what's The best PSMA scan to get Ga68... - Advanced Prostate...

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what's The best PSMA scan to get Ga68 or Ply

Bubasurf6 profile image
17 Replies

what's The best PSMA scan to get Ga68 or Ply

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Bubasurf6 profile image
Bubasurf6
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17 Replies
6357axbz profile image
6357axbz

They are both good but what is probably most important is the skill and experience of the person reading and interpreting the scan you get.

tango65 profile image
tango65

For low PSA (below 1, some may say below 0.5), probably the Pylarify may have a better detection rate than the Ga68 PSMA. There is not too much difference between these 2 PET/CTs.

Bubasurf6 profile image
Bubasurf6 in reply totango65

I have PSA .7 am scheduled for PSMA PETMRI Panel with Ga68 not PET CT for tomorrow at UCSF. I participated in PSMA Ga68 trial 3 years ago which Dr.Hope who was in charge of the trial read. I was told he and others at UCSF would be reading the scan.

Spyder54 profile image
Spyder54 in reply toBubasurf6

Bubasurf,The video I posted was from Dr Hope. Did you happen to see it from 2 days ago? Click my icon to see my recent posts. He seems excellent. UCSF is an excellent location. I live in St Petersburg, FL., but probably worth the airfare hotel expense. To attack effectively, we need to see where the trouble lies.Mike

LeeLiam profile image
LeeLiam in reply toSpyder54

The last video I see is with Dr. Klotz. Can you repost the link?

Spyder54 profile image
Spyder54 in reply toLeeLiam

Lee Liam. I hv just learned that Darryl does not want videos posted. He pulled 2 of my recent vids including that one. His perogotive. He is the Moderator. You can Google Dr Thomas Hope UCSF everything you wanted to know about PSMA and Scanning April 2021. Click videos and it should be near top👍

tango65 profile image
tango65 in reply toBubasurf6

I think a Ga 68 PSMA at a PSA of 0.7 is fine and they have a lot of experience at UCSF. The doctors in Munich where I had the Lu 177 PSMA treatment, recommended to do a Ga 68 PSMA if the PSA is 0.5 or higher.

cesces profile image
cesces in reply toBubasurf6

"PETMRI Panel with Ga68 not PET CT"

What are the advantages/disadvantages of PETMRI vs PET CT?

GP24 profile image
GP24 in reply tocesces

I had both. The sensitivity is the same but using the MRI the RO can determine better if the uptake is a tumor lesion or not.

Bubasurf6 profile image
Bubasurf6 in reply toGP24

Thanks I'm leaving now to drive to UCSF for my Scan today at 1:00pm Then meeting my Mo Dr. Aggarwal on 25 Th to discuss the treatment plan going forward. Thanks to everyone for all the replys to my question.

Seebs9 profile image
Seebs9 in reply toBubasurf6

Dr Aggaral was the Dr who ran the Pyl trial I participated in - He found more stuff than I wanted to know about so be prepared. Best of luck Brother.

Spyder54 profile image
Spyder54

If you look up Tall Allan’s post from 2 days ago, he posts locations and phone number for Ply sites. BUT…he also mentions how it may be more important how good the Radiologist reading the scan. I posted a video from UCSF (click on my icon to find post quickly). It is clear that it is easy to see a false positive. Your Radiologists experience with his scanning device is KEY!

Bubasurf6 profile image
Bubasurf6 in reply toSpyder54

Yes Agree about the Radiologist reading the scan which as I understand now will be Dr. Hope and two other radiologists who read my last one 3 years ago when I participated in thePSMA Ga68 trials at UCSF. I feel extremely lucky to have been at UCSF for this adventure over the last 7 years. I'll report the results of scan and treatment plan next week

Tall_Allen profile image
Tall_Allen

Pyl detects more at lower PSA, but radiologist is important too.

prostatecancer.news/2016/12...

