Psma Pet & Patient Safety During Covid
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Highly Sensitive New Type Of Prostate Cancer Scan Gains Fda Approval
What this means for patients:Today, a new type of prostate cancer scan known as 68Ga-PSMA-11 PET was approved by the FDA. This new PSMA PET scan can detect prostate cancer metastases much earlier, when they are much smaller, which may help to improve treatment of patients with prostate cancer.
PSMA, short for Prostate Specific Membrane Antigen, is a protein that is found in relatively larger amounts on the surface of prostate cancer cells. PSMA PET is a new imaging technology that allows doctors to see PSMA using a PET scanner. Compared to the scans currently used for prostate cancer detection, such as CT, bone scans, and MRI, PSMA PET is more sensitive and can detect much smaller prostate cancer metastases. PSMA PET can now be used for initial and subsequent management decisions in patients with certain types of prostate cancer, in order to determine if and where they have metastases. Researchers are studying how PSMA PET may change treatment and, ultimately, patient outcomes like disease progression and survival.
How does it work? The strategy is based on a small-molecule PSMA binding chemical attached to a radioactive reporter . This conjugate is introduced into the circulation of a patient where the conjugate accumulates at sites of prostate cancer and the unbound conjugate clears rapidly from circulation. The patients body is passed through an imaging camera that records areas where the PET tracer accumulated.
Patients And Reference Standard
From a total of 33 eligible patients , PSMA PET/CT was performed from head to feet in 19 patients and from base of the skull to mid thighs in 14 patients. Mean PSA at the time of imaging was 6.6±11.0 ng/ml . According to the reference standard, in the 33 patients, a total of 95 lesions were detected, of which 57 were lymph node metastases, 28 were bone metastases, 7 were local recurrences and 3 were pulmonary metastases. Eight out of the 95 lesions were proven histopathologically. As described above, the reference standard for the remaining 87 lesions was prior and/or follow-up imaging: MRI in 4 patients, CT in 7 patients, PET/CT in 17 patients and decrease of PSA after radiation therapy in 2 patients.
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Why Ct Scans Just Wont Cut It
On top of that, there are other reasons why cancer diagnoses and treatment plans based on a CT scan are far less accurate and effective than those based on better tests that are available to you now!
So when your cancer diagnosis and treatment plan is based on a CT scan, its appropriate for you to want more information and to wonder if there might be something more you can do to have better confidence and control over what is happening to you.
A cancer diagnosis is overwhelming for the best of us!
It makes perfect sense that if youve gotten a cancer diagnosis, you might feel too overwhelmed with emotion to want to start to tackle the logistics involved in getting the best possible treatment. Where would you even start, right?
Butyou probably already know exactly what you DONT WANT! And that is a good start
- You dont want to constantly be wondering whats happening in your body.
- You dont want to be worrying if your treatment is the right one or if its working.
- You dont want to be anxious all the time, because you dont know if your cancer is starting to grow elsewhere or if your tumors are shrinking.
- And you sure as heck dont want to be wondering for the rest of your life if you are truly cancer freeRight?
We understand how you feel, and we are here to help you. You do not need to do this alone.
We believe that knowledge is power.
Nina Ostend, client Damian Latch, client and colon cancer survivor
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What Is A Pet Scan And Why Is It Used For Prostate Cancer
New GE Discovery IQ PET Scanner
- What is a PET scan? A PET Scan, short for Positron Emission Tomography Scan, is an imaging technique that uses radioactive tracers to clearly image targeted areas in the body. It is primarily used in the diagnosis, initial staging and treatment strategy, to assess the effectiveness of therapy and for restaging, or the evaluation for recurrent disease after treatment.
- Why is a PET scan used for prostate cancer? PET scanning is used for prostate cancer because of its superior ability to target and capture images of prostate cancer on a cellular level. This allows for more accurate staging and restaging in the overall prostate cancer treatment strategy. With new radiotracers being developed and studied, PET scanning continues to lead the way in what will be possible for imaging during treatment of prostate cancer.
