Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Bone Metastasis Detection in Prostate Cancer Patients

Key clinical point: Bone metastases assessed with 68Ga-PSMA-11 PET/CT are prevalent even in patients with low serum prostate-specific antigen (PSA) levels indicating additional information may be provided with Ga-PSMA-11 PET/CT detection.

Major finding: 321 of 388 patients had a positive 68Ga-PSMA-11 study.

Study details: A retrospective analysis of 388 patients with prostate cancer enrolled in 5 prospective studies.


Pomykala KL, et al. J Nucl Med. 2019 Sep 20. doi: 10.2967/jnumed.119.230318.


Prostate cancer stage correlates with outcomes and drives the choice of therapy. Thus, identification of the true extent of disease spread is critical. However, accurate staging is an ongoing challenge. The retrospective study by Pomykala et al. describes the relationship between PSA levels and the incidence of bone metastases. Of particular interest, bone metastases were detected in 13% of patients undergoing initial staging of prostate cancer, and, more importantly, 17.6% of patients with a PSA < 5 ng/mL. This suggests that bone imaging should be considered in patients previously thought to be at a lower risk of metastatic disease. —Mark A. Klein, MD