Normal uptake areas in PSMA Gallium scan

[Wyldhare22]

My husband got the results, online, of a PSMA scan he had last week. We talk to his doctor tomorrow.

The person who read it said the prostate was surgically removed, when it was actually radiated, so we don’t have total faith in this report.

In the opening of the findings it says: “Physiologic radiotracer uptake is identified in the the salivary glands, spleen, liver, and small bowel.”

Initially we were alarmed, but after some research it looks like these areas may normally show uptake with Gallium. Is this correct?

[GP24]

Yes, this is correct, these organs have uptake without having cancer.

[tango65]

Yes, salivary glands, small intestine, liver, and proximal renal tubules express PSMA and will show up in the PSMA PET/CT.

Did they find any uptake in other areas? If they did, what were the SUV values?

[Wyldhare22 in reply to tango65]

Yes, they mentioned numerous places on his bones. L3 is 29.6 and left 5th rib at 15.2. However, prior to this scan his T1 had been 69.2, but got radiation, so seems he be better.

[lokibear0803]

wrt your report incorrectly pointing to a removed prostate:

From what I can tell, clinics can use templates to fill in their readouts after a scan. I’ve had several reports that mention the RP I never had.…recently, my Pylarify report made numerous references to FDG.

I asked the radiologist about the FDG thing and he confirmed their clinic is still transitioning things from their previous use of FDG…i.e. there was a template. In some cases, the radiologist might be in a hurry due to heavy patient demand; and in other cases s/he may not have an option to change certain sections/phrases in the template.

Other than that, the stmt about “Physiologic radiotracer uptake…” is something I see in every PSMA scan I get… i.e. it appears to be a std section of the template.

[Wyldhare22 in reply to lokibear0803]

Thank you, this is very useful to know!

[Cooolone]

SUV mean is the level of saturation in a given/known organ that allows for comparison to other areas. The radio tracer collects before it is processed and passed by the body. With G68-PET scan, this is mostly in the bladder. But also other spots as noted. Then any other artifacts seen on the image where the tracer collects is compared by the intensity or level of the tracer collected there. Prostate Cancer cells only ate PSMA sensitive, and other than organs the tracer is passing through will then therefore show up on the scan. The level or amount, due to the PSMA sensitivity will allow for an assessment to be performed. Usually, but don't quote me, anything above an SUV of 10 is suspect for PCa. But not always... It is always best to wait for the oncologist to explain the results of the scan. If questionable or you lack confidence in the findings, have them sent for a 2nd opinion... And for the matter, get yourself to a Major Cancer Center and one rated in Excellence! It is there that you'll get the very best in diagnosis and care!

Best Regards

[docbulldog]

I’m still learning about the PSMA scans I had before Plevicto injection and the scans following. Just had a CT and Bone scan 4 weeks after my last injection and I would say a template was used. Not happy about that because it was a key set of scans needed to help determine if I qualify to go on with #3 Plevicto treatment.