Interesting results. Now if the FDA would only approve the GA68 PSMA PET scan but, even if they do, it’s still pretty iffy on detecting cancer with my PSA level hanging out in the 0.10-0.13 range.
THE "NEW" PROSTATE CANCER INFOLINK
According to a presentation given yesterday at the ASCO meeting here in Chicago, PET/CT scanning with 68Ga-PSMA-11 is more accurate than 18F-fluciclovine PET/CT at detecting recurrent prostate cancer in men with early biochemical recurrence following radical prostatectomy.
The abstract of the presentation by Dr. Calais can be found here, and there is also a report on this presentation on the Renal & Urology News web site.
Basically, Calais and his colleagues carried out a prospective, single-center, single-arm, head-to-head Phase III study of paired 18F-fluciclovine (FACBC) and 68Ga-PSMA-11 (PSMA) PET/CT scans for localizing early biochemical recurrence (BCR) of prostate cancer in men who had previously undergone a radical prostatectomy.
The trial enrolled 50 consecutive patients with BCR and PSA levels ranging from ≥ 0.2 to ≤ 2.0 ng/ml who had not had any salvage therapy at the time they were scanned. All 50 patients were given…
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6 thoughts on “Gallium-68 PSMA vs. fluorine-18 fluciclovine PET/CT scans”
Our doctor has decided that the older methods of mri and cr scans are more reliable. Seems the other is only as reliable as the reader of the scan. We’ve done 2, one in Chicago and the other close to home.(axiom). Working with higher PSA than you, but not over 100.
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Thanks for your comment. It’s really interesting (and sometimes frustrating) to see how different doctors embrace different technologies and treatment options.
I agree that the abilities of the person interpreting the scan results plays a significant role. As these newer imaging technologies become more widespread, I suspect we’ll see reliability go up as those interpreting the results gain more experience.
Thanks again for sharing your thoughts.
Fluciclovine is an amino acid analog (of the amino acid Leucine). It’s uptake into tumor tissue is regulated by several amino acid transporters. This is relatively non-specific to prostate cancer, although it is indeed useful and better than a choline-based technique that preceded it. These earlier techniques are essential based on metabolic differences in the tissues, not whether they are derived from prostate.
On the other hand, PSMA is definitely prostate-specific and there would be a lower likelihood of false-positive indications.
Thanks for the elaboration, Tom. It’s great that there’s so much research going on in the area of finding a better imaging technology.
For me, I want to know where those cancer cells are gathering before starting salvage therapy, and having better imaging will get me closer to that answer.
Thanks again for weighing in.
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Hi Dan, I read this Prostate Cancer Infolink article and thought of you and intended to send you the link https://www.renalandurologynews.com/home/news/urology/prostate-cancer/pet-ct-imaging-for-recurrent-pca-detection-more-accurate-with-psma/
As you had already seen it but I am pleased that you also think this is important scientific research and have repeated it in your blog. I hope the FDA give it the support it needs.
Thanks, Charles. It’s something that’s near and dear to my heart as I try to determine what my next step is going to be.
I contacted UCLA several months ago to learn more about the trial and the option to have the Gallium-68 PSMA PET scan. In a nutshell, my PSA is still too low for the scan to reliably detect anything at this point. But I’m in no rush to have a rising PSA with a faster PSA doubling time. We’ll see where I am at my next PSA in October.
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