FAQ

Understanding PET and PSMA PET Scans for Prostate Cancer

  • PSMA stands for "prostate-specific membrane antigen," a type of protein found across all prostate tissues, notably in prostate cancer (prostate carcinoma). Though it's mainly associated with prostate tissue, PSMA can occasionally appear in other types of cancers too. Consequently, PSMA PET scans are highly effective in pinpointing the recurrence of prostate cancer and identifying metastatic disease in men newly diagnosed with high-risk conditions.

  • PET, or Positron Emission Tomography, is a technique that visualizes the metabolic activity in tissues and organs, aiding in disease detection and treatment monitoring.

  • A PSMA PET scan involves injecting a PSMA-targeting agent to detect PSMA-positive prostate cancer cells in the body, offering precise imaging of the cancer's location.

  • Several methods, including Digital Rectal Exam (DRE), PSA Test, Transrectal Ultrasound (TRUS), mpMRI, CT Scan, Bone Scan, ProstaScint Scan, and PET Scan, are employed for detection, diagnosis, staging, and monitoring.

  • PSMA PET scans are approved for both initial staging of high-risk prostate cancers and restaging in recurrent cases, providing higher sensitivity and specificity compared to Axumin, which is only approved for restaging.

  • Yes, a PSMA PET scan can help qualify patients for 177 Lu-PSMA radioligand therapy, although eligibility depends on multiple factors and varies by institution and clinical trial requirements.

  • No, the decision is based on various factors including Gleason Score, biopsy findings, previous therapy history, PSA levels, and doubling times. A comprehensive evaluation by your physician is necessary.

  • After arriving and providing your history, you'll receive an intravenous PSMA agent injection, wait for it to distribute, empty your bladder, undergo the scan, and then receive a disc with your scan data. The entire visit lasts about 1.5 hours.

  • Yes, the PSMA tracer piflufolastat (Pylarify) is FDA-approved. Side effects are rare, and it involves a radiation level comparable to a CT scan, with the tracer exiting the body within a few days.

  • Candidates include patients with suspected prostate cancer spread, potentially curable with various treatments, and those with a recurrence indicated by a PSA level rise post-local therapy.

  • No special preparation is needed. You'll receive an intravenous tracer injection, wait for absorption, undergo a 20-minute scan, and then leave. Your cancer doctor will review the scans and report.

  • PSMA PET scans are simpler to prepare for than other PET scans. You don't need to skip meals, avoid certain foods, or drink more water than usual before your scan. Keep taking your regular medications as you normally would. If you have diabetes, you don't need to take any extra steps – just follow your doctor's advice on medication and eating as usual.

  • Oklahoma Prostate Imaging in Oklahoma City is a leading provider of PSMA PET Scans, offering unparalleled expertise and experience in this specialized area. You can find us at 8516 South Portland Ave. OKC, OK 73159. You can schedule an appointment with us here.

  • Among all the imaging methods available today, PSMA PET Scans using PSMA (18F-DCFPyL) stand out for their ability to uncover more prostate cancer sites than any other test. If you or a loved one has prostate cancer, you might have gone through various scans like CT, MRI, or bone scans, each with their benefits and limitations. However, PSMA PET Scans excel in both identifying prostate cancer across the body and confirming that these findings are indeed prostate cancer. For example, while bone scans can pick up a wide range of abnormalities in the bones, they can't distinguish cancer from other conditions like arthritis. MRI scans provide detailed images of the prostate gland but don't offer a full-body view like PSMA PET scans. In essence, PSMA PET Scans are not only highly effective at detecting prostate cancer lesions but also have a high probability of accurately pinpointing prostate cancer.

  • PSA stands for Prostate-Specific Antigen. It's a biomarker found through a blood test and is associated with prostate health. Monitoring PSA levels helps track the status of prostate cancer over time. It's a critical part of managing your health post-diagnosis. A rising PSA level can indicate that prostate cancer is progressing, making it important to discuss the next steps with your doctor.

  • A biomarker is a measurable indicator of your cancer's characteristics, providing crucial information about its nature.

  • The FDA approved PSMA PET scans with 18F-DCFPyL on May 27, 2021. Soon after this approval, commercial production began, allowing various PET scan centers, including PET Imaging Institute of South Florida, to offer PSMA PET scans to patients.

  • PSMA PET scans are not primarily used for initially diagnosing prostate cancer. The standard approach to diagnosing this condition still relies on clinical assessments, traditional imaging, blood tests like PSA, and biopsies. These methods have proven effective in confirming a prostate cancer diagnosis. Once diagnosed, your doctor will consider various factors to determine your risk level. Based on this risk assessment, PSMA PET scans may then become useful for the initial staging of the disease. Additionally, after treatment, these scans can help identify and pinpoint any recurrence of prostate cancer.

  • Starting January 1, 2022, CMS introduced a specific billing code for PSMA PET Scans, enabling Medicare to establish a uniform reimbursement schedule. Consequently, PSMA PET Scans became reimbursable under Medicare. Following Medicare's lead, other major insurance providers have also included PSMA PET Scans in their coverage options. However, whether your insurance covers the scan depends on your personal medical history, needs, and the details of your insurance plan. Contact us for more information.

  • PET scans are billed with two codes: one for the scan and another for the injected tracer. CMS has set specific billing codes for PSMA tracers: Pylarify (January 1, 2022), Illuccix (July 1, 2022), and Locametz (October 1, 2022), also ensuring reimbursement for these tracers.

    Though third-party insurers aren't required to cover these tracers, they often align with Medicare's policies, and many have started to include PSMA tracers in their coverage, usually lagging 3-12 months behind Medicare's updates. However, coverage is contingent on your specific plan and medical needs, and not all insurers may reimburse for these tracers.

    If your insurance doesn't cover the scan or denies authorization, it's worth contacting them to request consideration for a special case. While coverage isn't guaranteed, there's a possibility of convincing them to cover both the scan and tracer costs.

    For uninsured patients or those whose authorization is denied, we offer a discounted scan rate of $1,000 plus the cost of the PSMA tracer, which could reach up to $5,000, depending on the source. Note that our discounted rate is available solely to those without insurance coverage, as contractual obligations with insurance carriers dictate our pricing policies.