Some people’s prostate cancer does not produce PSMA. In those cases, a PSMA PET scan can’t find anything. Neuroendocrine prostate cancer in particular can’t be seen.

The FDG PET scan is the recommended scan to use next to try to find metastasis that do not produce PSMA.

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If prostate cancer cells do not produce PSMA, a PSMA PET scan will not be effective in detecting metastasis. However, in such cases, FDG PET scans (which target glucose metabolism) may be able to visualize metastasis. This is because some prostate cancers, particularly advanced or neuroendocrine types, can rely more heavily on glucose metabolism for energy and thus show up on FDG PET scans.