PSMA Analysis needed

[CrocodileShoes]

I'm awaiting the visual images from my PSMA FDG scan. In the meantime, I've got a written report and I could do with your help.

The backdrop is that I'm hoping to be considered eligible for PSMA therapy in Melbourne in May-Aug. At the heart of it lies a really simple question (and apologies for my naivety): Does PSMA-Avid mean that I'd be a suitable candidate for treatment? Yes or no?

The more detailed response could come from our resident expertise putting this into simple layman's language:

______________________________________________________________

Radiology Examination 21513517: 07 Mar 2024 12:21

F18 PSMA Prostate

F18 PSMA Prostate

PRE-SCAN: Blood Glucose level (mmolf]): N/A Injection Activity (MBq) : 274.8

INDICATIONS

<03-55 7-035 Metastatic prosta cartine it date diese swer

therapy.

COMPARISON

Multiple prior imaging studies were reviewed, the most recent of which was a

contrast-enhanced CT performed in Leeds on 13/02/2024.

TECHNIQUE

Half-body acquisition from skull b a s e to upper thigh. 275 MBq o f 18E-PSMA

injected. Time of fl i g h t (TOF) and Q. Clear reconstructions used for PET imaging

e v a l u a t i o n . SUV measurements o b t a i n e d from TOF r e c o n s t r u c t i o n .

FINDINGS

As d e m o n s t r a t e d on t h e r e c e n t CT t h e r e is l o c a l l y advanced r e c u r r e n t d i s e a s e

w i t h i n the p e l v i s with a 8 . 8 cm t r a c e r - a v i d p r o s t a t i c mass invading i n t o the

b o w e l o b s t r u c t i o n .

base the laden nearine the mom colon at i t out pe i ence als

e x t e n d i n g s u p e r i o r l y i n t o t h e r e t r o p e r i t o n e u m . F u r t h e r s m a l l e r t r a c e r - p o s i t i v e

nodes are present within the meso-rectum and sigmoid mesentery. In addition

there i s r i g h t retrocrural nodal involvement,t r a c e r - a v i d i n t r a - t h o r a c i c n o d e s

in t h e right h i l a r a n d mediastinal regions and a tracer-positive left

s u p r a c l a v i c u l a r n o d e . T h e k n o w n w i d e s p r e a d b i l o b a r h e p a t i c m e t a s t a s e s a r e a l s o

PSMA-avid and there is extremely widespread sclerotic bony metastatic disease

throughout the axial and proximal appendicular skeleton including the skull

which is tracer positive. The remainder of PSMA biodistribution is unremarkable.

On review of the low-dose CT component there is prominence bibasal and lingular

a c e l e c t a s s , dependent changes within the both lungs, b i l a t e r a l g y n e c o m a s t i a , a

right i l i a c fossa stoma in-situ with an associated parastomal hernia which is

c a l c i fi c a t i o n , t r u n c a l s u b c u t a n e o u s oedema and d e g e n e r a t i v e changes w i t h i n t h e

s p i n e .

ordercomms.leedsth.nhs.uk/i..... 13/03/2024

Report For mr david john price Page 2 of 2

Patient name: MR DAVID JOHN PRICE

Hospital number: 3610605

NHS number: 448 274 9508

The kind don avance recurrent pro eate carcino

[Tall_Allen]

You mention FDG PET but you didn't provide the findings.

[GP24]

"Does PSMA-Avid mean that I'd be a suitable candidate for treatment? Yes or no?" It means yes.

But as Allen mentioned there could be non-PSMA-Avid tumor visible on an FDG PET/CT. If there is more non-PSMA-Avid tumor visible on the FDG PET/CT than on the PSMA PET/CT, you could question if Pluvicto is right for you. Anyway, as there are limited side effects from Pluvicto I would just try that and see if it works for you.

[Mcrpca]

yes