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Published in Advanced Prostate Cancer

Expert Opinion / Cases · February 20, 2020

Concerning, Non-definitive Bone Lesion on MR and Bone Scan

 

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  • Olivera Ivanov

    Feb 21, 2020

    Next step could be pet/ct and radiotherapy of the prostate and possibly of the left femur

  • Andrea Figus

    Feb 21, 2020

    I would propose a 6-month follow-up for skeletal injury, and a 1-year follow-up for the primitive prostate

  • Noureddine Benjaafar

    Feb 21, 2020

    Complete the workup by a CT scan of Chest and Abdomen

  • daniel lama

    Feb 21, 2020

    Get a Na+Flouride PET scan to evaluate the bone, treatment will depend on the results of the scan, don't feel surveillance is an option here

  • Hisashi Matsushima

    Feb 22, 2020

    DWIBS or PSMA-PET is recommended. When bone mets limited to femur, both primary and metastatic lesion should be treated with radiotherapy. ADT will not performed until polyprogression is determined.

  • Radoslav Mangaldzhiev

    Feb 22, 2020

    I recommend GA PSMA PETCT.

  • Elchin  Mansurov

    Feb 22, 2020

    İ recommend PSMA PET-KT

  • Olivera Ivanov

    Feb 22, 2020

    I agree with dr Lama and Matsushima

  • Richard Vance

    Feb 23, 2020

    PSMA or C11 Choline PET scan. In fact the USA is negligent in not doing these in lieu of ancient bone scan.

  • Huan Wang

    Feb 23, 2020

    I also recommend PSMA-PET-CT for the evaluation of the suspected bone metastasis.  I want to consult Dr. Matsushima why ADT is not a treatment choice for the patient, whether metastasis or not, at present. What is the evidence?

  • Ismail Abdelhafeez

    Feb 27, 2020

    If Gallium PSMA PET CT whole body excludes additional lesions, advise local radiotherapy to prostate and equivocal femur lesion.

  • Miklos Wenczl

    Feb 28, 2020

    I also recommend PSMA-PET-CT.
  • Comment deleted by User.

  • Andy Petrovski

    Mar 01, 2020

    Considering patient's age, any life-altering aggressive treatment, even relatively painless such as ADT, may do more harm than good. The patient needs to be consulted about risk profile of each treatment (including scans like PET-CT) so he could make a conscious decision as to what would fit best his remaining years. No one wants to buy a few months or even years if they are spent suffering from surgery / radiation / chemo and anxiety.

  • Ismail Abdelhafeez

    Mar 03, 2020

    On post radiotherapy follow up, there is a place for orchiectomy, pending on PSA response.

  • Prasanta Kumar Pradhan

    Apr 02, 2022

    PSMA PET/CT scan can be done and further treatment can be offered with RT  .

  • Apr 24, 2024

    Pending Moderator approval.
    Delete

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