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Research ArticleTheranostics

Combination of Forced Diuresis with Additional Late Imaging in 68Ga-PSMA-11 PET/CT: Effects on Lesion Visibility and Radiotracer Uptake

Ian Alberts, Jan Niklas-Hünermund, Christos Sachpekidis, Helle Damgaard Zacho, Clemens Mingels, Lotte Dijkstra, Karl Peter Bohn, Tilman Läppchen, Eleni Gourni, Axel Rominger and Ali Afshar-Oromieh
Journal of Nuclear Medicine September 2021, 62 (9) 1252-1257; DOI: https://doi.org/10.2967/jnumed.120.257741
Ian Alberts
1Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; and
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Jan Niklas-Hünermund
1Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; and
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Christos Sachpekidis
1Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; and
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Helle Damgaard Zacho
2Aalborg University Hospital, Universitetshospital, Aalborg, Denmark
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Clemens Mingels
1Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; and
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Lotte Dijkstra
1Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; and
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Karl Peter Bohn
1Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; and
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Tilman Läppchen
1Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; and
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Eleni Gourni
1Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; and
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Axel Rominger
1Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; and
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Ali Afshar-Oromieh
1Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; and
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  • FIGURE 1.
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    FIGURE 1.

    Comparison of old and new protocols. p.i. = after injection; i.v. = intravenously.

  • FIGURE 2.
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    FIGURE 2.

    Violin plots showing urinary bladder SUV for old and new protocols. Whereas increase in bladder SUVmean is seen for old protocol, this is not the case in new protocol.

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    FIGURE 3.

    Violin plots showing change in locally recurrent lesion SUVmax (prostatic fossa/seminal vesicle) vs. bladder SUVmean, that is, lesion-to-bladder contrast. Whereas a decrease in tumor-to-bladder ratio (i.e., lesion visibility) is seen at 2.5 h in old protocol, this was not the case in new protocol.

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    FIGURE 4.

    TBR change at 1.5 and 2.5 h. Points show mean TBR ± SE. Increase in TBR was lower for new protocol than for old protocol. p.i. = after injection.

  • FIGURE 5.
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    FIGURE 5.

    Example patient scan showing locally recurrent lesions (arrows) obscured by high bladder activity in old protocol at late imaging. Shown are low-dose CT (A and D), PET (B and E), and fusion of PET and low-dose CT (C and F) images 2.5 h after injection (A–C) and 1.5 h after injection (D–F).

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    TABLE 1

    Patient Characteristics

    ParameterOld protocolNew protocol
    Age (y)67.9 ± 6.769.2 ± 6.3
    Tracer (MBq)216.9 ± 35.7243.7 ± 39.5
    Gleason score7 (6–10)7 (6–9)
    Prostate-specific antigen1.1 ± 32.7 (mean, 11.5)0.5 ± 45.6 (mean, 7.6)
    TNM*T (1–4) N (0, 0–1) M (0, 0–1)T (1–4) N (0, 0–1) M (0, 0–1)
    • ↵* Classification of the Union for International Cancer Control, eighth edition.

    • Data are median ± SD followed by range in parentheses, unless otherwise noted.

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Journal of Nuclear Medicine: 62 (9)
Journal of Nuclear Medicine
Vol. 62, Issue 9
September 1, 2021
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Combination of Forced Diuresis with Additional Late Imaging in 68Ga-PSMA-11 PET/CT: Effects on Lesion Visibility and Radiotracer Uptake
Ian Alberts, Jan Niklas-Hünermund, Christos Sachpekidis, Helle Damgaard Zacho, Clemens Mingels, Lotte Dijkstra, Karl Peter Bohn, Tilman Läppchen, Eleni Gourni, Axel Rominger, Ali Afshar-Oromieh
Journal of Nuclear Medicine Sep 2021, 62 (9) 1252-1257; DOI: 10.2967/jnumed.120.257741

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Combination of Forced Diuresis with Additional Late Imaging in 68Ga-PSMA-11 PET/CT: Effects on Lesion Visibility and Radiotracer Uptake
Ian Alberts, Jan Niklas-Hünermund, Christos Sachpekidis, Helle Damgaard Zacho, Clemens Mingels, Lotte Dijkstra, Karl Peter Bohn, Tilman Läppchen, Eleni Gourni, Axel Rominger, Ali Afshar-Oromieh
Journal of Nuclear Medicine Sep 2021, 62 (9) 1252-1257; DOI: 10.2967/jnumed.120.257741
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