# PSMA PET

Source: https://onco.cc/technologies/psma-pet/  
OnCo record `psma-pet` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A prostate-cancer-specific PET scan that finds spread far earlier than CT or bone scan, and tells you whether a matched radioactive drug will work.

## Summary

PSMA PET uses small-molecule urea-based ligands that bind the active site of prostate-specific membrane antigen and are internalised, labelled with 68Ga or 18F. Approved agents are 68Ga-PSMA-11 (Illuccix, Locametz), 18F-DCFPyL (Pylarify, with Pylarify TruVu approved in March 2026) and 18F-rhPSMA-7.3 (Posluma). In clinical use since 2020, it is standard for initial staging of high-risk disease and for biochemical recurrence, where it detects disease at PSA below 0.5 ng/mL, far earlier than CT or bone scan. It is also the theranostic gatekeeper: a PSMA-positive scan is required to select patients for 177Lu-PSMA-617, as in VISION and PSMAfore. Around 10% of patients have PSMA-negative disease, and uptake in ganglia and salivary glands can be mistaken for tumour. It finds spread early and predicts whether the matched radioactive drug will work.

## Fields

- Kind: Technology
- Status: standard-of-care
- Last checked: 2026-09-04
- Principle: Small-molecule urea-based ligands bind PSMA's active site and are internalised.
- Since: 2020
- Strengths: Detects recurrence at PSA <0.5 ng/mL; Theranostic gatekeeper
- Limitations: PSMA-negative disease in ~10%; Uptake in ganglia, salivary glands

## Sources

- VISION: lutetium-177 PSMA-617 radioligand therapy extends survival in advanced prostate cancer (New England Journal of Medicine 2021): https://doi.org/10.1056/NEJMoa2107322
- ClinicalTrials.gov NCT03392428: TheraP (ANZUP 1603): https://clinicaltrials.gov/study/NCT03392428

