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East-Tallinn Central Hospital made an important step forward in the therapy of patients with prostate cancer

19. January 2018

On Friday, January 12th, 2018 the first 18F-PSMA PET/CT scans in Estonia were performed in patients with prostate cancer.

On Friday, January 12th, 2018 the first 18F-PSMA PET/CT scans in Estonia were performed in patients with prostate cancer. Scans were performed in two patients with biochemical relaps after surgical treatment, and in two patients with primary diagnosis in evaluating the dissemination of the disease. Based on the examination results, it is possible to choose the best treatment method for every single patient.

PSMA or prostate-specific membrane antigen binds to prostate cancer cells in the primary and also in metastatic lesions.

18F is a radioactive isotope of fluorine, it enables visualisation of the PSMA molecules by means of a hybrid imaging device. The hybrid imaging scanner consists of a positron emission tomograph (PET) and a computer tomograph (CT). The major advantage of PET/CT scan is the big imaging area – as a patient is examined from the base of skull to the midthighs, it is possible to find metastases outside the pelvic area also.

18F-PSMA PET/CT examination is predominantly used in case of biochemical relapse of prostate cancer. This examination allows very early detection of recurrent lesions in patients with very slight elevation of prostate-specific antigen (PSA) (starting from 0.1–0.2 ng/ml). Furthermore, the 18F-PSMA PET scan is beneficial in patients with primarily diagnosed high-risk prostate cancer (Gleason score >7, PSA >20 ng/ml, clinical stage T2c – 3a).

The implementation of this innovative method was made possible by international cooperation between Nuclear Medicine and Urology Centres of the East-Tallinn Central Hospital (Estonia), MAP Medical Technologies OY (Finland) and Alliance Medical BV (Netherlands).

A – PET-scan from the base of skull to midthighs. Physiological 18F-PSMA uptake in the salivary glands, kidneys, liver, spleen, intestines and urinary bladder. Multiple small recurrent lesions are revealed in the pelvic area.

B – CT-scan: small round nodules in front of the coccyx.

C – PET and CT images combined: lesions in the pelvic area in front of the coccyx are labelled with 18F-PSMA.

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