PET scanning has revolutionized the way prostate cancer is imaged because of its ability to target cancer on a cellular and molecular level. PET Scanning uses a radioactive tracer that is absorbed and visualized in cancerous cells related to the prostate. This makes a PET scan a better choice than more conventional imaging modalities that only evaluate an anatomical snapshot of abnormalities rather than the functional aspects of a PET scan.
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Hormone Therapy With Radiation
Prostate cancer cells need testosterone to grow. Hormone therapy aims to drastically lower testosterone levels to slow the cancers progression. Although it does not cure the cancer on its own, hormone therapy improves the effectiveness of radiation for high-risk disease and is often recommended in conjunction with radiation therapy for men with intermediate- or high-risk localized disease. However, hormone therapy may have significant side effects. These include loss of libido , hot flashes , changes in mood or memory, loss of bone and muscle density, body fat gain, and adverse effects on sugar or cholesterol metabolism. When offered as short-term therapy in conjunction with radiation, it is often well tolerated. How long a patient should receive hormone therapy remains controversial and depends on how aggressive his cancer is.
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How Is Psma Pet Imaging Different From Current Prostate Cancer Imaging
- Current standard technique called fluciclovine PET, involves physicians injecting patients with a synthetic radioactive amino acid.
- PSMA PET imaging is a FDA approved scan with more precise detection of prostate cancer for better treatment planning and targeted care.
- More effective in pinpointing and eliminating tumors not only in the prostate but also throughout the pelvis and the body in cases where the tumors have migrated.
- Imaging with PSMA PET was able to detect significantly more prostate lesions than fluciclovine PET in men who had undergone a radical prostatectomy but had experienced a recurrence of their cancer.
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Get Peace Of Mind With Your Cancer Care
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Take the first step toward feeling better and having more time with your loved ones: Make sure you have access to the most powerful diagnostic tools and treatments that medical science has to offer with expert guidance from our Scientific Research and Advocacy Team every step of the way.
Prostate Specific Membrane Antigen Ligands
PSMA is a transmembrane protein expressed by the prostate and overexpressed in prostate cancer . PSMA has long been a target for imaging patients with metastatic prostate cancer and was originally the target of indium capromab pendetide , a radiolabeled monoclonal antibody targeting the intracellular portion of the transmembrane PSMA protein. Although this was an improvement at the time over existing imaging techniques, the sensitivity and specificity of the examination were significantly limited due to the targeting of the intracellular portion of the PSMA protein which permitted radiotracer binding only in the setting of cellular apoptosis or necrosis . An additional practical limitation was that the kinetics of indium capromab pendetide mandated imaging at 57 days following radiotracer injection.
Figure 6
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The Future Of Psma Pet
This is a solid study and reflects the real-world experience with PSMA PET-CT in other countries, Dr. Pomper said. Because there are several PSMA-targeted tracers, a next step will be to have them approved for use in the United States outside of clinical trials, he added.
He predicted that, eventually, the different PSMA tracers will be tested head to head.
The Australian trial adds to a growing body of research on improving the detection of metastatic tumors in men with prostate cancer. One imaging agent, fluciclovine F18 which targets prostate cancer cells in a different way than PSMA-targeted tracersis already approved in the United States for use in men with previously treated prostate cancer that appears to be progressing .
PSMA PET-CT is also being studied in this group of men, Dr. Shankar said. One small clinical trial that directly compared PSMA PET-CT with fluciclovine F18 PET-CT showed that the PSMA-targeted scan found more metastatic tumors, regardless of their location. NCI is funding a similar but larger clinical trial.
Dr. Pomper noted that PSMA also is found at relatively high levels in the vasculature of a number of other cancersincluding kidney, thyroid, and breastso hes hopeful that PSMA PET-CT might be useful beyond prostate cancer.
Urologists and radiation oncologists in many places are already ordering this scan as the standard of care, he said.
