PSMA PET-CT
Ga-68 / F-18 PSMA PET-CT in Jaipur
Molecular imaging for prostate cancer
PSMA PET-CT is an advanced molecular imaging scan used primarily for the evaluation of prostate cancer. It uses a PSMA-targeted radiotracer to identify areas of prostate cancer activity and combines this information with detailed CT images.
At Arovida PET-CT Centre, Jaipur, PSMA PET-CT may be performed using appropriate Ga-68 or F-18 labelled PSMA radiotracers, depending on clinical indication and tracer availability.
What is PSMA PET-CT?
PSMA (Prostate-Specific Membrane Antigen) is a protein frequently expressed at higher levels in prostate cancer cells.
A PSMA-targeted radiotracer is administered intravenously and PET imaging detects areas showing PSMA uptake. CT provides anatomical localization.
When is PSMA PET-CT Used?
PSMA PET-CT may be useful for:
- Initial staging of appropriately selected prostate cancer patients
- Biochemical recurrence with rising PSA
- Detection of persistent or recurrent disease
- Evaluation of suspected lymph-node or bone metastases
- Assessment of selected distant metastatic disease
- Evaluation before PSMA-targeted radionuclide therapy
What Can PSMA PET-CT Show?
Depending on the clinical situation, it may help identify:
- Primary prostate cancer
- Pelvic lymph-node disease
- Distant lymph-node disease
- Bone metastases
- Selected visceral or soft-tissue metastases
- Sites of recurrent disease
The appropriate use depends on the patient's diagnosis, PSA, pathology, previous treatment and clinical question.
A negative scan does not completely exclude microscopic or low-PSMA-expressing disease.
Ga-68 PSMA vs F-18 PSMA
PSMA-targeted tracers are available with different radioactive isotopes, including Gallium-68 and Fluorine-18.
Different tracers have different physical and biological characteristics. The choice depends on the specific radiopharmaceutical, clinical indication, availability and imaging protocol.
PSMA PET-CT for Rising PSA
After prostatectomy or radiotherapy, a rising PSA may indicate persistent or recurrent disease.
PSMA PET-CT can help localize sites of disease and may assist the treating team in further management planning.
PSMA PET & Lu-177 PSMA Therapy
PSMA imaging can also play an important role in theranostics.
PSMA PET-CT can demonstrate PSMA-expressing disease and may form part of the assessment of patients being considered for Lu-177 PSMA radioligand therapy.
Preparation
Preparation is generally simpler than for FDG PET-CT.
Patients should:
- Follow the centre's specific instructions
- Maintain adequate hydration unless medically restricted
- Empty the bladder as advised
- Continue routine medicines unless specifically instructed otherwise
- Bring previous PSA reports, biopsy/histopathology and imaging
Please inform us if you:
- Have significant kidney disease
- Are pregnant or may be pregnant
- Are breastfeeding
- Have difficulty lying still
What Happens During the Scan?
- 1
Clinical history review
Your diagnosis, PSA and previous treatment are reviewed.
- 2
PSMA tracer injection
The radiotracer is administered through an IV line.
- 3
Uptake period
You rest while the tracer distributes through the body.
- 4
PET-CT scan
PET and CT images are acquired.
- 5
Expert interpretation
The findings are assessed in conjunction with your clinical history and previous imaging.
The complete visit generally takes several hours, depending on the tracer and protocol.
Important Limitations
PSMA PET-CT is a powerful molecular imaging technique, but:
- Not all prostate cancers express PSMA strongly.
- PSMA uptake is not completely specific for prostate cancer.
- Very small lesions may be difficult to detect.
- Benign conditions and some other malignancies can show PSMA uptake.
- Imaging does not replace biopsy when tissue diagnosis is required.
For Referring Physicians
Please provide:
- Histopathology / Gleason Grade Group
- Current and previous PSA
- PSA trend, where relevant
- Previous prostate MRI / PET-CT / CT / bone scan
- Surgery and radiotherapy details
- Systemic treatment history
- Current treatment
- Specific clinical question
Common clinical questions
- New diagnosis
- What is the extent of disease?
- Rising PSA
- Where is recurrent disease?
- Suspected metastases
- Is there nodal, osseous or distant disease?
- Before Lu-177 PSMA therapy
- Is there PSMA-expressing disease suitable for consideration of targeted therapy?
Frequently Asked Questions
PSMA PET-CT at Arovida
Advanced molecular imaging. Clinically focused interpretation.
For patients with prostate cancer, the right imaging study can provide important information about where the disease is and how extensively it may have spread.