2nd PSMA

[plato123]

T11 vertabrae. Small lytic lesion 1cm SUVmax 2.7. Looking for comparisons to your numbers for PSMA scan. SUVmax results.

Current PSA .23 Doubling time 36months

Pelvic floor is clean no hotspots dr’s are scratching as to why PSA is going up. So they are focused on the T11

[Tall_Allen]

The uptake is too low to be sure. Some types of PCa don’t express psma. Or your tumors may be too small.

[plato123 in reply to Tall_Allen]

what is concerning is PCA that does not produce PSMA is is usually aggressive intra-ductal variants Do you have any insight to this?

[Tall_Allen in reply to plato123]

I don't know why you think that. Many kinds of PCa don't express PSMA, and, as I said, they may be too small.

[tango65]

Discuss getting a 3T MRI of the lesion detected in the T11 to see if there is cancer in the bone marrow.

The SUV of this lesion is to close to the regular SUV of the blood pool to be sure is a met.

If there is cancer is not expressing PSMA the MRI most probable will identify it.

You could also discuss having a 18 F FDG PET/CT since mets with PSMA expression or without PSMA expression will show on this scan .

[MateoBeach]

That lesion is expressing PSMA therefore is highly likely to me a PC metastasis. Small lesions also have lower SUVmax. The MRI is a good idea. But I would want to have it treated with SBRT and not let it go. Consult your RO about it. High SUV is more about predicting response to Pluvicto.