Which imaging techniques are used in detecting Neuro Endocrine Prostate Cancer tumors?

[traveller64]

I wonder if Ga68 PSMA PET/CT is effective in detecting NEPC tumors

[Tall_Allen]

No, it absolutely does not detect it. Why are you asking? Do you have reason to suspect you have it?

[traveller64 in reply to Tall_Allen]

Allen, my recent blood test for NSE was elevated (54.6 ng/dl against ref range of <16.3). Chromogranin A test result is pending. LDH is normal

[traveller64 in reply to Tall_Allen]

I guess FDG PET/CT is useful in detecting NEPC tumors. On the other hand, FDP PET/CT detects normal Pca tumors but not as effective as PSMA PET/CT, right?

[Tall_Allen]

You have to be positive for several blood markers, not just one or two. Biopsy of metastasis and IHC analysis are more definitive. What is FDP PET?

[traveller64 in reply to Tall_Allen]

FDG (Fluorodeoxyglucose) PET. My MO thinks we should get the PSMA PET first. If Chromogranin A result comes in positive, then repeat the NSE test and then consider getting some other scan to detect NEPC, if there is any

[Tall_Allen in reply to traveller64]

NEPC will show up on FDG because it is fast-growing; it will not show up on PSMA PET - NEPC does not express PSMA. There is another PET indicator - Ga-68-DOTATATE that will show neuroendocrine of GI origin, but will usually not show neuroendocrine of prostate origin. Biopsy and IHC is the best way to diagnose it.

[traveller64 in reply to Tall_Allen]

Yes, biopsy is the best way to diagnose it but you should detect the tumor first by imaging.

[GP24]

My lab specifies that it needs the blood frozen for NSE tests. Otherwise the value will be too high. My doctor cannot freeze the blood so I no longer worry about elevated NSE.

For neuroendocrine tumors you could get a 68Ga-DOTATOC PET/CT.

[traveller64 in reply to GP24]

NSE result was well above the limit (55 vs 16). I will retest in a different lab making sure that they handle the blood properly. Do you get other NEPC tests regularly?

[GP24 in reply to traveller64]

I get a CGA test sometimes but NSE is of no value in my case as mentioned in my post. CGA is the main marker but you need more than one to begin testing for neuroendocrine cancer.

I know a patient who went to the lab and had is blood drawn there. This resulted in a normal NSE value.