68Ga-PSMA PET/CT in Osteosarcoma in Fibrous Dysplasia

Sasikumar, Arun; Joy, Ajith; Pillai, M.R.A.; Alex, Tony M.; Narayanan, Geetha

doi:10.1097/rlu.0000000000001646

Cited by 33 publications

(13 citation statements)

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“…Other pathologies such as Paget's disease [16,17], paragangliomas [21], and haemangiomas [22,23] have been reported to cause PSMA uptake in bone. Primary bone malignancies can also masquerade as prostate cancer metastasis [24][25][26]. Clinicians may consider follow-up imaging, especially if bony symptoms persist, even if PSA trends are reassuring.…”

Section: Discussionmentioning

confidence: 99%

Solitary rib lesions showing prostate‐specific membrane antigen (PSMA) uptake in pre‐treatment staging ⁶⁸Ga‐PSMA‐11 positron emission tomography scans for men with prostate cancer: benign or malignant?

et al. 2020

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Objectives To determine the proportion of solitary rib lesions on pre‐treatment 68Gallium‐labelled prostate‐specific membrane antigen (PSMA)/computed tomography (CT) scans in men with prostate cancer that are malignant and examine any predictive factors. Patients and methods This retrospective single tertiary referral institution cohort study of men reviewed the results of 68Ga‐PSMA‐11 positron emission tomography (PET)/CT scans performed for primary staging prior to treatment of prostate cancer from July 2014 to September 2019. Men with PSMA uptake outside the prostate in only the rib lesion were included. A solitary rib lesion was considered to be malignant if it increased in size on follow‐up imaging. A lesion was considered benign if the prostate‐specific antigen (PSA) level remained <0.1 µg/L following a radical prostatectomy (RP), <2 µg/L above nadir following radiotherapy (RT) as per the Phoenix criteria, histology was benign on rib biopsy, or follow‐up imaging showed no growth of the rib lesion. If a lesion did not meet these criteria it was considered indeterminate. Results A total of 62 men had PSMA uptake in a solitary rib lesion; 54 went on to have RPs and eight underwent RT. In all, 61 of the men (98.4%) met the criteria for a benign rib lesion. Only one man had a false‐negative malignant lesion. This man had a rib lesion with a low maximum standardised uptake value (SUVmax) of 2.21 reported as benign, but the postoperative PSA level was 0.67 µg/L and the rib lesion progressed on follow‐up imaging, with development of widespread metastases. Of the benign rib lesions, there were four false positives reported as possible metastases. Three had percutaneous rib biopsies, two of which came back with benign histology and one was indeterminate. The indeterminate biopsy patient had a RP and his postoperative PSA level was <0.1 µg/L. A total of 43 (69.4%) men with benign rib lesions had a SUVmax greater than the SUVmax of the malignant lesion. Conclusion To our knowledge, this is the first cohort study of men with PSMA‐avid solitary rib lesions on pre‐treatment 68Ga‐PSMA PET/CT staging scans for prostate cancer. Our results indicate that the vast majority of these lesions have low‐intensity uptake and are benign. Intervention to confirm this is not usually required.

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Section: Discussionmentioning

confidence: 99%

Solitary rib lesions showing prostate‐specific membrane antigen (PSMA) uptake in pre‐treatment staging ⁶⁸Ga‐PSMA‐11 positron emission tomography scans for men with prostate cancer: benign or malignant?

et al. 2020

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“…This biomarker can be noninvasively detected in the neovasculature of many tumors including several bone malignancies using PSMA-targeted radiopharmaceuticals. [59][60][61][83][84][85][86][87] By analogy to the osteoblastic prostate cancer metastases, PSMA expressed on the OST neovasculature 83,84 appears to be an excellent target for radionuclide-based targeted 227 Th-based antiangiogenic theranostics in OST.…”

