[99mTc]Tc-PSMA-I&S-SPECT/CT: experience in prostate cancer imaging in an outpatient center.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_5A12CBAF1DF6
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
[99mTc]Tc-PSMA-I&S-SPECT/CT: experience in prostate cancer imaging in an outpatient center.
Journal
EJNMMI research
Author(s)
Werner P., Neumann C., Eiber M., Wester H.J., Schottelius M.
ISSN
2191-219X (Print)
ISSN-L
2191-219X
Publication state
Published
Issued date
07/05/2020
Peer-reviewed
Oui
Volume
10
Number
1
Pages
45
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Prostate-specific membrane antigen (PSMA) SPECT imaging in prostate cancer (PCa) could be a valuable alternative in regions where access to PSMA-PET imaging is restricted. [ <sup>99m</sup> Tc]Tc-PSMA-I&S is a new <sup>99m</sup> Tc-labeled PSMA-targeting SPECT agent, initially developed for radio-guided surgery. We report on the diagnostic use of [ <sup>99m</sup> Tc]Tc-PSMA-I&S-SPECT/CT in PCa.
[ <sup>99m</sup> Tc]Tc-PSMA-I&S-SPECT/CT was performed and evaluated in 210 outpatients with PCa at a single center. Patients were imaged for biochemical recurrence (BCR, n = 152, mean PSA 8.7 ng/ml), for primary staging of high-risk PCa (n = 12, mean PSA 393 ng/ml), and restaging in advanced recurrent PCa (n = 46, mean PSA 101.3 ng/ml). Number and location of positive lesions were determined for the different subgroups. For BCR, detection rates were calculated, defined as the proportion of scans with at least one PSMA-positive lesion. PSMA positive lesions were detected in 65.2% of all 210 patients. Tumor tissue was mainly detected in lymph nodes (59%), in the bone (42%), and in the prostate (fossa) (28%). In the subgroup of patients referred for detection of BCR the detection rate increased from 20% at a PSA level < 1 ng/ml to 82.9% and 100% at PSA levels > 4 ng/ml and > 10 ng/ml, respectively. In the subgroup of high-risk patients referred for primary staging, 42% demonstrated metastatic disease. Restaging of advanced recurrent PCa revealed detectability of PSMA positive tumor lesions in 85% of the scans.
[ <sup>99m</sup> Tc]Tc-PSMA-I&S-SPECT/CT was useful in PSMA-targeted imaging of PCa at various clinical stages. At low PSA levels (< 4 ng/ml), detection rates of [ <sup>99m</sup> Tc]Tc-PSMA-I&S-SPECT/CT in BCR are clearly inferior to data reported for PET-imaging and should thus only be considered for lesion detection if imaging with PET is unavailable. However, at higher PSA levels (> 4 ng/ml) [ <sup>99m</sup> Tc]Tc-PSMA-I&S-SPECT/CT provides high detection rates in BCR. [ <sup>99m</sup> Tc]Tc-PSMA-I&S-SPECT/CT can also be used for primary staging and for restaging of advanced recurrent PCa. However, further studies are needed to assess the clinical value in these indications.
Keywords
PSMA, Prostate cancer, SPECT, Scintigraphy, [99mTc]Tc-PSMA-I&S
Pubmed
Web of science
Open Access
Yes
Create date
15/06/2020 16:12
Last modification date
05/04/2022 6:35
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