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PSMA, a new radioactive marker, detects tumor sites and metastases more accurately than choline PET/CT.
If the PSA level rises again after treatment of prostate cancer, this may be a possible indication of a relapse (recurrence). PSMA imaging with a newly developed slightly radioactive marker for PET (positron emission tomography), detects tumor sites and metastases even more precisely than the conventional choline PET/CT, which is currently still standard in many clinics. Since 2014, the West German Prostate Center has been using the new PSMA PET marker in cooperation with the Clinic and Polyclinic for Nuclear Medicine of the University Hospital Cologne.
"With the PSMA marker, we can achieve an even better contrast between tumor and healthy tissue," explains Dr. Neubauer from the West German Prostate Center. This is because while physicians reach certain limits with conventional choline PET/CT, the new substance can also detect recurrent tumors at PSA values below 1.0. Sensitivity to very small bone metastases is also significantly better.1/2 "This benefits not only patients with a recurrence but also men who are still suspected of having prostate cancer, even though the tissue sample has so far failed to detect a tumor," says the Cologne urologist.
Precise even for PSA values below 1.0
The innovative substance binds exclusively to the protein PSMA (prostate-specific membrane antigen), which is formed in prostate carcinomas and their metastases in up to ten times higher concentrations. The more aggressive the tumor, the more PSMA the tumor cells bind to their surface. In contrast, the protein is only present in very small quantities in men with a healthy prostate. If the slightly radioactively labeled PSMA marker (known as a tracer) is injected into the patient's bloodstream, it accumulates in the tumor tissue and can be visualized using the PET method. The PET examination is performed in the Department of Nuclear Medicine at the University Hospital of Cologne on a modern PET/CT scanner, which is particularly sensitive and requires less radiation exposure than conventional devices.
The examination using PSMA PET/CT improves diagnosis, but also further therapy planning. This enables us to distinguish precisely whether a patient with a prostate cancer recurrence should again undergo local treatment such as radiation or systemic treatment such as chemotherapy or hormone therapy.3 "If we are able to treat local recurrences and metastases even more specifically in the future, this will in turn increase the cure and survival rate," Neubauer sums up. Since November 2014, there has even been the option of PSMA-assisted therapy of PSMA-positive metastases in cooperation with the Department of Nuclear Medicine at the University Hospital of Cologne, in which the PSMA tumor detector is coupled with a therapeutically effective beta emitter.