Intraindividual Comparison of 99mTc-Methylene Diphosphonate and Prostate-Specific Membrane Antigen Ligand 99mTc-MIP-1427 in Patients with Osseous Metastasized Prostate Cancer
| Autor: | Walter Mier, Maximilian de Bucourt, Clemens Kratochwil, Frederik L. Giesel, Sabine Haufe, Uwe Haberkorn, Paul Flechsig, John W. Babich, Christophe Kremer, Ali Afshar-Oromieh, Hendrik Rathke, Tim Holland-Letz, Thomas Armor |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.diagnostic_test
business.industry Scintigraphy medicine.disease 030218 nuclear medicine & medical imaging 03 medical and health sciences Bone scanning Prostate cancer 0302 clinical medicine medicine.anatomical_structure 030220 oncology & carcinogenesis Glutamate carboxypeptidase II Medicine Radiology Nuclear Medicine and imaging Intraindividual comparison In patient Bone marrow Nuclear medicine business 99mTc-Methylene Diphosphonate |
| Zdroj: | Journal of Nuclear Medicine. 59:1373-1379 |
| ISSN: | 2159-662X 0161-5505 |
| DOI: | 10.2967/jnumed.117.200220 |
| Popis: | The objective of this study was to evaluate the rate of detection of bone metastases obtained with the prostate-specific membrane antigen (PSMA)-targeting tracer 99mTc-MIP-1427, as opposed to conventional bone scanning with 99mTc-methylene diphosphonate (99mTc-MDP), in a collective of patients with known advanced-stage osseous metastasized prostate cancer. Methods: Twenty-one patients with known metastatic disease were staged with both conventional bone scanning and PSMA ligand scintigraphy within a time frame of less than 10 d. Imaging included planar whole-body scanning and SPECT or SPECT/CT with 2 bed positions 3 h after injection of either 500-750 MBq of 99mTc-MIP-1427 or 600-750 MBq of 99mTc-MDP. Lesions were scored as typical tumor, equivocal (benign/malignant), or normal within a standard reporting schema divided into defined anatomic regions. Masked and consensus readings were performed with sequential unmasking: planar scans first, then SPECT/CT, the best evaluable comparator (including MRI), PET/CT, and follow-up examinations. Results: Eleven patients had PSMA-positive visceral metastases that were predictably not diagnosed with conventional bone scanning. However, SPECT/CT was required to distinguish between soft-tissue uptake and overlapping bone. Four patients had extensive 99mTc-MDP-negative bone marrow lesions. Seven patients had superscan characteristics on bone scans; in contrast, the extent of red marrow involvement was more evident on PSMA scans. Only 3 patients had equivalent results on bone scans and PSMA scans. In 16 patients, more suspect lesions were detected with PSMA scanning than with bone scanning. In 2 patients (10%), a PSMA-negative tumor phenotype was present. Conclusion: PSMA scanning provided a clear advantage over bone scanning by reducing the number of equivocal findings in most patients. SPECT/CT was pivotal for differentiating bone metastases from extraosseous tumor lesions. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|