Diagnostic sensitivity of Tc-99m HYNIC PSMA SPECT/CT in prostate carcinoma: A comparative analysis with Ga-68 PSMA PET/CT

Lawal, Ismaheel; Ankrah, Alfred O.; Mokgoro, Neo P.; Vorster, Mariza; Maes, Alex; Sathekge, Mike

doi:10.1002/pros.23379

Cited by 51 publications

(37 citation statements)

References 25 publications

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“…Patients were considered suitable for treatment if metastatic lesions identified demonstrated sufficient expression of the PSMA defined as uptake greater than twice the physiologic uptake in the normal liver. Synthesis of 68 Ga-PSMA-11 and the performance of PET/CT imaging were as we have previously reported [18, 19]. …”

Section: Methodsmentioning

confidence: 99%

225Ac-PSMA-617 in chemotherapy-naive patients with advanced prostate cancer: a pilot study

Sathekge

Bruchertseifer

Knoesen

et al. 2018

Eur J Nucl Med Mol Imaging

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Ac-PSMA-617 RLT of chemotherapy-naïve patients with advanced metastatic prostate carcinoma led to a ≥ 90% decline in serum PSA in 82% of patients including 41% of patients with undetectable serum PSA who remained in remission 12 months after therapy. The remarkable therapeutic efficacy reported in this study could be achieved with reduced toxicity to salivary glands due to de-escalation of administered activities in subsequent treatment cycles. This necessitates further exploration for informing clinical practice and clinical trial design.

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Section: Methodsmentioning

confidence: 99%

225Ac-PSMA-617 in chemotherapy-naive patients with advanced prostate cancer: a pilot study

Sathekge

Bruchertseifer

Knoesen

et al. 2018

Eur J Nucl Med Mol Imaging

Self Cite

272

235

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“…In contrast, the similar sensitivity and specificity found with PSMA PET/CT were derived from patients with clinically more challenging conditions. The specificity of SPECT imaging in our cohort with a high tumor burden seems to be overestimated, especially because recently published data indicated the superiority of 68 Ga-PSMA PET/CT over 99m Tc-PSMA SPECT/CT, particularly in patients with low-volume disease or PSA relapse (33,34).…”

Section: Discussionmentioning

confidence: 73%

Intraindividual Comparison of ^99mTc-Methylene Diphosphonate and Prostate-Specific Membrane Antigen Ligand ^99mTc-MIP-1427 in Patients with Osseous Metastasized Prostate Cancer

et al. 2018

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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 Tc-MIP-1427, as opposed to conventional bone scanning withTc-methylene diphosphonate (Tc-MDP), in a collective of patients with known advanced-stage osseous metastasized prostate cancer. 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 ofTc-MIP-1427 or 600-750 MBq of Tc-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. 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 Tc-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. 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.

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“…This might be due to the increased importance of PET's higher spatial resolution compared to SPECT when evaluating comparably small lesions associated with low PSA levels. In a relevant recent study, Lawal et al compared PSMA targeting SPECT ( 99m Tc‐HYNIC‐iPSMA) and PET ( 68 Ga‐PSMA‐HBED‐CC) ligands in the same 19 patients and found lower detection rates for the SPECT tracer. They found that the lesions size was a strong predictor of lesion detection in SPECT.…”

Section: Discussionmentioning

confidence: 99%

^99mTc‐MIP‐1404‐SPECT/CT for the detection of PSMA‐positive lesions in 225 patients with biochemical recurrence of prostate cancer

