Dual PSMA and FDG PET Imaging for Patients With Advanced Prostate Cancer

Inclusion criteria

• Male, age ≥ 18 years
• Histologically or cytologically confirmed prostate cancer (adenocarcinoma)
• Poor risk patients with mCSPC at study enrollment
• De novo or recurrent high volume mCSPC as per conventional imaging (CT chest abdomen pelvis, or MRI, plus bone scan) prior to starting ADT and ARPI
• High or low volume mCSPC plus PSA ≥4.0 after 6-8 months of initiating ADT
• Willing to undergo study PET scans and remain under the care of medical oncology, radiation oncology or urology physician at Princess Margaret Cancer Center.
• No prior PSMA or FDG PET imaging within the last 60 days at each specified time point on study
• Patients enrolled in clinical trials are eligible if they satisfy all other criteria of eligibility

Exclusion criteria

• Under a randomized-controlled trial with unknown allocation of systemic therapy
• Inability to undergo or successfully complete PSMA PET and FDG PET imaging exams
• Unable to provide written consent by patient and their legal representatives
• In the opinion of the treating physician:
• conditions which would significantly impair the patient's ability to comply with study procedures and follow up
• Significant uncontrolled comorbidity, which may negatively impact the safety or interpretability of study PET imaging

• another active malignancy
• patient on dialysis
• another radioisotope or investigational systemic agent within 5 half-lives prior to PET imaging