Andrej Vondrák
The diagnosis of prostate carcinoma and its stages using methods of nuclear medicine was historically limited to bone
scintigraphy. Implementation of PET/CT examination with 8 F-choline brought a huge diagnostic contribution of nuclear
medicine, where the diagnosis of bone metastases was enriched by the possibility to detect metastases in soft tissue
or possibly differentiation of carcinoma in the healthy prostate tissue after unsuccessful biopsies. At present, the
recent revolutionary moment in the prostate carcinoma diagnosis is the implementation of a new radio-pharmaceutical
drug determined for PET/CT scanning. It is 68Ga-PSMA (Gallium (Ga)-Labelled Prostate-specific Membrane Antigen).
Gallium 68 is a product of a generator, which is directly at the workplace of nuclear medicine, where the pharmaceutical
drug is prepared, and so the workplace is not dependent on its delivery from the cyclotron. 68Ga-PSMA is
substantially more advantageous than 18F-choline, and its diagnostic accuracy is in all indications higher, even at low
values of PSA. Last but not least there is a possibility of an entirely new procedure in the therapy of metastatic prostate
carcinoma in a form of theranostics, where after a precise diagnosis of metastatic prostate carcinoma with 68Ga-PSMA
it is possible to perform radionuclide therapy with alpha or beta emitters bound to PSMA.