PSMA PET Scan for Prostate Cancer: Procedure & Eligibility for Lutetium-177 Therapy in Turkey
- proficure
- May 12
- 4 min read
What is PSMA?
PSMA stands for Prostate-Specific Membrane Antigen. It is a protein found on the surface of prostate cells. While normal prostate tissue has low levels of PSMA, prostate cancer cells typically produce a very large amount of it. This abundance makes PSMA a target for both imaging and therapy, like a bright flag that marks where the cancer is.
What Is a PSMA PET Scan?
A PSMA PET scan is an imaging examination that allows doctors to see precisely where prostate cancer cells are located in the body. The term “PET” stands for Positron Emission Tomography, a technology that creates three-dimensional images of biological processes inside the body.
For this scan, a small amount of a radioactive tracer, most commonly gallium-68 gozetotide (also known as ⁶⁸Ga-PSMA-11), is given through an intravenous (IV) line into the bloodstream. This tracer is designed to bind to the same PSMA protein that the Lutetium-177 therapy targets. Because prostate cancer cells carry an abundance of PSMA, the tracer accumulates in areas of cancer and emits signals that the PET scanner detects, producing a detailed map showing the location and extent of the disease.
Why Is the PSMA PET Scan Necessary?
The PSMA PET scan serves as the essential gatekeeper to Lutetium-177 PSMA therapy. Before a doctor can recommend the treatment, the patient must undergo this scan. The reason is straightforward: the therapy will only work if the cancer cells express, or “display”, the PSMA protein on their surface. If there is insufficient PSMA, the radioactive medicine will have nothing to bind to, and the treatment will not be effective.
The scan answers two critical questions:
Where is the cancer? The scan provides a whole-body image that shows the location and extent of metastatic spread, including spread to bones, lymph nodes, liver, or other organs. This information helps the doctor understand the full picture.
Is the cancer PSMA-positive? The scan reveals whether, and how strongly, cancer cells take up the PSMA-targeted tracer. Only patients whose tumors demonstrate adequate PSMA uptake, defined by specific medical criteria, are considered eligible for the therapy.
Without this scan, medical teams cannot determine if Lutetium-177 PSMA therapy is likely to benefit the patient.
How Is the Scan Performed?
The PSMA PET scan is an outpatient procedure that typically follows these steps:
Preparation: The patient will be asked to hydrate well before the scan. In most cases, no special fasting or other preparation is required, though you should follow the specific instructions provided by your imaging center.
Injection: A small amount of the gallium-68 PSMA tracer is administered through an intravenous (IV) line into a vein in the arm. The injection itself feels similar to having blood drawn and takes only a few seconds.
Waiting Period: After the injection, the patient waits for approximately 60 minutes. This allows the tracer to circulate through the body and bind to PSMA-positive cells. During this time, the patient may be asked to drink water and empty bladder to help clear unbound tracer from the system.
The Scan Itself: The patient lies on a table that moves slowly through the PET scanner, which is a large, ring-shaped machine. The scan usually takes about 25 to 30 minutes. It is important to lie still; the machine does not cause any pain, and the patient can breathe normally.
After the Scan: Once the images are reviewed for quality, the patient can leave and resume your normal activities. The radioactive tracer naturally decays and is cleared from your body, primarily through urine, over the following hours. You may be advised to drink extra fluids to help flush it out.
The total appointment time is typically around two hours, though the scanning time itself is much shorter.
How Does the Scan Determine Eligibility?
After the scan is completed, a nuclear medicine specialist interprets the images. The assessment focuses on whether the tumors demonstrate sufficient uptake of the PSMA tracer.
The scan must confirm that the cancer cells are “visible” to the radioactive medicine. If the cancer lights up on the PSMA PET scan, there is a high probability that the Lutetium-177 therapy will successfully target and treat those cells.
Important Considerations
Timing matters: Expert guidelines recommend that the PSMA PET scan be performed within three months of planned treatment or since the most recent evidence of disease progression.
Not every patient qualifies: Some patients may have prostate cancer that has lost PSMA expression, or the expression may be uneven, present in some tumors but absent in others. If the scan reveals significant areas of PSMA-negative disease, Lutetium-177 therapy is unlikely to be the right choice, and your doctor will discuss alternative treatment options.
Safety of the tracer: The amount of radiation used in the gallium-68 PSMA tracer is low and is not known to cause any side effects in most patients. The radioactive element decays rapidly and is eliminated from the body within hours.
Summary of Key Points
A PSMA PET scan is an imaging test that uses a radioactive tracer gallium-68 gozetotide to find prostate cancer cells throughout the body.
It is a mandatory first step before Lutetium-177 PSMA therapy because it confirms whether the cancer is PSMA-positive, which is essential for the treatment to work.
The scan is painless, takes about two hours from start to finish, and involves a single IV and a period of lying still in the PET scanner.
Eligibility for Lutetium-177 therapy is based on specific criteria that assess how strongly the tracer binds to your cancer cells.
If the scan does not show sufficient PSMA uptake, alternative treatment strategies will be discussed with your medical team.
This article is intended for patient education purposes. Always discuss your individual situation, treatment options, and any questions you have with your own medical team.
References
University of Chicago Medicine. PSMA PET imaging for prostate cancer. Accessed 2026.
https://www.uchicagomedicine.org/cancer/types-treatments/prostate-cancer/diagnosis/psma-pet-imaging
U.S. Food and Drug Administration. FDA approves gallium 68 gozetotide for prostate cancer imaging. March 23, 2022.
National Cancer Institute. Gallium Ga 68 gozetotide. NCI Drug Dictionary. Accessed 2026.
https://www.cancer.gov/publications/dictionaries/cancer-drug/def/gallium-ga-68-gozetotide
Proficure is a patient navigation service based in Turkey, helping international patients arrange PSMA PET scans, Lutetium-177 therapy, and comprehensive prostate cancer care in JCI-accredited hospitals. Contact us to learn more about planning your scan in Turkey.
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