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

What is a PSMA PET Scan?

A PSMA PET/CT scan is an imaging test used for the diagnosis and management of prostate cancer.

PSMA stands for prostate-specific membrane antigen, a protein found on the surface of prostate cancer cells. In a PSMA PET/CT scan, a radioactive molecule that specifically binds to the PSMA protein is used as a tracer. This tracer is combined with a radioactive compound or isotope. The scan detects the areas where this tracer accumulates, thus identifying prostate cancer cells in the body.

PET/CT Visualizing PSMA Active Prostate Cells

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.

Insurance Coverage

FDA approved test in 2021, with Medicare Coverage approved in 2022. Patient must have undergone prior prostate cancer treatment and have a unknown rising PSA for coverage.

Statistics

Prostate cancer is the most common cancer among men, except for skin cancer. In 2023, an estimated 288,300 men in the United States will be diagnosed with prostate cancer. Worldwide, an estimated 1,414,259 people were diagnosed with prostate cancer in 2020. It is the fourth most commonly diagnosed cancer in the world.

Source: https://www.cancer.net/cancer-types/prostate-cancer/statistics

NCCN Commentary on PSMA PET

Because of the increased sensitivity and specificity of PSMA PET tracers for detecting micrometastatic disease compared to conventional imaging (CT, MRI) at both initial staging and biochemical recurrence, the Panel does not feel that conventional imaging is a necessary prerequisite to PSMA-PET and that PSMA PET/CT or PSMA-PET/MRI can serve as an equally effective, if not more effective front-line imaging tool for these patients.

Source: https://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Prostate Cancer Version 4.2023 — September 7, 2023