Objectives:  Describe the potential applications of ⁶⁸Ga PSMA PET/CT in prostate cancer (PCa) from diagnosis to treatment response evaluation.

Methods:  Retrospective analysis of ⁶⁸Ga-PSMA PET/CT for PCa during the 1 year period from 01.05.2015 to 30.04.2016 was done. 304 scans were done in 300 patients during this one year period. The indications for the scan and its usefulness in the clinical scenario was analysed.

Results: Lesion characterisation (103 cases) in suspected PCa patients revealed presence of foci suspicious of PCa in 58 (56%) patients and they were advised biopsy correlation. Scan negative patients 45 (44%); an immediate biopsy was avoided and put on follow up. ⁶⁸Ga-PSMA PET/CT as staging work up prior to initiating treatment was done in 62 patients and excluded distant metastasis in 40 patients. 22 patients showed at least one site of metastasis. 125 patients underwent ⁶⁸Ga-PSMA PET/CT for suspected recurrence evaluation and the culprit lesion/lesions could be identified in 110 (88%) patients. 4 cases ⁶⁸Ga-PSMA PET/CT was used for RT planning and it provided accurate identification of involved sites. 4 cases follow up ⁶⁸Ga-PSMA PET/CT was done after 6 cycles of chemotherapy and only one case showed scan concurrence with clinical/biochemical response. Three cases ⁶⁸Ga-PSMA PET/CT was done prior to ¹⁷⁷Lu-PSMA scan to assess feasibility of therapy. Six cases ⁶⁸Ga-PSMA PET/CT was done in patients on follow up post treatment with no biochemical or clinical evidence of disease recurrence (surveillance) however no active disease sites were identified in them.

Conclusion: The main indications for ⁶⁸Ga-PSMA PET/CT in PCa include lesion characterisation in suspected prostate cancer, initial staging work up in newly diagnosed cases and recurrence evaluation in suspected biochemical/clinical disease recurrence. ⁶⁸Ga-PSMA PET/CT is also finding potential application in radiotherapy planning, assessment of response to chemotherapy and in theranostics which requires to be validated further.