I'm having PSMA next week and am confused a little about the equipment used. In all my reading about the test, a CT or MRI is used in conjunction with the PSMA Pet, When I looked at my upcoming test on the portal it says PET SKULLBASE TO MIDTHIGH NOPR SUBSEQUENT. That tells me it's a PET Scan and the area of the body to be scanned. But It doesn't mention PSMA. So I called the radiology department and asked about it and the tech said it was a PSMA. The PSMA injection to be used is PYLARIFY® | Piflufolastat F 18. I also asked if it was combined with CT or MRI and he said no. I feel like he is mistaken. This from a radiology publication: "Combined PET/CT scanners perform almost all PET scans today. These combined scans help pinpoint abnormal metabolic activity and may provide more accurate diagnoses than the two scans performed separately."
I cant imagine Duke Cancer Center would using an obsolete methodology for PSMA Pet Scan. Somehow I need to get to get clarification.
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hwrjr
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My PSMA PET was done on a machine that looked like a CT scanner and produced images that showed the locations of any uptake from different planes. One plane looked down from above, another looked like it was taken between my legs aimed at my head. My RO showed me the images, and along with the planning CT, and the MRI he was able to pinpoint the lesion and during my SBRT was able to boost the dosage to the tumor.
I think you may be a victim of semantics as perhaps it is not a CT scan, but it will produce "CT-like" images.
From radiologyinfo.org : "Many imaging centers combine nuclear medicine images with computed tomography (CT) or magnetic resonance imaging (MRI) to produce special views. Doctors call this image fusion or co-registration. Image fusion allows the doctor to connect and interpret information from two different exams on one image. This leads to more precise information and a more exact diagnosis. Single photon emission CT/CT (SPECT/CT) and positron emission tomography/CT (PET/CT) units can perform both exams at the same time. PET/MRI is an emerging imaging technology. It is not currently available everywhere."
PSMA-PET/CT is a combined machine with a PET radiation detector and a CT X-ray machine in one unit. Please note that you will have to wait 1 hour after getting the injection of radionuclide material before you can get the scan, so that the injection can travel throughout the body and be uptake by any prostate cancer cells.
I had what they called PSMA PET/MR Imaging. They used Gallium for the PSMA IV injection but that is always changing. I waited about 60' before the imaging began. It was one machine. The total time under the machine was 1hr 10 min. The imaging technique was simultaneous according to my 1st Report. My results came in 2 Reports. the 1st Report was called the PET/MR PSMA Skull Base to Mid Thigh. This report discussed findings in the neck, chest, abdomen & pelvis and musculoskeletal. The 2nd report was called a MR PET Prostate w and wo Contrast. This 2nd report read like a 3T MPMRI. So in my mind, it was clearly an MRI. I, also, was confused about the verbage as others have pointed out. I would call the doctor to be clear. Also ask the radiology staff just to be clear. You're going to a National Comprehensive Cancer Center. They will know what they're doing. Good luck.
I just had a F-18 pylarify PET scan last week. It is definitely a CT scan…not an MRI. And as an aside, I learned that I have no detectable cancer in my body. Previous affected lymph nodes and bone lesions are completely gone. This is after three years on Lupron and Aberaterone. Woohoo! I know you will never be told you are ‘cured’ but I am currently cancer free as best as can be detected with current technology. <3
PSMA (Prostate Specific Membrane Antigen) PET (Positron Emission Tomography) scan detects cancer in this way: A molecule is bound to a radioactive substance. This molecule binds to the PSMA membrane that is found on prostate cells and more so to fast-growing (i.e. Cancer cells). This is called "uptake". The radioactive substance (Gallium-68 or Flourine-18) is able to be detected by the PET scan, which works very much like a CT scan does, giving an image 3 dimensions.
The collection of the binding ligand and the radioactive substance enables pretty good locating of prostate cancer tumors (groups of cancer cells) greater than a few millimeters. However, what they call "micro-metastases" are too small to be seen. But this imaging is the best diagnostic tool we have at the moment for locating of prostate cancers.
The radioactive substances have a short decay period ("half-life" is the term you should look up), but just know that you have a radioactive substance in your body which will eventually become less and less radioactive over time and passes out through your body via your kidneys and bladder. So you are told not to hold small children on your lap for a while and be cognizant of where your urine goes (down the toilet in most locations is just fine).
A similar process is may be used to deliver radioactive TREATMENT to prostate cancer (Radionuclide treatment). But since the radioactive substance is more powerful than is used for imaging, wherever the uptake is great, there may be side effects (uptake in the salivary glands sometimes results in "dry mouth syndrome") or undesired radiation of the kidneys or bladder (so getting well-hydrated is a good thing, to reduce the "loiter time" of the radioactive exposure to those organs).
Note: The PSMA antigen is what sluffs off prostate cells into your bloodstream in the normal healthy course of events and is what the PSA test detects. Normal PSA levels indicate normal prostate activity and abnormally high PSA levels in your bloodstream may signal a number of abnormal conditions, recent sexual activity, simple bacterial infection, benign prostate hypertrophy. trauma to the prostate or prostate cancer. After abnormal PSA levels are detected, further diagnosis is probably prudent.
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