Predictors Of Management Changes
Among 4 tested parameters , the 68Ga-PSMA-11 PET/CT TNM pattern was the only significant predictor of intended and implemented management changes.
Specifically, the probability of having an intended management change was higher in patients with pelvic nodal disease only than in patients with negative scans . Furthermore, intended management changes occurred more frequently in patients with positive 68Ga-PSMA-11 PET/CT scans than in those with negative scans . Figure 5 illustrates a PSMA T0N1M0 pattern.
68Ga-PSMA-11 PET/CT scan in 70-y-old man with BCR of initially high-risk prostate cancer 1 y after primary radical prostatectomy. Intended treatment before 68Ga-PSMA-11 PET/CT was active surveillance . 68Ga-PSMA-11 PET/CT showed intense 68Ga-PSMA-11 uptake in 4-mm right internal iliac pelvic lymph node . Intended treatment after 68Ga-PSMA-11 PET/CT was surgery, which was implemented. Patient underwent pelvic lymph node dissection 2 mo later, which confirmed metastatic prostatic adenocarcinoma. 68Ga-PSMA-11 PET maximum-intensity projection. Axial CT. Axial 68Ga-PSMA-11 PET/CT.
The probability of having implemented management changes was higher in patients with PSMA T0N1M0 and T0N1M1 patterns than in those with negative scans. Finally, implemented management changes occurred more frequently in patients with positive 68Ga-PSMA-11 PET/CT scans than in those with negative scans .
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Pet/ct For The Diagnosis Staging And Restaging Of Prostate Cancer
Michael Souvatzoglou1, Florian C Gaertner1, Sarah Schwarzenboeck1, Ambros J Beer1, M Schwaiger1and Bernd J Krause1,2
1Nuklearmedizinische Klinik und Poliklinik der Technischen Universität München, Ismaninger Str. 22, 81675, München, Germany
2Klinik und Poliklinik für Nuklearmedizin, Universität Rostock, Germany
- *Corresponding Author:
- E-mail:
Take Time To Make A Treatment Decision
Most prostate cancers grow relatively slowly, so immediate treatment is rarely necessary. Many men can safely take months to decide what to do. The decision process can be complicated. The chosen treatment can significantly affect your life, which makes it especially important to take time to educate yourself and confidently choose the approach that is most appropriate for you.
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How Is Prostate Cancer Treated
There are many treatment options for cancer limited to the prostate gland. You and your doctor should carefully consider each option. Weigh the benefits and risk as they relate to the aggressiveness and/or stage of the cancer as well as your age, overall health, and personal preferences. Standard treatments include:
- Surgery : The surgeon makes an incision in the lower abdomen or through the perineum and removes the prostate. If they cannot remove the entire tumor, you may need radiation therapy. You will need to keep a urinary catheter in place for several weeks after the procedure. Possible side effects can include incontinence and impotence. Some surgeons may use three small incisions to do robot-assisted prostatectomy. This may result in a shorter hospital stay and quicker recovery. This procedure may be preferable for some patients, but not for all.
- External beam therapy : a method for delivering a beam of high-energy x-rays or proton beams to the location of the tumor. The radiation beam is generated outside the patient and is targeted at the tumor site. These radiation beams can destroy the cancer cells, and conformal treatment plans allow the surrounding normal tissues to be spared. See the External Beam Therapy page for more information.
- Active surveillance: No treatment, with careful observation and medical monitoring.
Advanced treatment options may avoid or minimize some of the side effects associated with standard therapies. These options include:
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An enlarged prostate can also be the cause of other problems. If the enlarged prostate is causing symptoms, the best treatment would be a natural remedy. In the meantime, there are treatments for a wide range of conditions that cause a man to experience pain. A common surgical procedure involves an electric loop, laser, or electro-stimulation. The procedure is a safe and effective option for treating enlarged or symptomatic BPH.
