# PSMA PET

Source: https://nuclide.cc/technologies/psma-pet/  
Nuclide record `psma-pet` (Technology). Data CC BY-NC 4.0, attribute "Data from Nuclide (nuclide.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

- isotopes: [Fluorine-18](https://nuclide.cc/isotopes/f-18/), [Gallium-68](https://nuclide.cc/isotopes/ga-68/), [Germanium-68](https://nuclide.cc/isotopes/ge-68/), [Lutetium-177](https://nuclide.cc/isotopes/lu-177/)
- indications: [Biochemical recurrence of prostate cancer](https://nuclide.cc/indications/prostate-bcr/), [Localised prostate cancer, high and very high risk](https://nuclide.cc/indications/prostate-high-risk/), [Metastatic hormone-sensitive prostate cancer](https://nuclide.cc/indications/prostate-mhspc/), [Neuroendocrine and small-cell prostate cancer](https://nuclide.cc/indications/prostate-nepc/), [Non-metastatic castration-resistant prostate cancer](https://nuclide.cc/indications/prostate-nmcrpc/), [Prostate cancer](https://nuclide.cc/indications/prostate/)
- technologies: [AI in nuclear medicine](https://nuclide.cc/technologies/ai-in-nuclear-medicine/), [Cyclotron isotope production (F-18, Ga-68, Cu-64, Zr-89, At-211)](https://nuclide.cc/technologies/cyclotron-isotope-production/), [FES PET (oestrogen receptor imaging)](https://nuclide.cc/technologies/fes-pet/), [Gamma probes, handheld gamma cameras and dose calibrators](https://nuclide.cc/technologies/gamma-probes-dose-calibrators/), [Germanium-68/gallium-68 generators](https://nuclide.cc/technologies/ge68-ga68-generators/), [PET (positron emission tomography)](https://nuclide.cc/technologies/pet/), [PET tracer manufacturing and distribution](https://nuclide.cc/technologies/pet-tracer-manufacturing/), [PET/CT](https://nuclide.cc/technologies/pet-ct/), [Quantitative imaging biomarkers (RECIST, PERCIST, SUV, ADC)](https://nuclide.cc/technologies/quantitative-imaging-biomarkers/), [Radiohybrid (rh) chemistry](https://nuclide.cc/technologies/radiohybrid-chemistry/), [Radioligand therapy (beta emitters)](https://nuclide.cc/technologies/radioligand-therapy/), [Radionuclide generators and cold kits](https://nuclide.cc/technologies/radionuclide-generators-kits/), [Radiopharmacy and cyclotron networks](https://nuclide.cc/technologies/radiopharmacy-network/)
- targets: [PSMA](https://nuclide.cc/targets/psma/)
- drugs: [177Lu-PSMA-I&T](https://nuclide.cc/drugs/lu177-psma-it/), [Choline C-11](https://nuclide.cc/drugs/choline-c11/), [Copper-64 SAR-bisPSMA](https://nuclide.cc/drugs/cu-64-sar-bispsma/), [Florastamin F-18](https://nuclide.cc/drugs/florastamin-f18/), [Flotufolastat F-18](https://nuclide.cc/drugs/flotufolastat/), [Gallium-68 gozetotide (PSMA-11)](https://nuclide.cc/drugs/ga68-psma-11/), [Illuccix (kit for Ga-68 gozetotide)](https://nuclide.cc/drugs/illuccix/), [Locametz (kit for Ga-68 gozetotide)](https://nuclide.cc/drugs/locametz/), [Lutetium-177 vipivotide tetraxetan](https://nuclide.cc/drugs/pluvicto/), [Piflufolastat F-18 / Pylarify TruVu](https://nuclide.cc/drugs/pylarify/), [PSMA-1007 F-18](https://nuclide.cc/drugs/psma-1007-f18/)
- companies: [ABX advanced biochemical compounds](https://nuclide.cc/companies/abx-advanced-biochemical-compounds/), [Advanced Accelerator Applications (Novartis)](https://nuclide.cc/companies/advanced-accelerator-applications/), [Bracco Imaging](https://nuclide.cc/companies/bracco/), [CellBion](https://nuclide.cc/companies/cellbion/), [Clarity Pharmaceuticals](https://nuclide.cc/companies/clarity-pharmaceuticals/)
