Experience With PSMA PET Imaging

By GU Oncology Now Editors - Last Updated: April 4, 2022

This interview is part two of a roundtable led by Dr. Daniel George, Professor of Medicine, and Surgery in the Duke Cancer Institute, featuring Dr. Oliver Sartor, Medical Director of the Tulane Cancer Center; Dr. Preston C. Sprenkle, urologic surgeon and a urologic oncologist at Yale University; and Dr. Rana McKay, GU medical oncologist at the University of California-San Diego.

In this segment, Dr. George spoke to Dr. Sprenkle about his experience with PSMA PET scans. Dr. Sprenkle noted some challenges (of using PSMA PET), but expressed that the potential of Lutetium-based PSMA treatments is very exciting.

Dr. Daniel George:

Preston, I mean, from a urologic perspective, you guys are ordering a lot of PSMA PET scans now. I’m sure in the recurrent disease setting and whatnot, you’re seeing some variation. How does this resonate with you in terms of what your experience is with PET imaging?

Dr. Preston C. Sprenkle:

Yeah. So, I mean, we definitely are using it more. I think one of the challenges, we’re still defining how to act on things that are visible on PSMA that are small. I mean, we’re still not sure exactly how to interpret that compared to our previous standard of care imaging, like bone scan and CAT scan.

We are, I think, aggressively treating patients, but I think we’re all still waiting to see how that is going to work. I mean, this is with the standard of care. The introduction of Lutetium-based PSMA treatments, the potential for that is very exciting. I think that’s where we are at this point, I mean, where we have not had the opportunity to offer this yet on a trial basis in our center, but we’re very excited to see where it goes.

Dr. George:

Absolutely. It is interesting. We’re seeing this uptake early in the disease and we’re seeing it persist all the way through the natural history of this disease through hormonal therapy into castration resistance, and even into chemotherapy refractory settings.

I think that’s really helpful and I think something for us to think about as we look at these images and report on them. They’re not necessarily reporting on these kinds of ratios, but there’s things for us to take into consideration.

Watch part three of the roundtable segment to hear Dr. McKay discuss the palliative benefits of Lutetium-177 PSMA.

In additional segments, the panel discusses an overview of lutetium-177-PSMA and the VISION study, if lutetium-177 is perfect, the limitations and advantages of lutetium-177-PSMA, and additional PSMA therapies being studied.

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