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Spectrum Of Pet Radiopharmaca In Pc
18F-FDG remains the workhorse in PET imaging, however with very restricted applications for PC, as its role is limited in cases of neuroendocrine differentiation or of progressive disease presenting such characteristics. This occurs because of low to no glucose consumption by the classic prostatic primary and thereafter by its spread. Thus, the need for specific targeting arose.
Up to recently Choline labeled tracers either by 11C or 18F, were used as promising markers. This radiotracer, initially applied to restaging after biochemical recurrence and staging of high-risk patients has been practically abandoned due its low sensitivity . Other tracers like 11C -acetate or 18F-uorocyclobutane-1-carboxylic acid had been tested without standing up to the expectations presenting equal characteristics to Choline. Similarly, 18F-Uciclovire met the same fate to previously referred tracers .
Up to now, Prostate-specific membrane antigen seems to reign over all other tracers in PET PC imaging. PSMA also known as glutamate carboxypeptidase II, is a transmembrane glycoprotein highly expressed in prostate cancer cells. PSMA expression tends to increase with increased pathological Gleason grade and is thought to be upregulated with the emergence of androgen independence . An example of a PC patient imaged at the same time period with various tracers is illustrated in Figure 1.
Pet Scanning For Prostate Cancer
If you or a loved one has been diagnosed with any type of cancer, there are often many questions left unanswered. For those diagnosed with prostate cancer, a doctor may suggest having a PET scan as a part of an overall plan for treatment and monitoring for any recurrence or progression of disease. We hope this article may be a resource and help answer a few of the most common questions that we receive regarding PET scanning for prostate cancer.
With prostate cancer being the second leading cause of cancer death in American men , new advances in early detection and high-quality imaging for staging and restaging of prostate cancer have become a top priority for the medical community. Comprehensive cancer care requires high-quality imaging and is the driving force behind rapid and ongoing advancements in imaging techniques used for prostate cancer. In recent years, PET scanning for prostate cancer has become an increasingly popular choice to clearly locate and assess the extent of prostate cancer. While there have been many improvements across many conventional imaging modalities such as TRUS, CT, and MRI, this article is intended to highlight the essential role of advanced imaging such as PET scanning for prostate cancer.
Are you looking to learn more about PSMA PET scanning for prostate cancer? If you are in need of a PSMA PET Scan please join our priority list by
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Now Offering Axumin Pet Ct For Imaging Of Recurrent Prostate Cancer
Since one in seven men have prostate cancer, and a third of those treated will experience recurrence, early detection and treatment are important to their health. One main marker of prostate cancer is prostate cancer antigen , a protein that is often elevated in men with prostate cancer. When PSA in the blood indicates that the patient may have prostate cancer, a standard body or bone scan is usually done in order to see where the cancer is. However, these tests are unable to determine the location of cancer until PSA levels are increasingly elevated since the standard FDG PET CT scans are severely limited in uptake for prostate cancer. Axumin PET scans offer a significant advantage- the ability to detect recurrent cancer earlier on as well as a clearer picture of cancers progression, indicating whether or not or to what degree it has metastasized and where it is located.
Facbc Pet/ct For Recurrent Prostate Cancer
| The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. |
| First Posted : November 22, 2007Results First Posted : August 18, 2015Last Update Posted : June 21, 2016 |
Hypothesis:Anti-FACBC PET-CT will adequately detect local and extraprostatic recurrence, and lead to better characterization of disease status in restaging patients.
This is a study that will test a compound that has a small amount of radioactivity attached to it. This substance has a natural tendency to go to prostate tissue. The substance is called FACBC and it is given in the form of an injection into a vein. After the substance reaches the prostate, scans called PET or Positron Emission Tomography, are done. This is similar to having CAT scans or x-rays. Usually a compound called FDG is used for PET scans but this substance is eliminated by the kidneys and cannot reach the prostate. This substance called FACBC is not eliminated by the kidneys and may allow tumors in the prostate to be seen better. It is sometimes difficult to tell if a growth on the prostate is cancer with scans or x-rays that are usually done.
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