PET/CT vs Nuc Med Bone scan - Advanced Prostate...

Advanced Prostate Cancer
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PET/CT vs Nuc Med Bone scan

tcp5071967
tcp5071967
14 Replies

Does anyone have a position on a standard Nuc Med bone scan vs. a PET/CT scan prior to radiation treatment? My Nuc Med bone scan is for a baseline prior to my Radiation and ADT. My next question would then be "Would it change the initial treatment plan?"

(I am having a bit of lower back pain also) Below is the URL to an article which inspired my question.

auntminnie.com/index.aspx?s...

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Hidden
Hidden

Hi: Regular bone scan have very low sensitivity. I had a normal bone scan and a positive Gallium 68 PSMA PET/CT.

PET/CT scan are more sensitive than bone scans. Their sensitive depends on which technique is used.

Probably 11 C Acetate PET/CT , and Gallium 68 PSMA PET/CT scans are the most sensitive.

18 F FDG is less sensitive than either of the above.

Gallium 68 is probably the most sensitive,. It can detect metastasis with PSA as low as 0.4. There are a % of patients with PSMA negative cancers and those cancers are not detected by Ga 68 PSMA.

ncbi.nlm.nih.gov/pubmed/118...

ncbi.nlm.nih.gov/pmc/articl...

Anything, please let me know.

Best

Raul

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Cmdrdata
Cmdrdata
in reply to Hidden

Hey Raul, I can confirm that F18 Axumin (you call it 18 F FDG) is not sensitive enough even though my PSA has jumped from 0.9 to 4.2. I had this PET scan yesterday, got a copy of the DICOM formatted data and reviewed it with Osiris Lite on my Mac. I looked at all 152 images and did not see any cancer indication on bones or soft tissues/lymph nodes. This paper is a good comparison study: sciencedirect.com/science/a...

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tcp5071967
tcp5071967
in reply to Hidden

Thank you Raul80.

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Tjc1

Well i had the standard bone scan and MRI both negative. Then a month later i was given the axinum pet scan and it showed a lesion on my collar Bone and cancer returning in my postrate. So im kind of partial to the newer tracers and pet scan.

Thomas

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Hidden
Hidden
in reply to Tjc1

Nobody really doubts that the PET/CT particularly with GA 68 PSMA or 11C acetate or choline are more sensitive than the standard bone scan and CT scan with contrast.

I do not understand why doctors keep doing these old tests, except that doctors offer only what they do and they will not tell you to go around the corner where they have a better test

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tcp5071967
tcp5071967
in reply to Tjc1

That's the way I feel. Thank you

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Tjc1

It has to do with cost i believe. Im not sure but before the insurance pays i think you have to have the bone scan and MRI First. But what do i l know.

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mcp1941
mcp1941
in reply to Tjc1

I am scheduled for a T99 bone scan and CT scan in May. MO says I don't qualify for PET/CT scan unless bone scan comes back neg.

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Tjc1
Tjc1
in reply to mcp1941

Ahhhh ok mine were negitive so thats why i was able to get it.

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tcp5071967
tcp5071967
in reply to Tjc1

I had a negative Bone scan in October prior to surgery also.

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Tommyj2
Tommyj2
in reply to mcp1941

There is a dizzying array of scans that appear to be available to all with this disease... however, is there evidence that learning early of Oligometastasis translates into a change in tx plan that actually extends life span??..... The more I read the less convinced I am that there is a standard of care that correlates highly with extended lifespan in the majority of those receiving it.... but.... that might simply be my take from seeing such high variability in the responses of those here to oncological intervention.

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mcp1941
mcp1941
in reply to Tommyj2

My MO will NOT order a test if the results of the test will not change treatment plan.

Mike P.

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ggbk

I had been following a slowly rising PSA after RP and IMRT in early 2014. It went from .2 to2.3 in November 2017.

I had a Gallium 68 scan in December at UCLA and it found small nodules in my lungs that showed a faint to mild positive PSMA reaction . A follow up biopsy confirmed it was PCa metastasis. That lead to me starting Lupron Zitiga with prednisone immediately. I am so glad I had the Gallium 68 done because I was content to just follow the slowly rising PSA with nothing showing up on the usual PET/CT scan. The Gallium 68, I think, is the best scan out there right now and it sure changed the treatment plan for me.

Best of luck to you.

George

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tcp5071967

Thank you for the response. The best of luck to you and your fight.

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