Here is what I have learnt about PMSA PET/CT (prostate-specific membrane antigen , positron emission tomography/ computerized tomography) scans over the last 10 days:
An NHS PET/CT scan was use F18 Choline and has now been surpassed by newer tracers.
Ga68 (Gallium) is a PSMA radioactive tracer that is available in the UK. There is another PSMA tracer, confusingly called F18, but I have not found a site that uses this in the UK. Below is a quote I received from a Dr in Germany which I think explains the difference between the two very well:
“the radioactive tracer, i mentioned in the last email, was not F18 Choline. This is an old radiopharmaceutical and , i agree with you, not so accurate as the PSMA tracer. I was referring to F18 PSMA tracer. It is actually the same molecule (PSMA) but the radioactive isotope is F18. This tracer does not leave the body through the kidneys and the bladder, like Ga68 PSMA tracer does, but through the liver and the gallbladder. That means that the great advantage of the nonurinary excretion, is the better evaluation of the prostate bed because in this case there is no radioactivity in the bladder that would confuse our results. According to many scientific articles from our department F18 PSMA is more sensitive and can detect local recurrence earlier and more accurate comparing to Ga68 PSMA.I strongly believe that in your case with a PSA of 0.12 the F18 PSMA tracer is more suitable comparing to Ga68 PSMA.”
From my research I agree with what the Dr from Heidelberg Hospital says, and I am provisionally booked in for a scan on the 30th March, cost 2,100 Euros.
However because of the Coronovirus I am concerned that I will not be allowed to travel to Germany by then, so I am having a Ga68 scan at the London Clinic today, cost £2,640. If the results are not medically conclusive and my consultant thinks it is ok to wait another two weeks I will then go to Germany.
I am self funding the scans and it is definitely worth ringing around, as the hospital my consultant initially referred me to (Windsor based) had a 4 week waiting list (and took 5 days to return my call) The Royal Marsden and Paul Strickland Scanner Centre quoted "within two weeks" and the London Clinic a week. Communicating with Germany via e-mail, and they are very efficient.
I will keep the site updated with my progress.