Prostate Cancer Imaging · University Urology, PC · Knoxville, TN
PSMA PET Imaging for Prostate Cancer
The most sensitive staging and restaging tool available for prostate cancer. University Urology coordinates PSMA PET across the region — ordering, insurance authorization, and actionable interpretation for every patient who needs it.
About PSMA PET
What Is PSMA PET Imaging?
PSMA PET (Prostate-Specific Membrane Antigen Positron Emission Tomography) is a molecular imaging scan that detects prostate cancer cells with far greater sensitivity than conventional CT or bone scan. It works by targeting PSMA — a protein that is overexpressed on the surface of most prostate cancer cells — with a radioactive tracer that lights up on imaging wherever cancer is present.
Conventional imaging misses small deposits of prostate cancer that PSMA PET can detect. This changes treatment decisions. A man whose cancer appears localized on CT and bone scan may have microscopic regional or distant spread visible only on PSMA PET — and knowing that changes everything about how we approach his care.
PSMA PET is now endorsed by major guidelines including NCCN for staging high-risk disease, evaluating biochemical recurrence, and selecting patients for PSMA-targeted therapy (Pluvicto).
Why It Matters
PSMA PET Detects What Conventional Imaging Misses
Detects lesions as small as a few millimeters — far beyond the resolution of CT or bone scan.
Directly targets prostate cancer cells — reducing false positives from benign lymph nodes or bone changes.
Changes management in up to 50% of patients compared to conventional staging. Avoids unnecessary surgery, guides radiation fields, and identifies Pluvicto eligibility.
Clinical Indications
When We Order PSMA PET
PSMA PET is not a routine screening tool — it is ordered strategically based on where a patient is in their prostate cancer journey and what decision needs to be made. University Urology orders PSMA PET for the following indications:
High-Risk & Unfavorable Intermediate-Risk
For men with unfavorable intermediate-risk, high-risk, or very high-risk localized prostate cancer, PSMA PET is ordered before treatment to ensure the disease is truly localized before committing to surgery or radiation.
Regional & Metastatic Disease
When clinical staging suggests possible nodal or distant spread, PSMA PET defines the extent of disease with far greater accuracy than conventional CT and bone scan — directly shaping whether local or systemic therapy is the right approach.
Biochemical Recurrence After Treatment
PSA rise after radical prostatectomy or radiation is one of the most common indications. PSMA PET localizes recurrence — distinguishing local failure from regional or distant spread — even at very low PSA levels where conventional imaging is negative.
Augmenting Focal Therapy Candidacy
In select cases where clinical staging is equivocal or tumor characteristics raise questions about disease extent, PSMA PET can provide additional confidence in focal therapy suitability. It is used selectively — not routinely required — when it is likely to change the treatment decision.
Response to Systemic Therapy
For men on ADT, novel androgen inhibitors, or chemotherapy for metastatic disease, PSMA PET provides objective assessment of treatment response — identifying progression earlier than PSA alone.
PSMA-Targeted Therapy Selection
FDA approval of Pluvicto (177Lu-PSMA-617) requires PSMA PET confirmation of PSMA-positive metastatic castration-resistant prostate cancer. We coordinate the scan and the treatment together through our practice.
Our Process
How We Coordinate Your PSMA PET
We do not own a PSMA PET scanner — but we are the clinical gatekeepers who determine when the scan is indicated, order it, navigate insurance authorization, and translate the results into an actionable treatment plan. We work closely with imaging centers across the region to get scans scheduled quickly.
Clinical Evaluation & Indication Review
Your urologist reviews your PSA trend, pathology, prior imaging, and treatment history to determine whether PSMA PET is indicated and which specific clinical question it needs to answer.
Insurance Authorization
PSMA PET requires prior authorization from most insurers. Our team initiates the authorization process and provides the clinical documentation needed to support approval. We are familiar with the criteria each major payer uses and work to minimize delays.
Imaging Center Coordination
We work with multiple imaging centers across East Tennessee and the broader region to schedule PSMA PET efficiently. For patients with urgent clinical needs, we prioritize rapid scheduling.
Result Interpretation & Treatment Planning
Results are reviewed by your urologist in the context of your full clinical picture — not just as an isolated radiology report. We discuss findings directly with you and build your treatment plan around what the scan shows. Results are posted to your patient portal and reviewed at your follow-up visit.
For Referring Physicians
If you are referring a patient who may need PSMA PET staging or restaging, we welcome direct referrals. Our team will evaluate clinical appropriateness, manage the authorization, and provide a comprehensive treatment recommendation back to you. Complex oncology referrals are prioritized at our UTMC main campus locations.
PSMA-Targeted Therapy
PSMA PET & Pluvicto: The Critical Connection
Pluvicto (lutetium-177 PSMA-617) is an FDA-approved radioligand therapy for metastatic castration-resistant prostate cancer (mCRPC). It delivers targeted radiation directly to PSMA-expressing tumor cells throughout the body. PSMA PET is not optional for Pluvicto — it is required by the FDA to confirm PSMA positivity before treatment can begin. University Urology coordinates both the diagnostic imaging and the treatment through our practice, streamlining the path for eligible patients.
Men with mCRPC previously treated with androgen receptor pathway inhibition and taxane-based chemotherapy, confirmed PSMA-positive on PET imaging.
We order the PSMA PET, confirm eligibility, obtain authorization, and coordinate Pluvicto infusion cycles through our practice — keeping your care in one place.
Pluvicto is administered as an intravenous infusion every 6 weeks for up to 6 cycles, with PSMA PET and response assessment integrated throughout.
The VISION trial demonstrated significantly improved overall survival and radiographic progression-free survival versus standard of care in eligible mCRPC patients.
Expert Perspectives
PSMA PET’s Impact on Prostate Cancer Treatment
A GU Oncology Now discussion on how PSMA PET imaging is reshaping treatment decisions across the prostate cancer disease continuum — from initial staging to metastatic disease management.
Featured on GU Oncology Now — a peer education platform for genitourinary oncology clinicians.
Questions About PSMA PET or Pluvicto?
Our team coordinates imaging, authorization, and treatment. Reach out to get started.