## Connected records

- cancers: [Biochemical recurrence of prostate cancer](https://onco.cc/cancers/prostate-bcr/), [Ductal adenocarcinoma of the prostate](https://onco.cc/cancers/prostate-ductal-adenocarcinoma/), [Localised prostate cancer, high and very high risk](https://onco.cc/cancers/prostate-high-risk/), [Metastatic hormone-sensitive prostate cancer](https://onco.cc/cancers/prostate-mhspc/), [Neuroendocrine and small-cell prostate cancer](https://onco.cc/cancers/prostate-nepc/), [Non-metastatic castration-resistant prostate cancer](https://onco.cc/cancers/prostate-nmcrpc/), [Prostate cancer](https://onco.cc/cancers/prostate/)
- fronts: [Imaging](https://onco.cc/fronts/imaging/), [Radiopharmaceuticals & Theranostics](https://onco.cc/fronts/radiopharma/)
- technologies: [Biology-guided radiotherapy (RefleXion X1, SCINTIX)](https://onco.cc/technologies/biology-guided-radiotherapy/), [Cyclotron isotope production (F-18, Ga-68, Cu-64, Zr-89, At-211)](https://onco.cc/technologies/cyclotron-isotope-production/), [FES PET (oestrogen receptor imaging)](https://onco.cc/technologies/fes-pet/), [Gamma probes, handheld gamma cameras and dose calibrators](https://onco.cc/technologies/gamma-probes-dose-calibrators/), [Intraoperative fluorescence and Cerenkov imaging systems (SPY, Firefly, LumiSystem, LightPath)](https://onco.cc/technologies/intraoperative-fluorescence-imaging-systems/), [PET (positron emission tomography)](https://onco.cc/technologies/pet/), [PET tracer manufacturing and distribution](https://onco.cc/technologies/pet-tracer-manufacturing/), [PET/CT](https://onco.cc/technologies/pet-ct/), [PSA and MRI-first prostate cancer screening](https://onco.cc/technologies/prostate-screening-psa-mri/), [Quantitative imaging biomarkers (RECIST, PERCIST, SUV, ADC)](https://onco.cc/technologies/quantitative-imaging-biomarkers/), [Radioligand therapy (beta emitters)](https://onco.cc/technologies/radioligand-therapy/), [Radionuclide generators and cold kits](https://onco.cc/technologies/radionuclide-generators-kits/), [Radiopharmacy and cyclotron networks](https://onco.cc/technologies/radiopharmacy-network/), [Stereotactic ablative radiotherapy for oligometastatic disease](https://onco.cc/technologies/sabr-oligometastases/)
- targets: [PSMA](https://onco.cc/targets/psma/)
- drugs: [177Lu-PSMA-I&T](https://onco.cc/drugs/lu177-psma-it/), [Choline C-11](https://onco.cc/drugs/choline-c11/), [Florastamin F-18](https://onco.cc/drugs/florastamin-f18/), [Flotufolastat F-18](https://onco.cc/drugs/flotufolastat/), [Gallium-68 gozetotide (PSMA-11)](https://onco.cc/drugs/ga68-psma-11/), [Illuccix (kit for Ga-68 gozetotide)](https://onco.cc/drugs/illuccix/), [Locametz (kit for Ga-68 gozetotide)](https://onco.cc/drugs/locametz/), [Lutetium-177 vipivotide tetraxetan](https://onco.cc/drugs/pluvicto/), [Piflufolastat F-18 / Pylarify TruVu](https://onco.cc/drugs/pylarify/), [PSMA-1007 F-18](https://onco.cc/drugs/psma-1007-f18/)
- companies: [ABX advanced biochemical compounds](https://onco.cc/companies/abx-advanced-biochemical-compounds/), [Advanced Accelerator Applications (Novartis)](https://onco.cc/companies/advanced-accelerator-applications/), [ANZUP Cancer Trials Group](https://onco.cc/companies/anzup/), [Clarity Pharmaceuticals](https://onco.cc/companies/clarity-pharmaceuticals/), [Lightpoint Medical](https://onco.cc/companies/lightpoint-medical/)
- trials: [ORIOLE](https://onco.cc/trials/oriole/), [POP-RT](https://onco.cc/trials/pop-rt/), [proPSMA](https://onco.cc/trials/propsma/), [PSMA PET Combined With MRI for the Detection of PCa](https://onco.cc/trials/nct07052214/), [PSMA-PreRP](https://onco.cc/trials/psma-prerp/), [TheraP (ANZUP 1603)](https://onco.cc/trials/therap/), [VISION](https://onco.cc/trials/vision/)
- terms: [Biochemical recurrence (BCR)](https://onco.cc/terms/biochemical-recurrence/), [Disease volume (CHAARTED high-volume versus low-volume) and LATITUDE risk](https://onco.cc/terms/disease-volume-chaarted/), [Metastasis-free survival (MFS)](https://onco.cc/terms/metastasis-free-survival/), [Oligometastatic disease](https://onco.cc/terms/oligometastatic/), [PSA kinetics: PSA doubling time and PSA density](https://onco.cc/terms/psa-kinetics/), [Radical prostatectomy](https://onco.cc/terms/prostatectomy/), [Radiographic progression-free survival (rPFS)](https://onco.cc/terms/radiographic-progression-free-survival/), [Theranostics](https://onco.cc/terms/theranostics/), [TNM staging for prostate cancer, and what changed in the 9th edition](https://onco.cc/terms/tnm-prostate-cancer/), [What follows what in castration-resistant prostate cancer](https://onco.cc/terms/prostate-crpc-sequencing/)
