Whole Body PET CT scan vs. PSMA PET scan

swl1956

I asked my urologist to write a script for a PSMA PET scan. Which he said he did. I went for the scan, but upon viewing the results it was listed as Whole Body PET CT scan using F-18 FDG radiotracer. After reading a bit, sounds like I should of had 68GA-PSMA-11 radiotracer? I'm trying to be absolutely certain of no metastasis before embarking on a treatment decision. Anybody know the differences between these? Is the one I had adequate? Results below:

Impression

Focus of hypermetabolic activity along the right lateral aspect of the prostate gland at the level of the mid gland consistent with neoplasm. This corresponds to the finding on prior MRI of pelvis. No evidence of metastatic disease.

Narrative

Whole body PET CT scan:

HISTORY:Prostate cancer.

COMPARISON: None

FINDINGS:

Whole body PET CT scan was performed following the intravenous administration of 9.06 millicuries of F-18 FDG. Following the resting phase, attenuation and nonattenuation corrected images were obtained from the skull base to the proximal thighs along with CT images. The images were evaluated on independent workstation including fusion images.

There is physiologic activity within the lacrimal glands and salivary glands and there is also mild activity at the level of the supraglottic larynx. There is no hypermetabolic lymphadenopathy within the neck.

The chest shows no evidence of hypermetabolic pulmonary parenchymal mass or hypermetabolic lymphadenopathy. There are no pleural effusions.

The abdomen shows expected activity in the liver and spleen. There is no hypermetabolic lymphadenopathy within the abdomen. The kidneys concentrate of radionuclide normally. There is nonspecific bowel activity.

Within the pelvis, there is accumulation of radionuclide within the bladder. There is a hypermetabolic focus along the right lateral aspect of the prostate gland with the level of the mid gland with maximum SUV of 6.7. This corresponds to the hypointense T2 focus in the right side of the prostate gland as seen on prior MRI of 10/6/2023 and likely represents neoplasm. There is no hypermetabolic pelvic lymphadenopathy.

There are no hypermetabolic osseous lesions identified.

Clevelandguy

Hi,

From what I have read it seems the 68GA is a little more sensitive than the F-18 but whether its significantly better I don’t know. You might want to ask your doctor why they chose the F18 vs the 68GA. Tracer of choice? Insurance approved? Sounds like you had good results.

Dave 3+4

Old Salt

 I'm trying to be absolutely certain of no metastasis before embarking on a treatment decision.

Unfortunately, you will never be absolutely certain about the absence of metastasis.

More in general, until recently the scan that you got was the best available. The PSMA scan is supposed to be more sensitive, but depending on the circumstances may not have been approved by your insurance. Another possibility is that the PSMA scan simply wasn't available in your medical setting.

swl1956

I called the radiology department where I had the scan done. They told me there was an error made on the report. The F-18 FDG was incorrectly entered. They're updating the report for the radio tracer piflufolastat F-18 which is what they say they used. They tell me that is a PSMA PET scan. Google search found below info. Sounds like the right stuff?

US Brand Name Pylarify
Descriptions

Piflufolastat F 18 injection is used with a PET scan (positron emission tomography) of prostate-specific membrane
antigen (PSMA) positive lesions in men with prostate cancer. It is given in patients with suspected metastasis (cancer that has spread to the other parts of the body) who are candidates for initial treatment and with suspected recurrence (cancer that keeps coming back) based on an increased serum prostate-specific antigen (PSA) level.

swl1956

https://csn.cancer.org/discussion/comment/1714384#Comment_1714384

Yeah! Nothing is absolute. Although, I guess the PSMA PET is as good as it gets for finding metastasis?

Clevelandguy

Hi,

Old Salt is correct, even with a PMSA PET scan there is no absolute guarantee but the PET scan seems to be the gold standard for finding metastatic cancer. Be glad it came back negative.

Dave 3+4