Prostate Specific Membrane Antigen (PSMA) PET Imaging for Prostate Cancer

Illustration of a PSMA PET/CT with abnormal tracer activity confined to the left prostate lobe, consistent with biopsy proved cancer. No evidence of PSMA-avid metastasis.

ORDER FORM LINK

If you would like to have your patient receive a PSMA PET/CT exam with NCPIC please find our order form here. 

What is a PSMA PET Scan?

PSMA (Prostate-Specific Membrane Antigen) is a protein highly expressed on prostate cancer cells. PSMA PET/CT imaging uses a radiolabeled tracer that binds to PSMA, allowing detection of cancerous cells with exceptional sensitivity and specificity and was invented out of Johns Hopkins and Heidelberg, Germany. 

What is the current Insurance Coverage for PSMA?

PSMA PET imaging was FDA-approved in 2021 for detecting prostate cancer. Coverage has expanded for initial staging in high-risk patients (Gleason score ≥7, PSA ≥10 ng/mL). Medicare began covering PSMA PET in 2022 for patients with biochemical recurrence (rising PSA) after prior prostate cancer treatment, when the location of the disease is unknown.

There are two types of PSMA imaging isotopes: F-18 PSMA and Ga-68 PSMA. Which does NCPIC use and why?

NCPIC uses Pylarify (F-18 DCFPyL), a PSMA imaging radiopharmaceutical from Lantheus, due to its 110-minute half-life, higher spatial resolution, better tumor-to-background ratio, and enhanced contrast between cancerous and normal tissue compared to Ga-68.

Statistically, how impactful is PSMA PET/CT compared to conventional imaging?

PSMA PET/CT has demonstrated superior accuracy over conventional imaging.

A 2025 JAMA study found that 84% of high-risk nonmetastatic prostate cancer patients had positive PSMA-PET results, 46% were upstaged to M1 disease, and 24% had polymetastatic disease. Another study on biochemical recurrence showed that PSMA PET/CT altered disease staging in 65.5% of cases and changed management plans in 87.3% of patients, highlighting PSMA’s critical role in precise diagnosis and treatment planning.

NCCN Commentary on PSMA PET (2025)

The National Comprehensive Cancer Network (NCCN) clinical guide is linked Prostate Cancer (Version 1.2025 for your reference.   Overall, the NCCN has recognized the superior sensitivity and specificity of PSMA PET tracers in detecting micro metastatic disease compared to conventional imaging.

What are the current Prostate Cancer Statistics in 2025?

According to the American Cancer Society, in 2025, an estimated 313,000 new cases will be diagnosed in the United States. 

Prostate cancer remains the most common non-skin cancer among men with 1 in 8 men being diagnosed with prostate cancer in their lifetime and 60% of prostate cancer diagnosis occurring after age 65. 3.3 million men today have survived or are living with prostate cancer.