- ideas: [A university cyclotron network with shared regulatory files for new tracers](https://onco.cc/ideas/idea-fund-academic-radiopharma-pipeline/), [PSMA-PET-guided metastasis-directed therapy as a curative strategy in oligorecurrent prostate cancer](https://onco.cc/ideas/idea-psma-pet-guided-mdt/), [Qualify PSMA PET tumour volume as a validated imaging biomarker](https://onco.cc/ideas/idea-tr2-psma-volume-qualification/), [Randomise the order of treatment, not only the drugs: a strategy platform for metastatic prostate cancer](https://onco.cc/ideas/idea-prostate-randomise-the-sequence-not-only-the-drugs/), [When the blood test is positive, hunt for the lesion with sensitive imaging](https://onco.cc/ideas/idea-bio2-localise-the-mrd/)
- key papers: [[ 177 Lu]Lu-PSMA-617 versus cabazitaxel in patients with metastatic castration-resistant prostate cancer (TheraP): a randomised, open-label, phase 2 trial](https://onco.cc/key-papers/paper-therap-lancet-2021/), [Accuracy of gallium-68 PSMA-11 PET in localising recurrent prostate cancer: a prospective single-arm clinical trial](https://onco.cc/key-papers/paper-fendler-psma-pet-biochemical-recurrence-jama-oncol-2019/), [Diagnostic accuracy of 68Ga-PSMA-11 PET for pelvic nodal metastasis detection prior to radical prostatectomy and pelvic lymph node dissection: a multicenter prospective phase 3 imaging trial](https://onco.cc/key-papers/paper-psma-prerp-hope-jama-oncol-2021/), [proPSMA: PSMA PET-CT versus conventional imaging for staging high-risk prostate cancer](https://onco.cc/key-papers/paper-propsma-hofman-lancet-2020/), [Prostate-specific membrane antigen expression in normal and malignant human tissues](https://onco.cc/key-papers/paper-silver-psma-expression-normal-malignant-tissues-ccr-1997/), [VISION: lutetium-177 PSMA-617 radioligand therapy extends survival in advanced prostate cancer](https://onco.cc/key-papers/paper-vision-nejm-2021/)
- institutions: [All India Institute of Medical Sciences, New Delhi](https://onco.cc/institutions/aiims-delhi/), [Chulabhorn Hospital / Chulabhorn Royal Academy](https://onco.cc/institutions/chulabhorn-hospital/), [Comprehensive Cancer Center Freiburg (CCCF)](https://onco.cc/institutions/ccc-freiburg/), [European Association of Nuclear Medicine](https://onco.cc/institutions/eanm/), [Excel Diagnostics and Nuclear Oncology Center](https://onco.cc/institutions/excel-diagnostics-nuclear-oncology/), [Inselspital, Bern University Hospital / University Cancer Center Inselspital](https://onco.cc/institutions/inselspital-bern/), [IRCCS Istituto Romagnolo per lo Studio dei Tumori 'Dino Amadori' (IRST)](https://onco.cc/institutions/irst-meldola/), [LMU Klinikum München](https://onco.cc/institutions/lmu-munich/), [Movember](https://onco.cc/institutions/movember/), [Peter MacCallum Cancer Centre](https://onco.cc/institutions/peter-mac/), [Postgraduate Institute of Medical Education and Research, Chandigarh](https://onco.cc/institutions/pgimer-chandigarh/), [Radboudumc Centre for Oncology](https://onco.cc/institutions/radboudumc/), [Society of Nuclear Medicine and Molecular Imaging](https://onco.cc/institutions/snmmi/), [TUM Klinikum rechts der Isar / CCC München](https://onco.cc/institutions/tum-munich/), [Turku University Hospital Cancer Centre](https://onco.cc/institutions/turku-university-hospital/), [UCLA Jonsson Comprehensive Cancer Center](https://onco.cc/institutions/ucla-jonsson/), [UCSF Helen Diller Family Comprehensive Cancer Center](https://onco.cc/institutions/ucsf/), [University Hospital Düsseldorf / CIO Düsseldorf](https://onco.cc/institutions/uk-duesseldorf/), [West German Cancer Center (WTZ), University Hospital Essen](https://onco.cc/institutions/essen-wtz/)
- pairings: [PSMA PET → PSMA radioligand therapy](https://onco.cc/pairings/psma-pet-to-rlt/)
- roadmaps: [Molecular imaging roadmap: FDG → PSMA → FAP → antigen and immune PET](https://onco.cc/roadmaps/molecular-imaging-roadmap/), [Radiopharmaceutical roadmap: iodine → lutetium → actinium](https://onco.cc/roadmaps/radiopharma-roadmap/)
- people: [A. Oliver Sartor](https://onco.cc/people/oliver-sartor/), [Declan G. Murphy](https://onco.cc/people/declan-murphy/), [Ebrahim S. Delpassand](https://onco.cc/people/ebrahim-delpassand/), [Jeremie Calais](https://onco.cc/people/jeremie-calais/), [Johannes Czernin](https://onco.cc/people/johannes-czernin/), [Ken Herrmann](https://onco.cc/people/ken-herrmann/), [Louise Emmett](https://onco.cc/people/louise-emmett/), [Michael Hofman](https://onco.cc/people/hofman-michael/), [Michael J. Morris](https://onco.cc/people/michael-morris/), [Peter Bartenstein](https://onco.cc/people/peter-bartenstein/), [Rahul Aggarwal](https://onco.cc/people/rahul-aggarwal/), [Richard P. Baum](https://onco.cc/people/richard-baum/), [Thomas A. Hope](https://onco.cc/people/thomas-hope/), [Uwe Haberkorn](https://onco.cc/people/uwe-haberkorn/)
- bottlenecks: [Metastasis is understood least and studied last](https://onco.cc/bottlenecks/b-metastasis-biology/)
- collections: [Prostate Cancer Foundation (PCF)](https://onco.cc/collections/prostate-cancer-foundation/)
- pathways: [Organ tropism: seed and soil](https://onco.cc/pathways/organ-tropism-seed-soil/)

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JSON: https://onco.cc/api/v1/entities/psma-pet.json