Discordance Between Prostate-Specific Antigen and Positron Emission Tomography Imaging in Recurrent Prostate Cancer
Bibliographic record
Abstract
Prostate cancer biochemical recurrence (BCR) refers to a rise in prostate-specific antigen (PSA) after treatment. It remains a major diagnostic challenge. Positron emission tomography (PET) imaging, especially with prostate-specific membrane antigen (PSMA) tracers, has emerged as a highly sensitive tool for localizing prostate cancer recurrence. This review examines the use of PET scans in detecting prostate cancer recurrence, evaluates diagnostic challenges and pitfalls, and discusses the limitations of PET in the BCR setting. We also report a case of a 77-year-old man with early BCR after prostatectomy and multimodal therapy, whose PSA climbed progressively from 0.03 to 7.0 ng/mL over 7 years despite salvage treatments. Notably, four consecutive PET scans and a bone scan remained negative for recurrent or metastatic disease, highlighting the limitations of imaging in detecting occult micrometastatic prostate cancer. PET imaging has greatly improved recurrence detection. Still, false negatives and reading pitfalls can affect patient management.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".