Hi, when checking for the source of BCR and low-level PSA after surgery and radiation would it be best to go with the PSMA PET CT or the PSMA PET MRI? Seems that both are available but the wait list for the CT is longer.
My PSA is still low, but up to 0.29 from 0.15 last month and <0.05 in June. If I understand recent reports the test positively identifies source 50% of the time when PSA is > 0.2.
Previous post-surgery issues were in pelvic lymph nodes that were treated by radiation. Thanks
If it is the Siemens PET/MRI, definitely go for it! I'm very surprised that you're saying that the wait for the PET/CT is longer. There are only about a dozen PET/MRIs operating in the entire US. PET/CTs are available everywhere.
Hi TA, Yes I think it is the UCSF Siemens one using 68Ga-PSMA-11 . The PET/MRI includes an MRI of the pelvis which can help with local recurrence (but one can do that separately if needed). The PET/MRI will be more expensive and they indicate a three month back-log for PET/CTs, and about a month back-log for PET/MRIs.
Mind if I ask another question? Since I've already had RALP and radiation to the prostate bed is it reasonable to hope that the scan might identify avid nodes in the general prostate area but perhaps outside the template that was treated by radiation? My reasoning is thus local treatment / additional focused RT could be possible and effective. (I completed a course of adjuvant/salvage radiation therapy directed at the pelvic lymph nodes in February 2019).
Grateful for all your input.
Ah. That's because UCSF is only one of 2 places (UCLA is the other) where one can get the FDA-approved Ga68-PSMA-PET scans.
No, it is not reasonable to to hope that the PSMA PET will detect anything - a complete waste of money IMO. If you've already had radiation to the entire pelvic lymph node area in 2019, I don't see what you have to gain by more radiation to that area.
Ok, thanks for the perspective but I’m a bit confused. I was listening to Dr Eugene Kwan’s recent PCRI talk and took away the point that getting a PET scans when over 0.2 can really help in terms of staging (local, focal, regional, diffused) and pattern.
I’ll do more research and think through the possible outcomes and discuss with my team -- what the plan will be if a) we see something, or b) nothing is detected.
Thanks for the critical input. Getting the “you have a problem” diagnosis 3 times now has been difficult.
I (and many others) think Kwan is off-base in his assessment. He oversold C-11 Choline for many years and continues to oversell.
Hi TA I’m scheduled on October 18 Th at UCSF for a “ PSMA PETMR PANEL “Do you know if that short for PET MRI ? I’m contacting my MO to clarify also My PSA is .525 currently at my current doubling rate my PSA will be between .7 and .8 when I have the scan which I understand this is a good number to have the scan. I had RALPin 2014 followed up post surgery with Lupron and Radiation to prostate bed. Was non detectable for 1 year slow rise till 10/2018 entered 1 year UCSF trial 11/2018 PSA .820 went nondectable till 11/2020 Exactly 1 year after trial Mo believes high probability back to ADT at a minimum pending scan results. I really appreciate your thoughtful and through comments.
TA - you mentioned there are about a dozen PET/MRI's in the U.S. Is there a reference or web site which let's us find these (easily)? thanks for any tips ...
You can call Seimen's who manufactures them.