- trials: [CONDOR](https://nuclide.cc/trials/condor/), [ENZA-p](https://nuclide.cc/trials/enza-p/), [LIGHTHOUSE](https://nuclide.cc/trials/lighthouse/), [LuTectomy](https://nuclide.cc/trials/lutectomy/), [OSPREY](https://nuclide.cc/trials/osprey/), [POP-RT](https://nuclide.cc/trials/pop-rt/), [PRINCE](https://nuclide.cc/trials/prince-trial/), [proPSMA](https://nuclide.cc/trials/propsma/), [SPOTLIGHT](https://nuclide.cc/trials/spotlight/), [TheraP (ANZUP 1603)](https://nuclide.cc/trials/therap/), [VISION](https://nuclide.cc/trials/vision/)
- institutions: [All India Institute of Medical Sciences, New Delhi](https://nuclide.cc/institutions/aiims-delhi/), [ANZUP Cancer Trials Group](https://nuclide.cc/institutions/anzup/), [European Association of Nuclear Medicine](https://nuclide.cc/institutions/eanm/), [Excel Diagnostics and Nuclear Oncology Center](https://nuclide.cc/institutions/excel-diagnostics-nuclear-oncology/), [Inselspital, Bern University Hospital / University Cancer Center Inselspital](https://nuclide.cc/institutions/inselspital-bern/), [IRCCS Istituto Romagnolo per lo Studio dei Tumori 'Dino Amadori' (IRST)](https://nuclide.cc/institutions/irst-meldola/), [LMU Klinikum München](https://nuclide.cc/institutions/lmu-munich/), [Peter MacCallum Cancer Centre](https://nuclide.cc/institutions/peter-mac/), [Radboudumc Centre for Oncology](https://nuclide.cc/institutions/radboudumc/), [Society of Nuclear Medicine and Molecular Imaging](https://nuclide.cc/institutions/snmmi/), [TUM Klinikum rechts der Isar / CCC München](https://nuclide.cc/institutions/tum-munich/), [Turku University Hospital Cancer Centre](https://nuclide.cc/institutions/turku-university-hospital/), [UCLA Jonsson Comprehensive Cancer Center](https://nuclide.cc/institutions/ucla-jonsson/), [UCSF Helen Diller Family Comprehensive Cancer Center](https://nuclide.cc/institutions/ucsf/), [University Hospital Düsseldorf / CIO Düsseldorf](https://nuclide.cc/institutions/uk-duesseldorf/), [West German Cancer Center (WTZ), University Hospital Essen](https://nuclide.cc/institutions/essen-wtz/)
- terms: [Activity prescription: fixed versus dosimetry-guided dosing](https://nuclide.cc/terms/activity-prescription/), [Biochemical recurrence (BCR)](https://nuclide.cc/terms/biochemical-recurrence/), [Flare phenomenon](https://nuclide.cc/terms/flare-phenomenon/), [Oligometastatic disease](https://nuclide.cc/terms/oligometastatic/), [PSA kinetics: PSA doubling time and PSA density](https://nuclide.cc/terms/psa-kinetics/), [PSMA-RADS (PSMA reporting and data system)](https://nuclide.cc/terms/psma-rads/), [Radical prostatectomy](https://nuclide.cc/terms/prostatectomy/), [Specific activity and molar activity](https://nuclide.cc/terms/specific-activity/), [Theranostics](https://nuclide.cc/terms/theranostics/)
- pairings: [PSMA PET → PSMA radioligand therapy](https://nuclide.cc/pairings/psma-pet-to-rlt/)
- roadmaps: [Molecular imaging roadmap: FDG → PSMA → FAP → antigen and immune PET](https://nuclide.cc/roadmaps/molecular-imaging-roadmap/), [PSMA theranostics roadmap: antigen discovery → PSMA PET → 177Lu-PSMA-617 → earlier lines and alpha](https://nuclide.cc/roadmaps/psma-theranostics-roadmap/), [Radiopharmaceutical roadmap: iodine → lutetium → actinium](https://nuclide.cc/roadmaps/radiopharma-roadmap/)
