Netspot pet
PET PSMA has been out there for quite some time, and patients ask, “Why don’t we have this in the United States?” Now we do. This limits usage to our patients who can afford it, but at least it is a beginning. Insurance does not cover this it is not available for the population overall.
As far as I know, these are all cash-paid. Unfortunately, the other side is that there are still only a few centers that can provide this. Sometimes we face some situations and we say, “I wish I had this imaging available.” Now we do, and this is a major change. Even when they were running the trials to get approval from the FDA, we used to get our patients scanned over there because it acted as a better assessment for us. Thanks to them, and thanks to the fact that we have some here in California and in Los Angeles that have been helping us for quite some time. Fortunately, from our side, we have this approved, but it is still a great effort, as you said, from great leaders and institutions, and kudos to all of them.
Dr Abreu, as a clinician, can you give us any thoughts on the impact of cost on the accessibility for your patients?Īndre Abreu, MD: Yes. Initially, when they are first ramping up, they may not be able to deliver it, for example, every single day, so you may have to adapt that schedule. Check with your imaging sites to know their availability, the timeframe they can deliver within, and the supply chain.
#NETSPOT PET GENERATOR#
A lot of the success relies on commercial availability, right? Is it commercially viable? Just because you have a cyclotron there or a generator here capable of doing it, you still have to make it commercially viable. I must emphasize that when it comes to our radiopharmaceuticals, they tend to be very expensive. There are some places that can be supplied with a gallium-68 PSMA-11 and other radiopharmaceuticals that you cannot necessarily deliver from a cyclotron facility. That is too far, in many circumstances, for the gallium-68. The range that your cyclotron facility can deliver F18 may not be expansive if you are right at that 2-hour limit. It can literally sit on the counter, this gallium generator, which is very nice because if the half-life is only 68 minutes, you cannot transport it very far. It is a different generator, but there is the same idea it’s portable. Some people may have heard of generators, like how we get technetium-99 your hospital may have that technetium-99m generator. The other way it is made is through a generator. Just because it may have a cyclotron that can do it does not mean it is making it right now. It can be made by a cyclotron the same cyclotron that makes your F18 can make it, but it requires a different target. It is very fortunate you do not have to have a great memory to remember that. Gallium-68-this is easy to remember for your next dinner conversation-has a 68-minute half-life. F18 has a half-life of approximately 2 hours. You may not have known that, but in all those FDG PET scans that you ordered, the F18 comes from a cyclotron nearby. One of the differences in gallium-68 compared to F18 is that F18 is exclusively cyclotron-produced. This is nothing new, but obviously there are a lot more cases of prostate cancer than neuroendocrine tumors. That is a detection of neuroendocrine tumors, so we have had a gallium-68 approved PET tracer. That is gallium-68 dotatate or Netspot, and that is basically a PET octreotide scan, for those of you who may know that. There actually is another one approved urologists may not know about it, but they may have heard about it in their surgery conferences. We do not use gallium-68 tracers too much. Of course, for those of you listening, talk to your respective imaging centers because it depends upon your regional availability of things. I am going to talk a little about what this means from the nuclear medicine perspective. Again, kudos to their teams on both sides. Obviously, there were big teams in each group, but Thomas Hope, from UCSF and Johannes Czernin, MD from UCLA are their leaders. That is really what the field needed, this cooperative effort. Real kudos to those teams who came together from 2 institutions. It was a joint effort, for those of you who do not know, by UCLA (the University of California, Los Angeles) and UCSF (the University of California, San Francisco). Phillip Kuo, MD, PhD: To move on to the next question, which is important to discuss, particularly due to the approval in December of 2020-gallium-68 PSMA-11 was approved by the FDA, and will therefore officially be the first PSMA PET imaging agent to be approved.