Aspecific Uptake of 68GA-PSMA in Paget Disease of the Bone

Bourgeois, Sophie; Gykiere, Pieterjan; Goethals, Laurence; Everaert, Hendrik; Geeter, Frank De

doi:10.1097/rlu.0000000000001335

Cited by 30 publications

(19 citation statements)

References 25 publications

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“…Endothelial expression of PSMA in neovasculature known to occur in Paget disease has been postulated as the mechanism causing the PSMA-PET/CT positivity of this condition [5–8]. In the current case, we found some confirming evidence for this assumption with a weak PSMA positivity of endothelial cells in the bone affected by Paget disease (Figure 2(d)).…”

Section: Discussionsupporting

confidence: 80%

“…Paget disease is a common disorder affecting up to 3% of senior adults [9]. PSMA-PET/CT positivity seems to be a usual phenomenon in Paget disease [5–8] that should be taken into consideration when PSMA-PET/CT is used during workup of patients with prostate cancer in order to avoid a pitfall in this otherwise accurate and sensitive diagnostic tool [1–3]. Beside Paget disease, various other tumors [11], coeliac ganglia [12], splenosis [13], sarcoidosis [14], and subacute stroke [15] have been reported to cause false-positive PSMA-PET imaging findings.…”

Section: Discussionmentioning

confidence: 99%

“…68 Ga-labeled prostate-specific membrane antigen-targeted ligand positron emission tomography/computed tomography (PSMA-PET/CT) showed moderate PSMA positivity of this lesion (Figure 1(b)). Since Paget disease has been reported to cause PSMA positivity bone lesions [5–8], a bone biopsy was obtained for final workup that confirmed the diagnosis of Paget disease (Figure 2). After radical prostatectomy (pT3bpN0), PSA fell below the lowest detection level ruling out gross bone metastases.…”

Section: Case Presentationmentioning

confidence: 99%

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PSMA-PET/CT-Positive Paget Disease in a Patient with Newly Diagnosed Prostate Cancer: Imaging and Bone Biopsy Findings

Froehner

Toma

Zöphel

et al. 2017

Case Reports in Urology

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A 67-year-old man diagnosed with Gleason score 4 + 5 = 9 clinically localized prostate cancer with 68Ga-labeled prostate-specific membrane antigen-targeted ligand positron emission tomography/computed tomography (PSMA-PET/CT) positive Paget bone disease is described. Immunohistochemical staining revealed weak PSMA positivity of the bone lesion supporting the hypothesis that neovasculature might explain positive PSMA-PET/CT findings in Paget disease.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Case Presentationmentioning

confidence: 99%

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PSMA-PET/CT-Positive Paget Disease in a Patient with Newly Diagnosed Prostate Cancer: Imaging and Bone Biopsy Findings

Froehner

Toma

Zöphel

et al. 2017

Case Reports in Urology

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“…It may be more appropriate to administer a lower furosemide dose simultaneously with the radiotracer administration for the comfort of the patient, which is also recommended in the guidelines of EANM and SNMMI for administration of 68 Ga-PSMA [14]. PSMA expression is not specific to the prostate only; physiological background uptake is seen in the kidneys, bladder, intestines, and salivary glands as well as in pathological conditions such as Paget's bone disease and neovasculature of several solid tumours such as highgrade sarcomas [27][28][29][30][31]. Moreover, some prostatic malignant lesions exhibit minimal PSMA expression and can be difficult to detect on PET [32].…”

Section: Discussionmentioning

confidence: 99%

Optimization of PET protocol and interrater reliability of 18F-PSMA-11 imaging of prostate cancer

