RadteraPSMA PET/CT (Ga-68 PSMA-11 / F-18 Piflufolastat)
PET+ ContrastWhole Body
Indications
- Initial staging of intermediate/high-risk prostate cancer
- Biochemical recurrence (rising PSA after prostatectomy/radiation)
- Restaging and localization of metastatic disease
- Patient selection for PSMA-targeted radioligand therapy (Lu-177 PSMA)
Patient prep
- No fasting required
- Hydration encouraged; void before imaging (urinary tracer excretion)
- Provide PSA history and prior therapy
- Verify radiopharmaceutical-specific instructions
Contrast
AgentGa-68 PSMA-11 (Illuccix/Locametz) or F-18 piflufolastat (Pylarify) / F-18 flotufolastat (Posluma)
RouteIV
DoseGa-68 PSMA-11: 3-7 mCi (111-259 MBq); F-18 piflufolastat: ~9 mCi (333 MBq)
TimingGa-68 uptake 50-100 min (typ. 60 min); F-18 piflufolastat ~60 min (range 60-120 min)
Technique
- PET/CT skull base to mid-thigh (or vertex to feet); low-dose CT for AC/localization
- Arms up; ~2-4 min/bed position
- Diuretic/delayed pelvic imaging optional to clear bladder activity
Series / Sequences
| # | Series / Sequence | Plane | Notes |
|---|---|---|---|
| 1 | Whole-body PET | Axial/multiplanar | SUV quantification; PROMISE/miTNM reporting |
| 2 | CT | Axial | Attenuation correction + localization |
Key points
- High sensitivity for nodal/osseous metastases even at low PSA
- Physiologic uptake: salivary/lacrimal glands, liver, spleen, kidneys, bowel, urinary tract (bladder activity can obscure local recurrence)
- F-18 agents: better resolution, longer half-life enables delivery; some lower urinary excretion aids pelvic evaluation
- PSMA-negative disease exists (neuroendocrine dedifferentiation)
References
• SNMMI Appropriate Use Criteria for PSMA PET Imaging (J Nucl Med 2022;63:59)
• Ga-68 PSMA-11 and Pylarify package inserts (FDA)
• Radiopaedia: PSMA PET link
• Ga-68 PSMA-11 and Pylarify package inserts (FDA)
• Radiopaedia: PSMA PET link
Source: Researched — verify against your institution
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Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.