What post‑procedure precautions and patient instructions should be followed after an ^18F‑PSMA PET scan?

Post-Procedure Instructions After ¹⁸F-PSMA PET Scan

Patients should void their bladder immediately after the scan to reduce radiation exposure to the bladder and surrounding tissues, maintain adequate hydration for the remainder of the day, and can resume normal activities without specific restrictions.

Immediate Post-Scan Actions

Bladder Management

• Void immediately after imaging completion to minimize absorbed radiation dose to the bladder 1
• This is the single most important post-procedure step for radiation protection
• No catheterization is needed unless medically indicated for other reasons

Hydration

• Continue oral hydration throughout the remainder of the day 2
• Plain water is preferred
• This helps facilitate continued renal clearance of the tracer

Radiation Safety Precautions

Contact with Others

The effective dose from ¹⁸F-PSMA-1007 is approximately 4.4-5.5 mSv per 200-250 MBq examination 3, with an effective dose coefficient of 25 µSv/MBq 4. Given the relatively low radiation exposure and the physical half-life of ¹⁸F (approximately 110 minutes):

• No specific isolation from family members or the public is required
• Normal social contact can resume immediately
• The tracer has predominantly non-urinary clearance (only 8% urinary excretion in 20 hours) 4, which further reduces contamination concerns

Special Populations

Breastfeeding mothers:

• Interruption of breastfeeding is not required after ¹⁸F-PSMA administration, as minimal tracer is excreted in breast milk 5
• However, minimize close contact with infants for 4 hours post-injection to reduce radiation exposure from proximity to the mother 5
• This precaution is based on general principles for ¹⁸F-labeled tracers

Pregnant contacts:

• No specific restrictions beyond normal social distancing
• The short half-life and rapid clearance make prolonged precautions unnecessary

Activity Restrictions

Physical Activity

• No restrictions on normal daily activities
• Patients can drive themselves home
• Return to work immediately if desired
• Resume exercise without limitation

Metallic Items

• Any metallic items removed before the scan (jewelry, dental prostheses) can be replaced immediately 1

Follow-Up Considerations

Symptom Monitoring

• ¹⁸F-PSMA tracers are pharmacologically safe, non-toxic, and non-allergenic 2
• Adverse reactions are exceptionally rare
• No specific symptom monitoring is required post-procedure

Results Timeline

• Discuss expected timeline for results with the ordering physician
• No specific waiting period is required before receiving results

Key Differences from Other PET Tracers

Unlike ¹⁸F-FDG PET scans, ¹⁸F-PSMA does not require:

• Fasting restrictions post-procedure
• Blood glucose monitoring
• Delayed imaging sessions (though some centers may perform delayed acquisitions for specific indications)
• Restrictions on sugar intake after the scan

Common Pitfalls to Avoid

1. Do not assume urinary precautions are necessary: Unlike ⁶⁸Ga-PSMA-11, ¹⁸F-PSMA-1007 has minimal urinary excretion 3, so extensive bathroom precautions are not needed
2. Do not delay bladder voiding: The single most important action is immediate post-scan voiding
3. Do not restrict normal activities: Patients often unnecessarily limit themselves; reassure them that normal life can resume immediately