Expanding the frontiers in Diagnostic Nuclear Medicine: F-18 PSMA & F-18 FDOPA PET CT scans

Introduction to PET CT

PET scans or “Positron emission tomography” is a functional imaging modality, initially introduced for neurological research in the early 1970s. However, currently, this imaging modality forms the back-bone of oncological imaging and is one of the most requested investigations for evaluation of solid cancers. The commercial availability of radiopharmaceutical F-18 FDG (Fluoro-deoxy glucose) or radio-labelled glucose and fusion imaging modality such as PET CT, has helped its advancement from research laboratory to active clinical practice in the early 2000s. 

F-18 FDG PET CT scan

F-18 FDG PET CT scans are usually whole-body examinations which provide information about the structure and function of the tumour or cancer tissue. Apart from cancer imaging, F-18 FDG PET scans of the brain are quite popular and are used for evaluation of neurological disorders like dementia, epilepsy, movement disorders, encephalitis and other psychiatric diseases. Another important application is Cardiac PET scan which aims at diagnosis of myocardial viability or living tissue within the heart. This helps the cardiologists to decide the best treatment for patients with coronary artery disease (CAD). 

New radiotracers for PET CT scan

Globally, a lot of research is going on for the development of newer imaging molecules and radiotracers for PET CT scans. A decade back, Gallium-68 (Ga-68) labelled tracers were introduced for PET CT imaging e.g Ga-68 labelled DOTANOC and PSMA for evaluation of neuroendocrine tumours and prostate cancers. These molecules readily found acceptance among oncologists for evaluation of these malignancies.

F-18 PSMA and F-18 Fluorodopa PET CT scans

These are among the newest radiopharmaceuticals available for PET CT scans in our department. With the availability of these radiopharmaceuticals, we offer the entire spectrum of PET CT scans in our department.

(I) F-18 PSMA PET CT scan: F-18 PSMA is a radiopharmaceutical designed for PET CT imaging of prostate cancers. Prostate cancer is one of the most common cancers of elderly males. F-18 PSMA PET CT scan is currently used for following indications in prostate cancers:

  • Diagnosis and staging of the disease

  • Early treatment response evaluation, to differentiate between responder & non-responder

  • Detection of early recurrence

  • Evaluation of metastatic sites in prostate malignancy

 (II) F-18 Fluorodopa PET CT scan: Primarily, this radiopharmaceutical is used for diagnosis and evaluation of Parkinson’s disease and other movement disorders. However, these scans are also helpful in the evaluation of primary brain tumours (Gliomas), Medullary carcinoma of the thyroid and neuroendocrine cancers.

Indications of F-18 Fluorodopa PET CT scans are:

  • Diagnosis of Parkinson’s disease and other movement disorders

  • Diagnosis of primary brain tumours e.g. Gliomas

  • Radiotherapy planning of primary brain tumours

  • Diagnosis, treatment response evaluation and detection of recurrence in medullary carcinoma thyroid 

  • Evaluation of Neuro-endocrine tumours like Neuroblastomas, Phaeochromocytomas etc


 

Dr Ankur Pruthi

Consultant and Head

Department of Nuclear Medicine & PET CT

Manipal Hospital Dwarka

 

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