If you have prostate cancer, the type of PET scan you get might affect your treatment options. A new analysis of 17 studies involving nearly 1,500 patients found that four different radioactive tracers used in PSMA PET scans show very different levels of activity in the liver.
Two of the tracers, F-piflufolastat and Ga-PSMA-11, had similar liver uptake values (around 5.0 to 5.1). But two others, F-flotufolastat and F-PSMA-1007, showed significantly higher liver activity (7.2 and 12.1, respectively). This matters because doctors sometimes use the liver as a reference to decide if a patient's cancer is "PSMA-positive" and eligible for PSMA-targeted therapy.
If a tracer lights up the liver more, it could make the cancer appear less active by comparison, potentially excluding patients from a treatment that might help them. The study didn't look at actual treatment outcomes or safety, so we don't know if these differences change who gets treated or how well they do. But it raises an important question: should the choice of tracer be standardized?
For now, if you're getting a PSMA PET scan, it's worth asking your doctor which tracer they use and what that means for your results. This is early evidence, not a final answer.