Section: Druggable Ost Targets and Their Ligandsmentioning

confidence: 99%

Alpha-Particle Therapy for Multifocal Osteosarcoma: A Hypothesis

Baranowska‐Kortylewicz

Sharp

McGuire

et al. 2020

Cancer Biotherapy and Radiopharmaceuticals

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Osteosarcoma (OST) is the most common bone tumor in children and adolescents with a second peak of incidence in elderly adults usually diagnosed as secondary tumors in Paget's disease or irradiated bone. Subjects with metastatic disease or whose disease relapses after the initial therapy have a poor prognosis. Moreover, multifocal OST contains tumor-initiating cells that are resistant to chemotherapy. The use of aggressive therapies in an attempt to eradicate these cells can have long-term negative consequences in these vulnerable patient populations. 227 Th-labeled molecular probes based on ligands to OST-associated receptors such as IGF-1R (insulin-like growth factor receptor 1), HER2 (human epidermal growth factor receptor 2), and PSMA (prostate-specific membrane antigen) are expected to detect and treat osseous and nonosseous sites of multifocal OST. Published reports indicate that 227 Th has limited myelotoxicity, can be stably chelated to its carriers and, as it decays at targeted sites, 227 Th produces 223 Ra that is subsequently incorporated into the areas of increased osteoblastic activity, that is, osseous metastatic lesions. Linear energy transfer of a particles emitted by 227 Th and its daughter 223 Ra is within the range of the optimum relative biological effectiveness. The radiotoxicity of a particles is virtually independent of the phase in the cell cycle, oxygenation, and the dose rate. For these reasons, even resistant OST cells remain susceptible to killing by high-energy a particles, which can also kill adjacent quiescent OST cells or cells with low expression of targeted receptors. Systemic side effects are minimized by the limited range of these intense radiations. Quantitative single-photon emission computed tomography of 227 Th and 223 Ra is feasible. Additionally, the availability of radionuclide pairs, for example, 89 Zr for positron emission tomography and 227 Th for therapy, establish a strong basis for the theranostic use of 227 Th in the individualized treatment of multifocal OST.

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“…(82)(83)(84)(85)(86)(87)(88)(89)(90)(91). However, reports of malignancy arising from FD suggest the affected body region should be under long-term monitoring (90,91). Patients with FD have an increased risk of developing breast cancer (92).…”

Section: Fibrous Dysplasiamentioning

confidence: 99%

Symptomatic Mandibular Fibrous Dysplasia With Concurrent Triple X- and Premutation Stage Fragile-X-Syndrome: Case Report With Short Literature Survey

2019

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Background: Certain constitutive chromosomal abnormalities of the human X chromosome are relatively common in conspicuous neuropsychiatric findings. Although tumors or tumor-like lesions are occasionally reported in diseases of the X chromosome, they are numerically negligible, for example, in aneuploidy such as the triple X syndrome (TXS). Case Report: A 16-year-old female patient with a known TXS and premutation stage of fragile X syndrome was referred by her dentist for diagnosis and treatment of unilateral cheek swelling. The examination of the psychologically conspicuous patient revealed a unilateral mandibular tumor with dysesthesia of the mental nerve. Surgical removal of soft, crumbly spongiosa over the nerve canal resulted in sufficient pressure release of the constricted nerve and restoration of epicritic sensitivity. Imaging findings and histological and molecular genetic examination revealed monostotic craniofacial fibrous dysplasia. Conclusion: Although the data in the literature do not give reason to suppose an accumulation of neoplasms in TXS, a numb chin syndrome should be a reason for detailed diagnostics. Careful diagnosis allows for customized therapy. This is the first report on the coincidence of TXS, fragile X syndrome, and fibrous dysplasia in a single individual.

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68Ga-PSMA PET/CT in Osteosarcoma in Fibrous Dysplasia

Cited by 33 publications

References 10 publications

Solitary rib lesions showing prostate‐specific membrane antigen (PSMA) uptake in pre‐treatment staging ⁶⁸Ga‐PSMA‐11 positron emission tomography scans for men with prostate cancer: benign or malignant?

Solitary rib lesions showing prostate‐specific membrane antigen (PSMA) uptake in pre‐treatment staging ⁶⁸Ga‐PSMA‐11 positron emission tomography scans for men with prostate cancer: benign or malignant?

Alpha-Particle Therapy for Multifocal Osteosarcoma: A Hypothesis

Symptomatic Mandibular Fibrous Dysplasia With Concurrent Triple X- and Premutation Stage Fragile-X-Syndrome: Case Report With Short Literature Survey

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68Ga-PSMA PET/CT in Osteosarcoma in Fibrous Dysplasia

Cited by 33 publications

References 10 publications

Solitary rib lesions showing prostate‐specific membrane antigen (PSMA) uptake in pre‐treatment staging 68Ga‐PSMA‐11 positron emission tomography scans for men with prostate cancer: benign or malignant?

Solitary rib lesions showing prostate‐specific membrane antigen (PSMA) uptake in pre‐treatment staging 68Ga‐PSMA‐11 positron emission tomography scans for men with prostate cancer: benign or malignant?

Alpha-Particle Therapy for Multifocal Osteosarcoma: A Hypothesis

Symptomatic Mandibular Fibrous Dysplasia With Concurrent Triple X- and Premutation Stage Fragile-X-Syndrome: Case Report With Short Literature Survey

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Solitary rib lesions showing prostate‐specific membrane antigen (PSMA) uptake in pre‐treatment staging ⁶⁸Ga‐PSMA‐11 positron emission tomography scans for men with prostate cancer: benign or malignant?

Solitary rib lesions showing prostate‐specific membrane antigen (PSMA) uptake in pre‐treatment staging ⁶⁸Ga‐PSMA‐11 positron emission tomography scans for men with prostate cancer: benign or malignant?