Diagnostic Performance of 99m Tc-iPSMA SPECT/CT in the Initial Staging of Patients with Unfavorable Intermediate-, High-, and Very High-Risk Prostate Cancer: A Comparative Analysis with 18 F-PSMA-1007 PET/CT.

Autor: Vargas-Ahumada JE; Nuclear Medicine Department, Instituto Nacional de Cancerología, Tlalpan, Mexico City 14080, Mexico., González-Rueda SD; Nuclear Medicine Department, Instituto Nacional de Cancerología, Tlalpan, Mexico City 14080, Mexico., Sinisterra-Solís FA; Nuclear Medicine Department, Instituto Nacional de Cancerología, Tlalpan, Mexico City 14080, Mexico., Casanova-Triviño P; Nuclear Medicine Department, Instituto Nacional de Cancerología, Tlalpan, Mexico City 14080, Mexico., Pitalúa-Cortés Q; Nuclear Medicine Department, Instituto Nacional de Cancerología, Tlalpan, Mexico City 14080, Mexico., Soldevilla-Gallardo I; Nuclear Medicine Department, Instituto Nacional de Cancerología, Tlalpan, Mexico City 14080, Mexico., Scavuzzo A; Urologic Sugery Department, Instituto Nacional de Cancerología, Tlalpan, Mexico City 14080, Mexico., Jimenez-Ríos MA; Urologic Sugery Department, Instituto Nacional de Cancerología, Tlalpan, Mexico City 14080, Mexico., García-Pérez FO; Nuclear Medicine Department, Instituto Nacional de Cancerología, Tlalpan, Mexico City 14080, Mexico.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2023 Dec 13; Vol. 15 (24). Date of Electronic Publication: 2023 Dec 13.
DOI: 10.3390/cancers15245824
Abstrakt: Prostate cancer is a leading cause of cancer death in men worldwide. Imaging plays a key role in disease detection and initial staging. Emerging data has shown the superiority of PSMA imaging with PET/CT over conventional imaging for primary diagnoses. Single photon emission computed tomography is more available worldwide, and the imaging agent is low in cost. The aim of this study is to compare the diagnostic accuracy of 99m Tc-EDDA/HYNIC-iPSMA SPECT/CT to 18 F-PSMA-1007 PET/CT in the primary diagnosis of prostate cancer and the impact on clinical staging.
Methods: In this prospective controlled study, 18 patients with histologically confirmed prostate cancer with unfavorable intermediate-, high-, and very high-risk characteristics were recruited to undergo 18 F-PSMA-PET/CT and 99m Tc-iPSMA SPECT/CT. The median age of the patients was 71 years old, and the median PSA level was 23.3 ng/mL. Lesions were divided into the prostate, seminal vesicles, lymph nodes, bone, and visceral metastases. Volumetric analysis was also performed between the two imaging modalities and correlated with PSA levels.
Results: A total of 257 lesions were detected on 18 F-PSMA-PET/CT: prostate (n = 18), seminal vesicles (n = 12), locoregional lymph nodes (n = 62), non-locoregional (n = 67), bone (n = 90), and visceral (n = 8). Of these, 99m Tc-iPSMA-SPECT/CT detected 229 lesions, while both reviewers detected 100% of the lesions in the prostate (18/18), seminal vesicles (12/12), and visceral (8/8); LN LR (56/62; 90%), NLR (57/67; 85%), and bone (78/90; 86%). There were no statistically significant differences between volumetric parameters ( t = -0.02122; p = 0.491596).
Conclusions: 99m Tc-iPSMA SPECT/CT is useful in the primary diagnosis of prostate cancer. Despite it showing a slightly lower lesion detection rate compared to 18 F-PSMA PET/CT, it exhibited no impact on clinical staging and, consequently, the initial treatment intention.
Databáze: MEDLINE
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