Comparison of bone scintigraphy and 68Ga-PSMA PET for skeletal staging in prostate cancer

Abstract

Ga-PSMA PET outperforms planar BS for the detection of affected bone regions as well as determination of overall bone involvement in PC patients. Our results indicate that BS in patients who have received PSMA PET for staging only rarely offers additional information; however, prospective studies, including a standardized integrated x-ray computed tomography (SPECT/CT) protocol, should be performed in order to confirm the presented results.

11C-Acetate-PET/CT Compared to 99mTc-HDP Bone Scintigraphy in Primary Staging of High-risk Prostate Cancer

“…However, as in other retrospective studies, we found this time range reasonable since the growth rate of PC metastases is relatively slow (22).…”

“…Second best would be histopathological confirmation, which could not be obtained in this study. Confirmation of PET/CT findings with clinical follow-up data and consensus, best valuable comparator, instead of histopathology has been used in other comparative imaging studies in PC and is regarded as an established procedure for validation (21,22). We chose not to verify our results with pre-treatment consensus in order to avoid circle evidence, since both ACE-PET/CT and BS results contributed to the final conclusion.…”

PSMA Ligands for PET Imaging of Prostate Cancer

“…In detecting sites of nodal or bone involvement in preoperative patients, cross-sectional imaging has shown a limited pooled sensitivity and specificity of 42% and 82%, respectively, for CT and 39% and 82%, respectively, for MRI (3), as up to 80% of lymph node metastases in PC are harbored in normal-sized lymph nodes (2). Several studies showed a clear superiority of PSMA ligand PET/CT over standard-of-care imaging (CT, MRI, or bone scanning) (21,(46)(47)(48)(49). For example, in a retrospective analysis of 130 patients with primary intermediate-to high-risk PC using templatebased pelvic histopathology as a reference, 68 Ga-PSMA-11 PET performed significantly better than morphologic imaging for N staging both on a patient and a template basis (P 5 0.002 and , 0.001, respectively).…”

“…For bone metastases, Pyka et al demonstrated that 68 Ga-PSMA-11 PET significantly outperformed bone scanning because of both its high sensitivity and its high specificity on a patient and region basis (P 5 0.006 and P , 0.0001, respectively). Because a histologic gold standard is not feasible in most cases for bone lesions, a best valuable comparator was defined on the basis of this study on a consensus review of all available current and follow-up images (including bone scanning/SPECT, PET, CT, MRI) and clinical data (48).…”

Is PSMA PET-CT Better than Bone Scan? When and Why

“…For BMs PSMA PET has unique distinction of being positive in bone marrow metastasis and not being positive in degenerative bone disease. In a direct comparison, PSMA PET outperformed planner BS for detection of affected bone regions as well as overall bone disease volume [24,25]. Overall 17.6% of affected bone regions were exclusively recognized only by PSMA PET while only 1.2% of bony regions exclusively detected by BS.…”