Guidelines and Protocols

1. Execution of PET scans – acquisition and technique

There are several national and international bodies that issue guidelines. These are often established quite broadly in order to be able to include as many centers as possible.

Ga-68-PSMA PET/CT

Joint EANM and SNMMI procedure guideline for prostate cancer imaging: version 1.0

Ga-68-PSMA en F-18-PSMA tracers

including [F-18]PSMA-1007, [F-18]DCFPyL, [F-18]CTT-1057, [F-18]rh-PSMA-7, [F-18]-JK-PSMA-7, [F-18]AIF-PSMA-11

European Nuclear Medicine Guide. Update 2020.

2. PSMA Therapy Guideline

There is still a lot of new data coming in about Lu-177-PSMA therapy. There is already a general guideline available from the EANM.

3. Acquisition of PSMA SPECT after Lu-177-PSMA Therapy

Scan form Lu177

SPECT after Lu-177-PSMA therapy

4. Radiation Hygiene following Lu-177-PSMA Therapy

Radiation hygiene following Lu-177-PSMA therapy

5. Indication PSMA PET

Current identified possible indications for imaging with PSMA PET as prepared by Dutch and European urology associations NVU 2019 and EAU
 

  • European Directive of the EAU
    • who states that a PSMA PET/CT should be offered to patients with a biochemical recurrence (PSA > 0,2 ng/ml). Only if PSMA PET/CT is not available, Fluciclovine or Choline PET/CT can be considered if PSA > 1.0 ng/ml
    • This guideline makes no recommendations for the use of PSMA PET/CT as the primary approach

6. Review PSMA PET

More extensive instruction on structured reporting according to the EANM guideline

Sample blank standard report for initial staging or biochemical recurrence

Response Evaluation
According to current guidelines, PSMA PET is not (yet) indicated for response evaluation after systemic therapy. However, consensus statements are available for possible indications and the assessment of a PSMA scan in the context of response evaluation.