PSMA PET Scans Improve Radiation Treatment After Prostatectomy

A Phase 2 clinical trial studied whether PSMA PET scans could improve radiation treatment for men whose PSA began to rise after radical prostatectomy, a sign that prostate cancer may have returned.

The study included 128 men who were randomly assigned to receive either standard salvage radiation therapy or radiation that was customized using information from a PSMA PET scan. In the PSMA PET group, doctors were able to identify and treat additional areas of cancer, including lymph nodes and small metastatic tumors, that would otherwise have gone undetected.

After about three years of follow-up, men whose treatment was guided by PSMA PET scans were significantly less likely to experience treatment failure, including a rising PSA, cancer recurrence on imaging, the need for additional treatment, or death. The greatest benefit was seen in men whose PSA level was at least 0.3 ng/mL when treatment began.

Importantly, the more targeted treatment did not increase side effects or reduce quality of life.

These findings suggest that PSMA PET imaging can help physicians tailor radiation therapy more precisely after prostatectomy, leading to better cancer control without increasing treatment-related complications. Larger studies are now underway to confirm these promising results.

JAMA Oncology. Published online October 2, 2025.