Comparison F18 and galium 68 - Advanced Prostate...

Advanced Prostate Cancer

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Comparison F18 and galium 68

NOCanceros profile image

Hello good people

I did psma pet ct in germany and f18 was involved.year 2016.

I did psma pet ct in sweden only galium 68. year 2021

The question which is the best or both are good..............!

Have a nice summer time

George

19 Replies

IMO, Both are very good. But Ga68 is better.

NOCanceros profile image
NOCanceros in reply to LearnAll

Hello I always learning from Learn all .

Nice to hear something from you.

George

The f18 is probably a tiny bit better at very low PSA levels. I would not worry about that difference.

F18 is more sensitive at lower PSA:jnm.snmjournals.org/content...

There are approximately one trillion cells in an avrage human being. At any point of time, there are several million cancer cells which are circulating in every human's blood and tissues. But, these cancer cells are being attacked and killed by our innate immune defense system thru Macrophages, Phagocytes and Natural Killer cells every day. Some cancer cells which are more fragile ..are imploding and dying each moment by hostile mileu (environment) in our body. There is a constant war between cancer cells and our defense cells. This keeps the body of a normal human cancer diagnosis free as the number of cancer cells are not enough and organized to form colonies and grow fast to cause damage. So scans which are extremely sensitive might see these small number of cancer cells which always are there. The danger of this can be that there is risk of unnecessary, overtreatment These cells if growing very slowly and dying in hands of defense cells can remain harmless for years or even decades. Super sensitive Scans like F18 or Ga68 needs to read carefully to determine exact extent of cancer at a given point in time so the Doctor can choose whether treatment is needed and if yes, how much and what kind of treatment is sufficient.

NOCanceros profile image
NOCanceros in reply to LearnAll

A Very good narration thnxGeorge

I believe that PET PSMA CT does not pick up cells but rather small tumours several milimeters in size but I agree if somebody without training and experience would look at the images of the scan, all the arthrosic joints and some glands and organs in the body take up Gallium and could be mistaken for mets. That is why it is so important to go to Excellency Centers where you meet highly trained and expert operators and doctors

Any thoughts from anyone here about, or citations for, the comparative effectiveness of standard F18-FDG vs. Ga68 PSMA imaging in detecting metastasis in men with biochemical recurrence (esp. those with an intact prostate after IMRT)?

GP24 profile image
GP24 in reply to novatimo

The doctors I met told me the results are the same. In the study Allen cited the authors write in their conclusion "Our results indicate that imaging with 18F-DCFPyL may even exhibit improved sensitivity". So the authors write it may be a bit better.

There is an important difference between the two having to do with the route they follow to leave the human body. Ga follows the urinary track, so it masks bladder and prostate. F on the other hand leaves via the liver, so it masks metastases there. Depending on the suspected location of metastasis one can prove better than the other.

LearnAll profile image
LearnAll in reply to Justfor_

In case of Ga68 scan ..The Radiologist can rectify this masking of prostate and bladder area . He/She takes a scan early within few minutes of injecting Ga68. At this early time, Ga68 has not accumulated in prostate and bladder areas and therefore, gives a clear picture. Then the Radiologist takes scan again after 20 or 30 minutes . By this technique , Ga68 scan can show every single area of the body harboring any cancer cells.

Justfor_ profile image
Justfor_ in reply to LearnAll

If only it was that simple...

LearnAll profile image
LearnAll in reply to Justfor_

There is a research article about this technique. I do not have it handy. Will have to search again.

Justfor_ profile image
Justfor_ in reply to LearnAll

There is no need to search for anything. This is standard practice all along the imaging range called contrast enhancement. It is the difference of two images without and with the radio ligant. It is useful yet has its limitations.

Man that is very precise you did your homework

I did a PSMA PET Ga68 scan at UCLA in L.A. on 05Mar21...booked my appointment by phone on 03Jan21...PSMA PET had just been FDA approved on 22Dec20...so this train is moving fast...UCLA quoted me $3300 cash price; I went thru my Insurance and guess what; PAID MORE after all their 'discounts;' yes...I would have saved a little had I paid cash (this is another story though)...

- 310-794-1005 Scheduling number UCLA - 200 Medical Plaza; Westwood, L.A. CA

- North elevator to B1 Ste B114

Very quick, results in one week...everyone was very open and you have access to all the Doctors you see on the YouTube promoting the UCLA PSMA PET program...they actually answer your emails...

Just an option as to travel to Sweden is gonna cost a lot more than going to L.A....

NOCanceros profile image
NOCanceros in reply to RMontana

Hello my situation which i wrote before about my right lung and right kidney ,so the drs. decided to make psma pet ct with contrast later. this kind of checking is a new thing in sweden and it costed me 35us dollars the reason is we pay Tax 31-32 % of our wages or salary.Before i did it in germany twice, it costed 2500 usD./Time

i got 90% from the social insurance.

George

NOCanceros profile image
NOCanceros in reply to RMontana

HelloI read about Australia there are 60 hospitals using PSMA PET CT.

G68 is superior in regard to sensitivity, it is the Gold Standard to which all others are compared. There's a reason for this...

The study constantly referenced in this regard clearly points out that the F18 contrast agent is "non-inferior". Additionally, it was not a true head to head study as the F18 dwell time and dosages were different than the G68 in this study! This was referenced in the study... meaning had the G68 contrast been used in the same methodology, the improved results of the F18DCFPYL scans would not be so differentiating.

It is "BETTER" because it's half life is 2x that of G68 which will expand access to it by allowing the contrast agent to be formulated off-site and shipped to where it will be used. Additionally, the methodology used to make the contrast agent produces almost 2x as much agent per batch as compared to G68. These two items will make it a great change in access to sensitive scanning for PCa patients.

This is better, but "BETTER" is relevant.

CONDOR Study

clincancerres.aacrjournals....

OSPREY Study

auajournals.org/doi/10.1097...

Good reading that provides insight...

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

All in all if you read the data, on a comparative, F18 @ 88% to G68 @85% but F18 using a higher dosage and longer dwell time that provides those results... Ehhhhh, no, it's not better, but an alternative and option which is great!

Just my thoughts ;)

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