At what PSA level should I get a PSMA PET Scan?
PSA level alone is not necessarily the sole data point for deciding whether or not to get a PSMA PET Scan. Many factors are involved in determining your risk of metastatic disease (if PSMA being performed for initial staging) or prostate cancer recurrence (if PSMA being performed for restaging). Many other factors will be evaluated by your ordering physician and will likely include your Gleason Score, other findings at the time of biopsy and/or prostatectomy, history of previous therapy, rate of rise of your PSA, doubling times, etc.
Your treating physician will make a determination as to whether or not PSMA PET Scanning is indicated. One of those factors is the PSA level. Generally speaking, PSMA PET Scans using PSMA (18F-DCFPyL) have been shown to be effective at PSA levels above 0.2ng/mL. Also generally speaking, the higher the PSA level (when restaging patients), the more likely a PSMA PET Scan is to detect and identify recurrent prostate cancer.
Again, these are general guidelines, and it’s important to remember that a “negative” PSMA PET Scan does not necessarily 100% exclude the presence of prostate cancer. However, of all available conventional and advanced imaging techniques available today, PSMA PET Scans show the most promise in being able to identify metastatic disease and/or prostate cancer recurrence and guide further management.