Reply to 'Re: Prostate‐specific membrane antigen positron emission tomography in addition to multiparametric magnetic resonance imaging and biopsies to select prostate cancer patients for focal therapy'.

This article is a response to a previous study on the use of prostate-specific membrane antigen-positron emission tomography (PSMA-PET) in conjunction with multiparametric MRI (mpMRI) and biopsies for local staging of prostate cancer. The authors agree that PSMA-PET should be used for staging in higher-risk patients, and that the addition of pelvic PSMA-PET to mpMRI improves sensitivity and negative predictive value in the screening setting. However, they argue that PSMA-PET also has value in increasing overall test sensitivity and negative predictive value when used with mpMRI and biopsies for local staging, particularly in patients considering focal therapy. They acknowledge that PSMA-PET may not identify all lesions unsuitable for focal therapy, but argue that the clinical significance of these lesions is arguable. They also suggest that the use of PSMA-PET can improve the selection of patients with unifocal disease and potentially reduce overtreatment. The authors conclude that while high-quality mpMRI is valuable, the addition of PSMA-PET can increase overall sensitivity and improve focal therapy outcomes. [Extracted from the article]