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Clinical opinions / 30 Sep, 2019

What is a PSMA-PET scan?

A/Prof David Pryor

How PSMA-PET scans work and why they are important for prostate cancer treatment

At Icon, we use many different tests and scans to ensure our patients receive the best possible treatment for their cancer. For men with prostate cancer, one of the latest and most accurate tools used to detect the location of their cancer is the PSMA-PET scan.

A positron emission tomography (PET) scan is a nuclear medicine scan that tracks the uptake of a small amount of liquid radioactive material (also known as a tracer) in the body after it has been injected into the blood stream. Most PET scans use a type of radiolabeled sugar to detect the cancer, as the majority of cancers grow quickly and need sugar for that growth. The cancers show up as “bright” on the PET scan, providing additional information compared to a standard CT scan.

So, how is a PSMA-PET scan different to a standard PET scan?

Unlike other cancers, prostate cancer generally grows slowly and often doesn’t show up on standard PET scans. For a PSMA-PET scan we use a different type of radioactive tracer that is targeted specifically at a protein present on most prostate cancer cells, called Prostate Specific Membrane Antigen or PSMA. A PSMA-PET scan can see small deposits of prostate cancer down to a few millimetres in size, so it is particularly good at detecting prostate cancer in the early stages when it first starts to spread.

An accurate assessment of whether, and where, the cancer has spread means that we can better tailor treatment to our patients’ individual circumstances. Currently PSMA-PET scans are most useful when undertaken as part of the initial staging for men with localised but ‘high risk’ prostate cancer, for men who appear to have a few limited sites of metastatic spread (called oligometastases) or for men with PSA recurrence after their initial surgery or radiotherapy.

Australia has been an early adopter of this technology and PSMA-PET scans are becoming increasingly available in most cities around the country. At Icon, on-site radiology services provided by Qscan are available at many of our centres across Australia:

A/Prof David Pryor is a Radiation Oncologist at Icon Greenslopes and Icon Redland.

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