177Lu PSMA Protocol National _Version 2 FINAL 9 July
Execution of PET scans – acquisition and technique
There are several national and international bodies that issue guidelines. These are often established quite broadly in order to be able to include as many centers as possible.
Ga-68-PSMA PET/CT
Joint EANM and SNMMI procedure guideline for prostate cancer imaging: version 1.0
Ga-68-PSMA en F-18-PSMA tracers
including [F-18]PSMA-1007, [F-18]DCFPyL, [F-18]CTT-1057, [F-18]rh-PSMA-7, [F-18]-JK-PSMA-7, [F-18]AIF-PSMA-11
PSMA Therapy Guideline
There is still a lot of new data coming in about Lu-177-PSMA therapy. There is already a general guideline available from the EANM.
Radiation Hygiene following Lu-177-PSMA Therapy
Indication PSMA PET
Current identified possible indications for imaging with PSMA PET as prepared by Dutch and European urology associations NVU 2019 and EAU
- Prostate carcinoma guideline module
- Biochemical recurrence. After radical prostatectomy, at PSA > 0,2 ng/ml
- In primary staging as an alternative to bone scan and CT scan
- European Directive of the EAU
- who states that a PSMA PET/CT should be offered to patients with a biochemical recurrence (PSA > 0,2 ng/ml). Only if PSMA PET/CT is not available, Fluciclovine or Choline PET/CT can be considered if PSA > 1.0 ng/ml
- This guideline makes no recommendations for the use of PSMA PET/CT as the primary approach
Review PSMA PET
More extensive instruction on structured reporting according to the EANM guideline
Sample blank standard report for initial staging or biochemical recurrence
Response Evaluation
According to current guidelines, PSMA PET is not (yet) indicated for response evaluation after systemic therapy. However, consensus statements are available for possible indications and the assessment of a PSMA scan in the context of response evaluation.
