@heavyphil It's probably on a similar trajectory to PSA testing, following the Gartner hype curve. First they find a new diagnostic tool and get very excited. Then they over-apply it. Then a reaction kicks in and they stop using it as much as they should. Then finally they figure out how to fit it in with the rest of the ecosystem and make it genuinely useful.

PSA testing fell into the Trough of Disillusionment 10-15 years ago, because doctors were making too aggressive treatment choices (especially for older patients) based on only mildly-elevated PSA readings. As a result, health authorities stopped recommending routine PSA screening in most countries, and the number of de-novo *advanced* prostate cancer cases shot up through the roof (because they starting missing the more-serious cases). Now they're cautiously moving back towards routine screening, but without an overreaction to a mildly-elevated PSA, with new options like active surveillance.

I'd say that PSMA-PET scans are currently teetering at the top of the Peak of Inflated Expectations, and there will be a strong reaction to over-treatment (like radiating every little spot that lights up "just in case"), but eventually it will find its place.