Gallium-68 PSMA PET/CT is the most successful current imaging technology used to evaluate the spread of prostate cancer to other organs or tissues.
Gallium-68 PSMA PET/CT
It is the most successful current imaging technology used to evaluate the spread of prostate cancer to other organs or tissues. A prostate-specific substance called PSMA is bound to the gallium-68 radioisotope and administered to the patient via intravenous injection, followed by imaging with a PET/CT device. Gallium-68 PSMA binds to specific molecules in prostate cancer cells, allowing the visualization of cancerous tissues. This method does not expose patients to high levels of radiation.
Planning for the examination should be done a day in advance. Therefore, appointments are necessary. After the medication is administered intravenously, there is a waiting period of 45-60 minutes. The imaging duration inside the device is approximately 20 minutes, during which the patient must remain still. The total time spent in the Nuclear Medicine Department may take 2-3 hours. It is recommended to drink plenty of water before and after the examination. Since radiation will remain in the body for a period (8-12 hours) after the examination, it is particularly important to maintain distance from pregnant women and children.
This is the most advanced technology that can be used for the diagnosis of neuroendocrine tumors. There is a special receptor called "somatostatin" on the surface of neuroendocrine tumor cells. DOTATATE is a peptide-based compound that can bind to these receptors. When combined with a radioactive substance called "Gallium-68" and administered to the patient, the PET/CT device can accurately visualize the tissues containing tumor cells. In this method, patients do not receive a high dose of radiation.
Lutetium-PSMA (177Lu-PSMA) treatment is a radionuclide therapy that is increasingly used for patients with advanced prostate cancer. The aim of this treatment is to reduce tumor size and stop the proliferation of tumor cells. In this context, both the progression of the disease can be controlled, and symptoms of advanced disease, such as widespread bone pain and fatigue, can be alleviated. This treatment is generally used when the disease progresses, spreads, or when other treatments such as chemotherapy cannot be tolerated by the patient.
The radiation used in this treatment is designed to destroy cancer cells. The PSMA injected into the body travels toward the tumor and targets cancerous cells. In addition to prostate cancer cells, PSMA is also present in tissues such as salivary glands, tear glands, and kidneys. Therefore, these tissues may also be exposed to radiation. However, this effect is at a low level, and since PSMA binds directly to cancer cells, it does not exhibit the destructive side effects of chemotherapy. Side effects such as dry mouth, temporary fatigue, or a temporary decrease in blood values may occur in some patients. These effects can be monitored through blood tests conducted at regular intervals during the post-treatment period. Additionally, patients who may be at risk for side effects can be identified through tests conducted before treatment decisions are made. With personalized treatment strategies supported by test results and dosimetry studies for each patient, side effects can be kept to a minimum.
The radiation used in Lutetium-Octreotide treatment is designed to destroy cancer cells. Smart molecules that target somatostatin receptors injected into the body travel toward the tumor and target cancerous cells. In addition to cancer cells, somatostatin receptors are found in many different organs. Therefore, these tissues may also be exposed to radiation. However, this effect is at a low level, and since smart molecules bind directly to cancer cells, they do not exhibit any of the destructive side effects of chemotherapy. Side effects may appear in the form of a temporary decrease in blood values in some patients. These effects can be monitored through blood tests conducted at regular intervals during the post-treatment period. Additionally, patients who may be at risk for side effects can be identified through tests conducted before treatment decisions are made. With personalized treatment strategies supported by test results and dosimetry studies for each patient, side effects can be kept to a minimum.
Radium treatment is a type of therapy used in patients with prostate cancer that has metastasized to the skeletal system and bones. The goal of this treatment is to destroy cancer cells in the bones, thereby leading to a reduction or even disappearance of tumors. In addition to its therapeutic effects, it is also used to alleviate pain caused by bone metastases.
The energy level of the radiation used in radium treatment is very high, which gives it significant destructive power. However, this alpha radiation can only travel short distances due to its nature. Here, a short distance refers to a length equivalent to the size of about 2 to 10 cells. Thanks to these properties, alpha radiation destroys cancer cells in the bone without affecting healthy normal cells. The side effects seen after treatment are rare and generally manifest as a temporary decrease in blood values. Therefore, patients should be monitored at regular intervals after treatment.
Ac-225 PSMA is the name of the radioactive substance given to patients in targeted alpha therapy for prostate cancer. It is a treatment that can be used in metastatic advanced prostate cancer patients. The goal of this treatment is to reduce tumor size, stop the proliferation of tumor cells, and destroy tumor cells. Radionuclide therapies are preferred when the disease progresses, spreads, or when other treatments such as chemotherapy are ineffective or their side effects cannot be tolerated by the patient. Generally, the first choice of treatment for patients who have been decided to receive radionuclide therapy is Lutetium PSMA therapy. Lutetium-PSMA has been applied to thousands of patients both worldwide and in Turkey. Among the main goals of Lutetium-PSMA treatment are to reduce symptoms, extend survival, and improve quality of life. However, in some patients, there may be no response to treatment despite Lutetium-PSMA therapy, or the response to treatment may be insufficient. In fact, the disease may continue to progress despite treatment. It is increasingly shown in the medical literature that targeted alpha therapies with Actinium-225-PSMA yield much better results in this group of patients.
The radiation used in Actinium (Ac-225) treatment is designed to destroy cancer cells. The PSMA injected into the body targets cancerous cells as it travels toward the tumor. In addition to prostate cancer cells, PSMA is also found in tissues such as salivary glands, tear glands, and kidneys. Therefore, these tissues may also be exposed to radiation. However, this effect is very low, and since PSMA binds directly to cancer cells, it does not exhibit any of the destructive side effects of chemotherapy. Side effects such as dry mouth, temporary fatigue, or a temporary decrease in blood values may occur in some patients. These effects can be monitored through blood tests and examinations conducted at regular intervals during the post-treatment period.
Last Updated Date: 21 September 2023
Publication Date: 21 September 2023
Nuclear Medicine Department
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