Bubasurf6 profile image
Bubasurf6 in reply toTall_Allen

Just got my results from yesterdays PSMa at UCSF Any thoughts.

FINDINGS:

Prostate bed: No evidence of local recurrence in the prostate bed.

Pelvic lymph nodes: No evidence of pelvic or retroperitoneal lymphadenopathy.

Distant sites of disease:

Extrapelvic nodes: No evidence of extra-pelvic lymphadenopathy.

Bones: 9 x 6 mm right posterior pubic/ischial radiotracer avid lesion (Se:Im 15:23)

Soft tissue metastases: No evidence of soft tissue metastases.

Whole Body MR: Additional, non-diagnostic MR images were obtained for anatomic localization.

Brain: No large masses, hydrocephalus or extra-axial fluid collections.

Chest: No large pulmonary masses or pulmonary nodules. Note, MRI is limited for assessment of pulmonary nodules. If pulmonary nodules assessment is clinically warranted, a CT chest is recommended. CLINICAL HISTORY:

70 years man with biochemical relapse with prostate cancer; Management = Prostatectomy

Most recent PSA = 0.7 ng/ml; PSA date = 10/13/2021

TECHNIQUE: MRI of the abdomen and pelvis was performed. At the same time a whole body PET acquisition was acquired using Ga-68 PSMA-11. Additional whole body T1 and T2 weighted images were acquired. Please see separate dictation for whole body findings and PET findings.

MEDICATIONS:

Dotarem - 15.76 mL - Intravenous

FINDINGS:

Prostate bed: No evidence of local recurrence in the prostate bed.

Pelvic lymph nodes: No evidence of pelvic or retroperitoneal lymphadenopathy.

Distant sites of disease:

Extrapelvic nodes: No evidence of extra-pelvic lymphadenopathy.

Bones: 9 x 6 mm right posterior pubic/ischial radiotracer avid lesion (Se:Im 15:23)

Soft tissue metastases: No evidence of soft tissue metastases.

Whole Body MR: Additional, non-diagnostic MR images were obtained for anatomic localization.

Brain: No large masses, hydrocephalus or extra-axial fluid collections.

Chest: No large pulmonary masses or pulmonary nodules. Note, MRI is limited for assessment of pulmonary nodules. If pulmonary nodules assessment is clinically warranted, a CT chest is recommended.

Abdomen: Grossly unremarkable abdominal organs. Evaluation of the small and large bowel is limited in the setting of PET/MRI due to peristalsis and artifact from bowel gas. Small renal cyst

IMPRESSION:

1. Right posterior pubic/ischial bone radiotracer avid metastatic lesion. No additional sites of metastatic disease.

I have appointment withMO Aggarwal on 25Th but I was trying to be a little more informed before the appointment

Tall_Allen profile image
Tall_Allen in reply toBubasurf6

He will probably discuss with you starting Lupron because you are metastatic.

Bubasurf6 profile image
Bubasurf6 in reply toTall_Allen

Thanks for the in put. Well the plan we settled on was SBRT on int one met they found then 3-6 months Lupron. He did suggest that I get two PSA TEST 30 days apart after the SBRT. He was very clear that this may not be conclusive and that it may not be a prostate metastasis. But because the PSMA or no other test is 100%. He dit feel that since my PAS is sill very low 0.7 that if we do the SBRT and get two blood tests 30 days apart that my PSA May drop indicating that the spot they Used SBRT ON May have been to largest area peoducing the 2 month doubling rate. He said that would indicate that we WACKED the biggest MOLE. But then back to Lupron to keep on working on getting rid / starving renaining Pc Cancer cells( as many as possible)He believes that the SBRT ( May reduces the PSA that it would confirm that We hopefully hit eve hit the biggest PSA factory and the the Lupron May add QOL Utill PSAt becomes detachable AGAIN. I not counting on it but someone has to win the lottery. I know I bought enough of the PSA tickets Thanh again

Dave

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