Front-line clinicians generally don't get involved in decisions...

Front-line clinicians generally don't get involved in decisions around specific tracer choices to use on individual patients. Their role is to request a PET scan, stating relevant information, such as: "Previous prostatectomy for Stage X Prostate cancer and now has a rising PSA". They want the most accurate test!

The Imaging service that does the test uses the most appropriate tracer that's available and accessible. If there is same day versus next day imaging, the patient will be advised of this, together with the pros and cons. But the main objective is to ensure the Radiologist who will then read the image does not miss cancer if its present (Sensitivity).

The front-line clinician then gets a report, with the relevant disclaimers. If the scan says NEGATIVE, the patient gets told the results, including a cautious statement about false negatives.

Miss a cancer now, and a few months later, the patient may be back to a repeat scan due to a further rising PSA! At some stage, metastatic lesions may be large enough to be found (even by plain X ray that is being done for trauma or other unrelated issue)! Perhaps another important point to make here is that, the Radiologist who reads the new scan always compares the new images with all available previous images! So, the miss comes out.

Missing a cancer is in no-one's interest! As it turns out, healthcare services do audit themselves, so its hard for these things to stay under the radar for too long. There are Tumour boards too!

To make matters worse, some countries (like the US) allow advertising, so Clarity (or whoever) will be allowed to place ads stating things like: "At Clarity Imaging, we use the cutting-edge Cu64 PET/CT technology, which offers superior sensitivity and precision compared to traditional imaging methods."!

IN SUMMARY;
a) It's actually unethical (and professional misconduct) to knowingly use a less accurate test when a more accurate one exists, is available and accessible.
b) Issues of access (availability, cost, technical skills, etc), and patient choice (for whatever reason) matter, and will influence uptake.