Posted 6/29/2015 2:44 AM (GMT 0)
My F18 sodium scan actually confirmed the absense of bony mets. Depending on who I talk to, either the prior diagnosis of bony mets was incorrect or Lupron shrank them.
Like Steel Guy, I am a proponent of F18 sodium and in my case C-11 Acetate scans that are less subjective than the standard bone scintigram.
The C-11 Choline is only offered at Mayo and is sometimes covered by insurance. The C-11 Acetate is only offered in a few other places due to its extremely short half life, special cyclotron etc and is not covered by insurance.
At AZ Molecular Imaging in Phoenix, (I recommend Dr. Fabio Almeida very highly) the normal cost is $3,000 but since I was also having the F18 test the day before, they discounted my out of pocket to be $2,500.
The F18 showed I did not have bony mets but was suspicious for lymph node involvement that the C-11 Acetate confirmed was three micro LN's all contained in the pelvic region. So my diagnosis was downgraded from stage 4 palliative radiaiton for pain only to locally advanced that I had treated by SBRT radiation and Provenge combo therapy, Zytiga, Lupron, Xgeva/Prolia, and am now on intermittent hormonal therapy vacation.
The PSA threshold as SteelGuy mentioned is typically >=2 for the C-11's but my PSA was only 0.26 at the time and identified some LN's while most likely other mets bone or other LN involvement were still being masked by the Lupron.
My rationale was that even though the best scans could not see them, SBRT would zap anything in its path regardless. So my SBRT was to the prostate, to what we would be calling the prostate bed had it been removed (still have it, no surgery) and to the entire pelvic girdle not just to the 3 identified LN's.