E. David Crawford, MD, presents “Need to Know: Rapid Fire PET Tumor Board Discussions.”
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How to cite: Crawford ED. Need to Know: Rapid Fire PET Tumor Board Discussions. July 16, 2025. Accessed Aug 2025. https://grandroundsinurology.com/pet-tumor-board-program-2025-need-to-know-rapid-fire-1/
PET Tumor Board Program 2025 – Need to Know Rapid Fire 1 – Summary
In this 16-minute “Need to Know” segment, a panel of experts led by E. David Crawford, MD, Editor in Chief of Grand Rounds in Urology and Professor of Urology at the University of California, San Diego, addresses key clinical questions surrounding PSMA PET imaging in prostate cancer. The format is rapid-fire, offering concise insights on managing complex diagnostic scenarios. Participants include:
- Wayne G. Brisbane, MD, Assistant Professor of Urology, University of California, Los Angeles, Los Angeles, California
- Sean P. Collins, MD, PhD, Professor and Vice Chair of Faculty Affairs in the Department of Radiation Oncology, University of South Florida, Tampa, Florida
- Sherief H. Gamie, MD, Nuclear Medicine Physician, University of California, San Diego, San Diego, California
- Daniel P. Petrylak, MD, Professor of Medicine (Medical Oncology) and of Urology, Yale School of Medicine, New Haven, Connecticut
The panel considers how to proceed when faced with a negative PSMA PET with high suspicion for recurrence. They then consider whether repeat scans should ideally use the same imaging agent and machine. All agree that interpretation consistency across scans is equally critical.
The group discusses how PSMA PET can inform surgical and radiation strategies. Dr. Brisbane acknowledges its value in delineating disease extent, and Dr. Collins anticipates a future of PSMA-guided dose intensification, possibly enhanced by PET/MRI fusion. Dr. Gami confirms that PET/MRI technology is advancing rapidly, with cost barriers declining.
The discussion turns to Axumin PET. While not ideal for local recurrence, it may be helpful for low-grade disease or equivocal cases. Dr. Collins highlights its historical utility before PSMA’s emergence, though Dr. Gami warns it may miss small-volume disease.
Tracer excretion into the bladder remains a major interpretation challenge. The panel stresses that tracer selection and future development of non-renal tracers may mitigate this risk.
The session concludes with consensus that PSMA PET is reshaping prostate cancer care—enabling earlier, more precise interventions—but that interpretation nuances and technological limitations remain important considerations in clinical decision-making.
