Question about PSMA PET scan -what to be asking

[StrongFives]

I’m three years out from SBRT for low risk (3 plus 4) prostate cancer. I’m scheduled for a PSMA scan next week due to a 1.4 rise in psa. What questions should I be asking about the scan to be sure I get the most accurate results? Are there particular radioactive agents that are better than others? Particular machines better than others? Any reason not to get the scan? Many thanks to you all.

[Tall_Allen]

The currently approved PSMA indicators are excreted in the urine, so false positives are possible if SUV max is low. Ask for an mpMRI too. The two together are best for finding intraprostate tumors.

[StrongFives in reply to Tall_Allen]

Thanks Tall. Much appreciated. Can you clarify if the mpMRI is to be done with the PSMA scan? I think my doctor said something about having a CT at the same time as the PSMA scan but not MRI. Also is there anything to be asking pre-test about SUV?

[Tall_Allen in reply to StrongFives]

PET and CT are done together in the same machine. There are PET/MRI combo machines, but they are rare. mpMRI is different from MRI. It has to be done separately from the PET/CT.

SUV max is what it is - nothing to be done in advance. Xtandi might increase PSMA expression in the short term, so you might discuss taking it from now until the PET scan.

[StrongFives in reply to Tall_Allen]

Very helpful. Thanks.

[StrongFives]

Is there utility to getting pet-ct if I can’t get pet mri?

[Tall_Allen in reply to StrongFives]

I probably didn't explain that well.

A PET and a CT are built into the same machine. They always come together. Forget about the combined PET/MRI - there are maybe a dozen in the whole US.

I am suggesting a separate mpMRI, not a PET/MRI.

[dans_journey]

Hey Strong,

I had a PSMA PET scan at UCLA on 30 November 2021 along with a concurrent CT scan. I documented my experience in a blog post in case you want to know what it's like. Good luck!

dansjourney.com/2021/12/01/...