Some people do not produce PSMA, but less than 10% of prostate cancer patients have this problem. Many of them are due to neuroendocrine prostate cancer. Some patients have PSMA for some lesions, but not for others, so the scan can only see some of the metastasis.

The FDG scans can detect those lesions that don’t produce any PSMA. The choline scan can see some neuroendocrine cancers because they may be only partially converted and some PSMA tissue can still be there.

The choline scan is only available for Mayo.

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While a choline PET scan is primarily used for imaging prostate cancer, it can also be useful in visualizing neuroendocrine prostate cancer (NEPC). However, NEPC can also be visualized using other imaging techniques, such as PSMA PET/CT and FDG PET/CT.

While PSMA PET scans are primarily used for prostate cancer, they can sometimes detect neuroendocrine cancer, particularly when it exhibits neuroendocrine differentiation. However, PSMA is not the primary or most reliable tracer for neuroendocrine tumors, and somatostatin receptor based PET scans are often preferred.