- ideas: [A university cyclotron network with shared regulatory files for new tracers](https://nuclide.cc/ideas/idea-fund-academic-radiopharma-pipeline/), [Bispecific PSMA/GRPR radioligands for discordant prostate cancer lesions](https://nuclide.cc/ideas/idea-bispecific-radioligands/), [PSMA-PET-guided metastasis-directed therapy as a curative strategy in oligorecurrent prostate cancer](https://nuclide.cc/ideas/idea-psma-pet-guided-mdt/), [Qualify PSMA PET tumour volume as a validated imaging biomarker](https://nuclide.cc/ideas/idea-tr2-psma-volume-qualification/), [Terbium-161 instead of lutetium-177 in the same ligands](https://nuclide.cc/ideas/idea-tb161-instead-of-lu177/)
- collections: [Prostate Cancer Foundation (PCF)](https://nuclide.cc/collections/prostate-cancer-foundation/)
- people: [A. Oliver Sartor](https://nuclide.cc/people/oliver-sartor/), [Declan G. Murphy](https://nuclide.cc/people/declan-murphy/), [Ebrahim S. Delpassand](https://nuclide.cc/people/ebrahim-delpassand/), [Jeremie Calais](https://nuclide.cc/people/jeremie-calais/), [Johannes Czernin](https://nuclide.cc/people/johannes-czernin/), [Ken Herrmann](https://nuclide.cc/people/ken-herrmann/), [Louise Emmett](https://nuclide.cc/people/louise-emmett/), [Matthias Eiber](https://nuclide.cc/people/matthias-eiber/), [Michael Hofman](https://nuclide.cc/people/hofman-michael/), [Michael J. Morris](https://nuclide.cc/people/michael-morris/), [Peter Bartenstein](https://nuclide.cc/people/peter-bartenstein/), [Phillip H. Kuo](https://nuclide.cc/people/phillip-kuo/), [Rahul Aggarwal](https://nuclide.cc/people/rahul-aggarwal/), [Richard P. Baum](https://nuclide.cc/people/richard-baum/), [Stefano Fanti](https://nuclide.cc/people/stefano-fanti/), [Thomas A. Hope](https://nuclide.cc/people/thomas-hope/), [Uwe Haberkorn](https://nuclide.cc/people/uwe-haberkorn/), [Wolfgang P. Fendler](https://nuclide.cc/people/wolfgang-fendler/)
- key papers: [Appropriate use criteria for prostate-specific membrane antigen (PSMA) PET imaging](https://nuclide.cc/key-papers/paper-jadvar-snmmi-psma-auc-jnm-2022/), [LuPSMA trial: single-arm phase 2 study of 177Lu-PSMA-617 in metastatic castration-resistant prostate cancer](https://nuclide.cc/key-papers/paper-hofman-lupsma-lancet-oncol-2018/), [PSMAfore: 177Lu-PSMA-617 versus a change of androgen receptor pathway inhibitor in taxane-naive mCRPC](https://nuclide.cc/key-papers/paper-psmafore-lancet-2024/), [TheraP: [177Lu]Lu-PSMA-617 versus cabazitaxel in metastatic castration-resistant prostate cancer](https://nuclide.cc/key-papers/paper-therap-lancet-2021/), [VISION: lutetium-177 PSMA-617 radioligand therapy extends survival in advanced prostate cancer](https://nuclide.cc/key-papers/paper-vision-nejm-2021/)
- opportunities: [GRPR imaging when the PSMA scan is negative](https://nuclide.cc/opportunities/opp-grpr-psma-negative-prostate/)
- bottlenecks: [Authorized user shortage for radionuclide therapy](https://nuclide.cc/bottlenecks/b-authorized-user-shortage/), [Site readiness and referral pathway delays](https://nuclide.cc/bottlenecks/b-site-readiness-referral/)
- fronts: [Molecular imaging](https://nuclide.cc/fronts/f-molecular-imaging/), [Radioligand therapy](https://nuclide.cc/fronts/f-radioligand-therapy/)

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