Relationship between PSA kinetics and Tc‐99m HYNIC PSMA SPECT/CT detection rates of biochemical recurrence in patients with prostate cancer after radical prostatectomy

Liu, Chang; Zhu, Yao; Su, Hengchuan; Xu, Xiaoping; Zhang, Yingjian; Ye, Dingwei; Hu, Silong

doi:10.1002/pros.23696

Cited by 11 publications

(7 citation statements)

References 27 publications

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“…In a large study of 225 patients reported by Schmidkonz et al [15], it was found that the detection capabilities of prostate cancer with the biochemical progression of [ 99m Tc]Tc-MIP-1404 SPECT-CT are comparable to those of 68 Ga-PSMA PET-CT at levels of PSA > 2 ng/mL. At lower than these values and a smaller volume of the tumour tissue substrate, the sensitivity of SPECT-CT studies is reduced to 54% [16]. Liu et al [17], report that at lower PSA values < 0.5 ng/mL the diagnostic value of [ 99m Tc]HYNIC-PSMA SPECT-CT is 48.6%.…”

Section: Discussionmentioning

confidence: 95%

SPECT-CT Imaging with 99mTc-PSMAin Patients with Recurrent Prostate Cancer

Sergieva¹,

Mangaldgiev²,

Dimcheva³

et al. 2021

Nucl. Med. Rev.

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Background: Prostate-specific membrane antigen (PSMA) is a cell surface glycoprotein with a large extracellular domain with overexpression of the prostatic tumour cells. Several small molecules of PSMA ligands of inhibitors binding to the active site of PSMA were developed. [ 99m Tc]Tc-PSMA-T4 is a new radiopharmaceutical (Polatom) for imaging loco-regional metastases and/or local relapse in patients with prostate cancer.The purpose of this work was to evaluate the clinical application of SPECT-CT imaging with [ 99m Tc]Tc-PSMA-T4 in patients with recurrent prostate cancer.Material and methods: Thirty-six patients with prostate cancer, aged 60-80 years with biochemical relapse of PSA (ranged from 0.1 to 73 ng/mL) were included. Three patients were studied after tru-cut biopsy, hormonal and cytoreductive radiotherapy and 33 patients out of 36 -after radical treatment (total prostatectomy or definitive radiotherapy of the tumour). All of them underwent whole-body imaging examinations with subsequent target SPECT-CT studies of the pelvis, abdomen and/or chest, 1-3 hrs post i.v. administration of [ 99m Tc]Tc-PSMA-T4. The average activity dose was 6.3 MBq/kg in a man of 70 kg. A Dual-head SPECT-CT gamma camera with a low dose CT scan (Symbia T2, Siemens) was used. The images were interpreted based on all other clinical and radiological data. Follow-up could be conducted in 11/36 patients during that period.Results: Normal biodistribution of the radiopharmaceutical with high activity background was observed in the liver, spleen, kidneys, lacrimal and salivary glands, bowels and urinary bladder. Positive imaging for local relapse in the prostate bad was imaged in 21 patients, lymph node metastases -in 16 cases, bone lesions -in 10 cases, pulmonary metastases -in 2 cases, hepatic lesions were visualised in one of them and in another -adrenal suprarenal metastasis with intensive tracer uptake significant for overexpression of PSMA. There was a suspicion for local recurrences in 4 patients with negative MRT studies who were followed up. In 3 cases, previously treated bone metastases were partially negative without tracer uptake, only some progressive bone lesions were positive. Five patients were with negative results. Sensitivity was 84.37% (27/32), specificity -100% (4/4) and accuracy -86.11% (31/36). Conclusions:In conclusion SPECT-CT imaging with [ 99m Tc]Tc-PSMA-T4 could be applied in patients with prostate cancer for the diagnosis of recurrent disease to determine personalized treatment for each patient. Specific uptake of this tracer, depicted by SPECT-CT images has clinical importance of identifying and assessing PSMA expression before consideration of Radio Ligand Therapy (RLT) with [ 177 Lu]Lu-PSMA. SPECT-CT imaging with [ 99m Tc]PSMA is promising and reliable nuclear medicine approach to monitoring therapeutic effect after treatment and for restaging of the disease.

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Section: Discussionmentioning

confidence: 95%

SPECT-CT Imaging with 99mTc-PSMAin Patients with Recurrent Prostate Cancer

Sergieva¹,

Mangaldgiev²,

Dimcheva³

et al. 2021

Nucl. Med. Rev.

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“…Two studies by Schmidkonz and colleagues reported that the overall detection rates of 99mTc-MIP-1404 for BCR of PCa were 77% (174/225) (10) and 70% (42/60) (12), respectively. Similarly, Su et al (20) and Liu et al (21) reported detection rates of 78% (39/50) and 73% (151/208) for 99mTc-HYNIC-PSMA in the localization of BCR. A detection rate of 57% (87/152) was reported for 99mTc-PSMA-I&S, which is lower than our finding (22).…”

Section: Discussionmentioning

confidence: 76%

Diagnostic performance of 99mTc-HYNIC-PSMA SPECT/CT for biochemically recurrent prostate cancer after radical prostatectomy

Duan

Shi

et al. 2022

Front. Oncol.

