Is Pet-Ct Really Valuable For Prostate Cancer Investigations?

I know that PET-CT has been mentioned many times in this forum as valuable for assessment of disease evolution and spread to other organs. I have been rather enthusiastic about it myself, but it appears that (at least) in the particular case of prostate cancer, its usefulness is still subject of scientific debate. That is, there are reports of false positives/negatives in trials using PET and also the best type of radioactive tracer that is used to identify the metabolic activity of certain cancer cells seems questionable. As far as I understand, FDG is the most widespread tracer in use today, while studies have shown that others such as choline or acetate are more accurate in the case of prostate cancer. 

My question this time is:  in PET-CT units open to public are the patients injected with a radioactive tracer that is specifically targeted to the type of cancer they suffer of, or it is just FDG for everyone? Would it even be possible to try several tracers for best accuracy?

I do not wish to spoil anyone's joy about this wonderful method that is available to keep track of cancer cells, but it is peharps good to be realistic about its true capability in particular cases... and ask the right questions before and after such tests.

Thank you and I look forward to your replies. 

 

I'm glad you raised this issue. I'm being treated for prostate cancer and have had to deal with it. My doc routinely gets both FDG and F18 Fluoride PET/CT scans on his patients. I've held off getting the FDG scan because I've read that it isn't very sensitive for prostate metastases since prostate cells don't use much glucose. On the other hand, the F18 Fluoride scan is said to be excellent at detecting bone metastases. One article gave sensitivity and specificity figures of 100% for F18 Fluoride/CT scans. You don't often see numbers that good for any test. For what it's worth, there's a Combidex scan for prostate cancer metastases available in Holland that detects lymph node metastases with nearly 90+ sensitivity and specificity and without the need for a CT scan.

If you are concerned about those tests - ask your Dr. about having a Prostascint test done.