et al. 2017

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Background 99mTc‐MIP‐1404 (Progenics Pharmaceuticals, Inc., New York, NY) is a novel, SPECT‐compatible 99mTc‐labeled PSMA inhibitor for the detection of prostate cancer. We present results of its clinical use in a cohort of 225 men with histologically confirmed prostate cancer referred for workup of biochemical relapse. Methods From April 2013 to April 2017, 99mTc‐MIP1404‐scintigraphy was performed in 225 patients for workup of PSA biochemical relapse of prostate cancer. Whole‐body planar and SPECT/CT images of the lower abdomen and thorax were obtained 3‐4 h p.i. of 710 ± 64 MBq 99mTc‐MIP‐1404. Images were visually analyzed for presence and location of abnormal uptake. In addition, quantitative analysis of the SPECT/CT data was carried out on a subset of 125 patients. Follow‐up reports of subsequent therapeutic interventions were available for 59% (139) of all patients. Results Tracer‐positive lesions were detected in 77% (174/225) of all patients. Detections occurred at the area of local recurrence in the prostate in 25% of patients (or a total of 56), with metastases in lymph nodes in 47% (105), bone in 27% (60), lung in 5% (12), and other locations in 2% (4) of patients. Detection rates were 90% at PSA levels ≥2 ng/mL and 54% below that threshold. Lesional SUVmax values were, on average, 32.2 ± 29.6 (0.8–142.2), and tumor‐to‐normal ratios 146.6 ± 160.5 (1.9–1482.4). The PSA level correlated significantly with total uptake of MIP‐1404 in tumors (P < 0.001). Furthermore, total tumor uptake was significantly higher in patients with Gleason scores ≥8 compared to those with Gleason scores ≤7 (P < 0.05). In patients with androgen deprivation therapy, the detection rate was significantly higher compared to patients without androgen deprivation therapy (86% vs 71%, P < 0.001). Based on 99mTc‐MIP‐1404‐imaging and other information, an interdisciplinary tumor board review recommended changes to treatment plans in 74% (104/139) of those patients for whom the necessary documentation was available. Conclusion SPECT/CT with 99mTc‐labeled MIP‐1404 has a high probability in detecting PSMA‐positive lesions in patients with elevated PSA. Statistical analysis disclosed significant relationship between quantitative 99mTc‐MIP‐1404 uptake, PSA level, and Gleason score.

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Diagnostic sensitivity of Tc-99m HYNIC PSMA SPECT/CT in prostate carcinoma: A comparative analysis with Ga-68 PSMA PET/CT

Cited by 51 publications

References 25 publications

225Ac-PSMA-617 in chemotherapy-naive patients with advanced prostate cancer: a pilot study

225Ac-PSMA-617 in chemotherapy-naive patients with advanced prostate cancer: a pilot study

Intraindividual Comparison of ^99mTc-Methylene Diphosphonate and Prostate-Specific Membrane Antigen Ligand ^99mTc-MIP-1427 in Patients with Osseous Metastasized Prostate Cancer

^99mTc‐MIP‐1404‐SPECT/CT for the detection of PSMA‐positive lesions in 225 patients with biochemical recurrence of prostate cancer

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Diagnostic sensitivity of Tc-99m HYNIC PSMA SPECT/CT in prostate carcinoma: A comparative analysis with Ga-68 PSMA PET/CT

Cited by 51 publications

References 25 publications

225Ac-PSMA-617 in chemotherapy-naive patients with advanced prostate cancer: a pilot study

225Ac-PSMA-617 in chemotherapy-naive patients with advanced prostate cancer: a pilot study

Intraindividual Comparison of 99mTc-Methylene Diphosphonate and Prostate-Specific Membrane Antigen Ligand 99mTc-MIP-1427 in Patients with Osseous Metastasized Prostate Cancer

99mTc‐MIP‐1404‐SPECT/CT for the detection of PSMA‐positive lesions in 225 patients with biochemical recurrence of prostate cancer

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Product

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Intraindividual Comparison of ^99mTc-Methylene Diphosphonate and Prostate-Specific Membrane Antigen Ligand ^99mTc-MIP-1427 in Patients with Osseous Metastasized Prostate Cancer

^99mTc‐MIP‐1404‐SPECT/CT for the detection of PSMA‐positive lesions in 225 patients with biochemical recurrence of prostate cancer