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Objectives99mTc-HYNIC-PSMA is a novel technetium-99m-labeled small-molecule inhibitor of prostate-specific membrane antigen (PSMA) for detection of prostate cancer. The present study investigated the diagnostic yield of 99mTc-HYNIC-PSMA Single photon emission computed tomography (SPECT)/CT in 147 patients with biochemically recurrent prostate cancer after radical prostatectomy.Methods147 patients with biochemical relapse after radical prostatectomy were finally eligible for this retrospective analysis. The median prostate-specific antigen (PSA) level was 8.26 ng/mL (range, 0.22-187.40 ng/mL). Of the 147 patients, 72 patients received androgen deprivation therapy (ADT) at least 6 months before the 99mTc-HYNIC-PSMA SPECT/CT. All patients underwent planar whole-body scans and subsequent SPECT/CT of the thoracic and abdominal regions after intravenous injection of 705 ± 70 MBq of 99mTc-HYNIC-PSMA. Images were evaluated for the presence and location of PSMA-positive lesions, in which SUVmax were also measured. Detection rates were stratified according to PSA levels, ADT and Gleason scores. The relationships between SUVmax and clinical characteristics were analyzed using univariate and multivariable linear regression models for patients with positive findings.ResultsOf the 147 patients, 99mTc-HYNIC-PSMA SPECT/CT revealed at least one positive lesion in 118 patients with a high detection rate (80.3%). The detection rates were 48.6% (17/35), 85.1% (40/47), 92.1% (35/38), and 96.3% (26/27) at PSA levels of greater than 0.2 to 2, greater than 2 to 5, greater than 5 to 10, and greater than 10 ng/mL, respectively. PSMA SPECT/CT indicated local recurrence, lymph node metastases, bone metastases, and visceral metastases in 14 (9.5%), 73 (49.7%), 48 (32.7%) and 3 (2.0%) patients. The detection rates of local recurrence and metastasis increased with increasing PSA levels. The detection rate was higher in patients treated with ADT than those without (90.3% vs. 70.7%; P =0.0029). In patients with Gleason scores ≥8, detection rate was slightly higher than those with ≤7 (81.7% vs. 78.5%), but not statistically significant (P = 0.6265). Multivariable linear regression analysis showed a significant correlation of PSA levels and ADT with SUVmax (P=0.0005 and P=0.0397).Conclusions99mTc-HYNIC-PSMA SPECT/CT offers high detection rates for biochemically recurrent prostate cancer after radical prostatectomy. The detection rate and SUVmax were positively correlated with PSA levels and ADT.

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“…While the overall detection rate of PSMA SPECT/CT of 77% was comparable to PET diagnostics, it is important to note that for low PSA levels (<2 ng/mL), SPECT/CT showed considerably lower detection rates of only 54% compared to PSMA PET/CT. The highest detection rate for SPECT/CT at very low PSA levels (<0.5 ng/mL) was described by Liu et al [44] with 48.6%. In patients with PSA relapse and PSA values <1 ng/mL after primary treatment, two smaller retrospective studies showed detection rates for PSMA SPECT/CT of only 36.4% and 30%, respectively [4546].…”

Section: Main Bodymentioning

confidence: 99%

Performance and Impact of Prostate Specific Membrane Antigen-Based Diagnostics in the Management of Men with Biochemical Recurrence of Prostate Cancer and its Role in Salvage Lymph Node Dissection

Krimphove

Theißen

Cole

et al. 2020

World J Mens Health

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Up to 50% of prostate cancer (PCa) patients experience recurrence or disease persistence following local therapy with curative intent. Certainly, some of these men are candidates for adjuvant or salvage local surgical or radiation therapy (RT) approaches including stereotactic/hypo fractionated radiotherapy, salvage lymphadenectomy or prostatectomy [1-3]. However, this clinical decision is typically based in the absence of

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Relationship between PSA kinetics and Tc‐99m HYNIC PSMA SPECT/CT detection rates of biochemical recurrence in patients with prostate cancer after radical prostatectomy

Abstract: The Tc-99m HYNIC PSMA SPECT/CT detection rate is influenced by trigger PSA, PSAdt, and PSAvel. Like PSA, PSAdt is an independent predictor of Tc-99m HYNIC PSMA SPECT/CT. PSAdt should be taken into account by physicians especially when PSA <1 ng/mL.

Cited by 11 publications

References 27 publications

SPECT-CT Imaging with 99mTc-PSMAin Patients with Recurrent Prostate Cancer

SPECT-CT Imaging with 99mTc-PSMAin Patients with Recurrent Prostate Cancer

Diagnostic performance of 99mTc-HYNIC-PSMA SPECT/CT for biochemically recurrent prostate cancer after radical prostatectomy

Performance and Impact of Prostate Specific Membrane Antigen-Based Diagnostics in the Management of Men with Biochemical Recurrence of Prostate Cancer and its Role in Salvage Lymph Node Dissection

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