et al. 2020

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Background: Several scan parameters for PET imaging with 18 F-PSMA-11 such as dosage, acquisition time and scan duration were evaluated to determine the most appropriate scan protocol, as well as the effect of furosemide administration on lesion visualization. Forty-four patients were randomly assigned to a dosage group (2.0 ± 0.2 or 4.0 ± 0.4 MBq/kg 18 F-PSMA-11). All patients received a full-body PET/CT 1 h and 3 h after radiotracer injection with a scan duration of 3 min/bed position. For comparison of the scan duration, images were reconstructed for 1.5 and 3 min/bed position. Patients were intravenously administered 0.5 mg/kg furosemide with a maximum dose of 40 mg. To evaluate the furosemide effect, 22 additional patients were recruited and received one full-body PET/CT 1 h after administration of 2.0 ± 0.2 MBq/kg 18 F-PSMA-11 with a scan duration of 3 min/bed position. To this group, no furosemide was administered. Images were scored on image quality using a 7-point scale and each suspicious lesion was described. To assess interrater reliability, two nuclear physicians scored all scans independently and described all observed suspicious lesions. Results: The 4 MBq/kg group received for all reconstructed images (60 min p.i., 1.5 and 3 min/bed position and 180 min p.i., 1.5 and 3 min/bed position) the highest median image quality score compared to the 2 MBq/kg group (p values < 0.01). When comparing all reconstructed images, the highest image quality score was given to images at 60 min p.i., 3 min/bed position for both dosage groups (score 5 and 6 for 2 and 4 MBq/kg, respectively). The addition of furosemide administration decreased the interference score with one point (p = 0.01106) and facilitated the evaluation of lesions in proximity to the ureters. The interrater reliability for the comparison of each lesion separately after more than 40 18 F-PSMA-11 scan readings showed an increasing κ value from 0.78 (95% CI, 0.65-0.92) to 0.94 (95% CI, 0.87-1). Conclusion:Although the results indicate an administered activity of 4.0 ± 0.4 MBq/kg, preference will be given to 2.0 ± 0.2 MBq/kg due to the small difference in absolute score (max 1 point) and the ALARA principle. For evaluation of lesions in proximity to the ureters, the co-administration of a diuretic can be useful. The increase of the κ value from 0.78 to 0.94 suggests a learning curve in the interpretation of 18 F-PSMA-11 images.

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“…A disadvantage of PSMA ligands is uptake in other organs such as the kidney, small bowel loops, salivary glands, ureters, and the urinary bladder . Furthermore, reports are accumulating on uptake of the tracer in other cancers or benign conditions, like sarcoidosis and inflammation …”

Section: Introductionmentioning

confidence: 99%

Ultra‐small superparamagnetic iron oxides for metastatic lymph node detection: back on the block

Fortuin

Brüggemann

Linden

et al. 2017

WIREs Nanomed Nanobiotechnol

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In the past 15 years, encouraging clinical results for the detection of small lymph node metastases was obtained by the use of Combidex‐enhanced MRI (CEM, also known as magnetic resonance lymphography). Withdrawal of the European Medicines Agency approval application by the manufacturer made it impossible for patients to benefit from this agent; a loss, especially for men with prostate cancer. Current conventional imaging techniques are not as accurate as CEM is, thus a surgical diagnostic exploration (extended lymph node dissection) is still the preferred technique to evaluate the lymph nodes, resulting in peri‐ and postoperative complications. In 2013, the Radboud University Medical Center (Radboudumc) obtained all licenses and documentation for the production process of Combidex (ferumoxtran‐10), and manufactured the contrast agent under supervision of the Department of Pharmacy. Since 2014, 310 men with prostate cancer have been examined with CEM in the Radboudumc. Within this cohort, seven minor possibly contrast‐related adverse effects were observed after administration of Combidex. As the contrast agent is now back again in the Netherlands, this review highlights the working mechanism, previous results, observed side effects since the reintroduction, and the future perspectives for Combidex. WIREs Nanomed Nanobiotechnol 2018, 10:e1471. doi: 10.1002/wnan.1471This article is categorized under: Diagnostic Tools > In Vivo Nanodiagnostics and ImagingTherapeutic Approaches and Drug Discovery > Nanomedicine for Oncologic Disease

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Aspecific Uptake of 68GA-PSMA in Paget Disease of the Bone

Cited by 30 publications

References 25 publications

PSMA-PET/CT-Positive Paget Disease in a Patient with Newly Diagnosed Prostate Cancer: Imaging and Bone Biopsy Findings

PSMA-PET/CT-Positive Paget Disease in a Patient with Newly Diagnosed Prostate Cancer: Imaging and Bone Biopsy Findings

Optimization of PET protocol and interrater reliability of 18F-PSMA-11 imaging of prostate cancer

Ultra‐small superparamagnetic iron oxides for metastatic lymph node detection: back on the block

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