Prostate Cancer Imaging

Understanding prostate cancer imaging

A variety of imaging scans may be used to help your doctor biopsy, diagnose, and stage prostate

cancer. Imaging can also help determine if and where the cancer has spread, help plan treatment,

or determine if treatment is working.

^{CT=Computed Tomography; MRI=Magnetic Resonance Imaging; PET=Positron Emission Tomography; PSMA PET=Prostate-Specific Membrane Antigen PET}

Be sure to talk to your doctor about which scans might be best for you. Here are some questions to get you started:

• What are the differences between a CT scan, MRI scan, and PSMA PET scan?
• Will I need more than one imaging scan?
• How long do these scans take and how do I prepare?
• How often will I need to have scans?
• What kind of imaging agent will be used?
• Should I be concerned about side effects from any of the imaging agents?
• Does my PSA level have to be rising to qualify for any of these imaging scans?
• What will the results tell me?

Conventional imaging

Conventional imaging options usually include:

• Ultrasound – Can be used to look for suspicious areas in the prostate
• Bone Scan – Shows prostate cancer that may have spread to bones
• MRI Scan – Can help determine if a biopsy is needed, guide needles for a biopsy, and help determine the stage of prostate cancer
• CT Scan – Can help detect prostate cancer in lymph nodes and, after a recurrence, can help determine organ involvement

What is PSMA?

PSMA = Prostate-Specific Membrane Antigen

PSMA is a protein found on the surface of normal prostate cells, but it is found in higher amounts on prostate cancer cells. It is present in more than 80% of prostate cancer cells in men with prostate cancer. PSMA has been the subject of extensive and promising research over the last several decades. It is now used as a target for imaging to diagnose metastatic or recurrent prostate cancer, and it is also being explored as a target for medications that can treat prostate cancer. This dual purpose is why some refer to PSMA as a “theranostic” – a combination of the terms ‘therapeutics’ and ‘diagnostics’.

PSMA PET scan

A PSMA PET (positron emission tomography) scan is an imaging procedure used to help detect prostate cancer cells within the body. For this procedure, a radioactive agent is injected into the bloodstream prior to the PET scan. The agent then attaches to the PSMA protein on the prostate cancer cells. Once there, it glows in the PET images that are taken to indicate where prostate cancer cells that have traveled outside the prostate may be. This procedure allows prostate cancer cells to be found that may not have been picked up on traditional scans like CT scans and bone scans. A few PSMA PET imaging agents are now approved by the FDA for use in patients whose prostate cancer has recurred or spread.