Psma-pet scan results

[witantric]

PCa Warriors:

I am on Active Surveillance(AS )with one core GL6 at 10%. I am part of a clinical trial that uses PSMA-pet scan to track progression. I guess the goal is to catch progression early and maybe avoid biopsies. The results are given below.

Two things grabbed my attention from the report.

Hepatobiliary: No abnormal uptake. A few cysts. Gallstones in an otherwise unremarkable gallbladder.

Pelvic organs: Prostatomegaly with BPH. No suspicious uptake. Uptake midline posterior transition zone correlates with urinary excreted radiotracer within the prostatic urethra.

Thoughts? What the heck is Prostatomegaly?

Should I be worried about the "few cysts"?

Keep fighting.

Fellow warrior in WI

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Results

Impression

IMPRESSION:

No evidence of primary prostate cancer or metastatic disease.

Narrative

EXAM: PET MRI SKULL BASE TO THIGH

CLINICAL INFORMATION: 61 years old patient with newly diagnosed prostate cancer in the right apex, Gleason score 3+3. Patient is referred for further evaluation.

TECHNIQUE:

Radiopharmaceutical: 8.50 mCi of 18F-DCFPyL

Intravenous injection site: Left antecubital fossa

Uptake time: 60 minutes pelvis, 107 minutes body

Field of view: Skull base to mid-thighs

Intravenous contrast: gadobenate dimeglumine (Multihance) administered as part of concurrent dedicated regional MRI

Oral contrast: Not administered

MRI protocol: Same day MR pelvis with and without contrast

COMPARISON: MR pelvis 3/5/2024 and 10/31/2023.

FINDINGS:

Physiologic background liver standardized uptake value (SUV mean and SUV max) reported for comparison between PET studies: 8.5 and 11.5.

Visualized head/neck: Physiologic uptake of the lacrimal and salivary glands.

Head/neck lymph nodes: No suspicious head/neck lymph nodes.

Lungs: No lung nodules or abnormal uptake.

Pleura/pericardium: No pleural or pericardial effusion.

Thoracic lymph nodes: No suspicious thoracic lymph nodes.

Other chest findings: No abnormal uptake.

Hepatobiliary: No abnormal uptake. A few cysts. Gallstones in an otherwise unremarkable gallbladder.

Spleen: No abnormal uptake.

Pancreas: No abnormal uptake.

Adrenals: Within normal limits.

Kidneys/bladder: No abnormal uptake. Physiologically excreted tracer activity within the renal collecting system and urinary bladder.

Bowel/peritoneum: No suspicious bowel uptake or abnormality.

Pelvic organs: Prostatomegaly with BPH. No suspicious uptake. Uptake midline posterior transition zone correlates with urinary excreted radiotracer within the prostatic urethra.

Abdominopelvic lymph nodes: No suspicious lymph nodes.

Musculoskeletal/soft tissues/skin: No suspicious osseous lesions.

Other: None.

[Tall_Allen]

It just means your prostate is enlarged, which is what BPH is. Cysts are a common benign finding.

[witantric in reply to Tall_Allen]

Thanks Tall_Allen. I don't know why these reports don't put index of terms at the end. It will really help the patients.

[pd63 in reply to witantric]

What if it picked up something asymptomatic and serious but untreatable, does pet scan pick up such things as aneurysms, I'm no expert.Just think maybe sometimes best not to know!

[witantric in reply to pd63]

Good point! The person leading the study did warn me of that. She said that few patients in the study were diagnosed with something else (e.g. bladder cancer, and liver cancer,...) So, she did warn me of that in my pre interview. But you raise a fair point...

[pd63 in reply to witantric]

It's good if something treatable is found but nightmarish otherwise

[witantric in reply to pd63]

That is a fair point. The scan in the study was very extensive (full body and pelvis). The entire thing (injecting tracer, waiting, scans) took >4 hours. They have a lot of patients dropping out of the study. Maybe the duration of the entire procedure is one of them...

[maley2711 in reply to witantric]

yes, these scan of all types find things that may alarm us. My lung nodules are stable.MRI found 2 hernias didn't know I have!!! Back/vertabral abnormalities, etc. Sister had a scan that ended up with her having an unpleasant endoscopy to check for bile duct cancer....threw a scare into her!!! an MRI done for something else reported a bile duct cyst...which are somewhat common evidently..

[Mgtd in reply to witantric]

Simple. They are written by doctors for doctors.

[Mcrpca]

prostatomegaly means the prostate is large. Cysts are common a generally not a problem.

[jethrotullag]

Prostatomegaly = BPH. Redundant statement

[TFU589]

witantric,

Unless I missed it in the earlier posts, but can you provide where this PSMA AS triali is being performed?

Interesting topic, found this article if anyone else wants to take a look. Hope that link works.

Expanding the role of PSMA PET in active surveillance

bmcurol.biomedcentral.com/a...

[witantric in reply to TFU589]

My clinical trial was in Madison, WI with UW health. I think it is this one:

urology.wisc.edu/blog/2023/...

Feel free to message me. I can tell you my experience. Since they combine the PSMA-PET Scan and normal mri scan, the process is actually quite long.

[TFU589]

Thank you for the information, I will contact you if I think I might be interested.

Looks like they are using a new "radiotracer called Pylarify".(F-DCFPyL).

They used that one, and another one in the study that I posted.