Concierge imaging · London
PSMA PET scan - London.
A prostate-specific molecular scan for staging intermediate and high-risk prostate cancer, locating biochemical recurrence at very low PSA, and confirming eligibility for Lutetium-177 PSMA therapy. Reported by a consultant nuclear medicine physician.
All-inclusive private cost £2,400 to £3,800.
What it is
Positron emission tomography with a prostate-specific tracer.
PSMA PET-CT combines positron emission tomography with a low-dose CT, using a radiolabelled molecule that binds prostate-specific membrane antigen (PSMA), a protein overexpressed on more than 90 percent of prostate cancer cells. The three tracers in UK private use are 68Gallium-PSMA-11, 18F-DCFPyL (Piflufolastat, brand name Pylarify) and 18F-PSMA-1007.
The scan visualises the primary tumour within the prostate, nodal involvement in the pelvis and retroperitoneum, bone metastases and distant soft-tissue sites, with sensitivity far exceeding conventional CT combined with a bone scan.
When it is used
Four established indications.
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Initial staging
Intermediate and high-risk prostate cancer, per the updated NICE NG131 pathway. In many UK centres PSMA PET-CT now replaces CT plus bone scan for baseline staging.
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Biochemical recurrence
Rising PSA after prostatectomy or radiotherapy. PSMA PET localises the site of relapse at PSA values as low as 0.2 to 0.5 ng/mL, well before conventional imaging turns positive.
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Lutetium-177 PSMA eligibility
Mandatory before Lutetium-177 PSMA radioligand therapy in metastatic castration-resistant prostate cancer, to confirm sufficient PSMA expression across all disease sites.
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Response assessment
Selected use after systemic therapy or radioligand therapy, to track metabolic response across known disease sites.
Why it out-performs CT plus bone scan
Small-volume disease conventional imaging cannot see.
PSMA PET-CT detects nodal deposits below the 8 mm threshold that CT relies on, identifies bone metastases that a technetium bone scan misses, and delivers both nodal and skeletal information in one visit rather than two. It is particularly valuable when PSA is rising after prior treatment and conventional imaging has come back negative.
68Ga vs 18F tracers
Which PSMA tracer, and why.
68Ga-PSMA-11
The historical gold standard, produced on site from a Gallium-68 generator. Short 68-minute half-life limits how far it can be shipped.
18F-DCFPyL (Piflufolastat, Pylarify)
Longer 110-minute half-life allows cyclotron delivery to multiple London centres from a central radiopharmacy, with diagnostic accuracy equivalent to 68Ga-PSMA-11.
18F-PSMA-1007
Predominantly hepatic clearance rather than urinary. Excellent for pelvic and skeletal assessment because the bladder stays clear, but less useful for suspected liver metastases.
On the day
Two to three hours in the centre.
Fasting is not required. A cannula is placed for the intravenous radiotracer injection, followed by a 60-minute quiet uptake period. The PET-CT acquisition itself takes 20 to 40 minutes. The effective radiation dose is approximately 10 mSv, comparable to a standard contrast-enhanced CT.
All-inclusive private cost in London is £2,400 to £3,800, covering radiotracer, PET-CT acquisition and the consultant nuclear medicine physician report. Pricing varies by tracer and centre.
Where to have it
London centres with a PSMA radiopharmacy licence.
- University College London Hospital (UCLH) Private PET
- HCA London Bridge Nuclear Medicine
- The Royal Marsden Private PET
- Guy’s and St Thomas’ Private PET
- Bupa Cromwell Nuclear Medicine
- GenesisCare (selected UK sites)
Timing after radiotherapy
We typically wait 6 to 12 months after radiotherapy before a restaging PSMA PET-CT. Earlier scans risk false-negative interpretation because post-radiation inflammation can mask residual disease.
NHS availability
PSMA PET is available at specialist NHS centres and expanding rapidly. NICE approved 68Ga-PSMA-11 (TA1073, 2024) for staging intermediate and high-risk prostate cancer, for investigation of biochemical recurrence, and for confirming eligibility for 177Lu-PSMA therapy.
Related pages
Continue reading.
FAQs
Common questions about PSMA PET.
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Is the radiation dose safe?
A PSMA PET-CT delivers roughly 10 mSv, comparable to a standard contrast-enhanced CT and less than a whole-body FDG PET-CT combined with a bone scan. For prostate cancer staging or restaging, the clinical benefit clearly outweighs the dose.
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Will my insurance cover it?
Most UK private policies now cover PSMA PET-CT when it is clinically indicated by a consultant urologist or oncologist and pre-authorised. Bupa, AXA Health, Vitality, Aviva, WPA, Cigna and Healix all recognise the study for staging and biochemical recurrence.
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Should I have PSMA PET before or after a prostate biopsy?
PSMA PET is normally arranged after a positive biopsy for staging, or after a rising PSA post-treatment for restaging. Before biopsy it is rarely used, because a raised PSA alone does not confirm cancer.
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Can PSMA PET give a false positive?
Yes, occasionally. PSMA is not entirely prostate-specific and can accumulate in benign lymph nodes, healing rib fractures, Paget disease, and some non-prostate tumours. A consultant nuclear medicine physician interprets uptake in clinical context.
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Can the scan be repeated later?
Yes. PSMA PET is often repeated to reassess response after radiotherapy, hormone therapy or Lutetium-177 PSMA, or to look for new sites of disease when PSA rises again. There is no fixed limit on repeat studies when clinically justified.
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What PSA level do I need before a PSMA PET is worthwhile?
PSMA PET can locate recurrence at very low PSA values, typically from 0.2 ng/mL upwards after prostatectomy and slightly higher after radiotherapy. Detection rates rise sharply above 0.5 ng/mL and are excellent above 1 ng/mL.
Concierge PSMA PET, London
Rising PSA, or awaiting staging?
Send the referral letter and recent PSA trend. We recommend the right tracer, the right centre and a firm cost within one working day.