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Why would PSMA-PET scan fail to detect known primary GG2 tumor?

Prostate Cancer | Last Active: Feb 5 5:17pm | Replies (2)
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@jsh327

PSMA PET scans are not 100% accurate. Sensitivity is dependent upon many factors, including tumor size. Many studies including the following: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8832487/. Your doctor should be able to explain why this is possible. It is one of the reasons that prostate cancer often does not show up with low PSA values (< 0.4) after the removal of a prostate.

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mulberry | @mulberry | Feb 5 5:17pm

Sorry for taking so long to get back to you, jsh327. Thank you very much for your reply and link.

As you may have sensed, I was quite worried about my scan when I posted.

Since my posting, I have heard back from my Urologist. I also had a visit with my Radiation Oncologist, he showed me the scan images and how the bladder lights up in a way that can obscure small areas in the prostate. He also checked with their Nuclear medicine/radiology specialist. Thankfully they have assured me that there is no evidence of metastatic disease.

One thing I learned is the concept of micro and macro sites and, if I understood correctly, the cells which can be seen under the pathologist's microscope may not be sufficient to light up on a PSMA-PET scan. So, one concern I had was that I might have one of the more aggressive cancers that don't show up in PSA or PSMA. But the doctors explained that the biopsy tissue would show that "highly differentiated" tissue.

Thanks again!

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