity compared to conventional imaging techniques. Its increasing adoption has significantly influenced radiotherapy decision-making, yet its true clinical impact remains under investigation. This narrative review explores the role of PSMA-PET/CT in guiding radiotherapy decisions across different clinical scenarios, from primary treatment planning to biochemical recurrence and oligometastatic disease. We assess its impact on target delineation, treatment modifications, and overall patient management while addressing existing knowledge gaps. 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