RT Journal Article
SR Electronic
T1 Tc-99m bone scan vs Tc-99m PSMA scintigraphy in advanced metastatic prostate cancer patients
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 759
OP 759
VO 58
IS supplement 1
A1 Hendrik Rathke
A1 Frederik Giesel
A1 Paul Flechsig
A1 Sabine Haufe
A1 Uwe Haberkorn
A1 Clemens Kratochwil
YR 2017
UL http://jnm.snmjournals.org/content/58/supplement_1/759.abstract
AB 759Objectives: Evaluation of the diagnostic potential of the PSMA-targeting tracer 99mTc-MIP1427 in comparison to conventional bone scan with 99mTc-MDP in patients with known osseous metastasized prostate cancer using identical imaging equipment, protocol and nuclide.Methods: n = 21 patients with known mCRPC were staged with both, conventional bone scan and PSMA-scintigraphy, within a time-frame of 2-10 days. Imaging was evaluated with a blind-read by 4 experts in nuclear medicine. Imaging included planar whole-body scans and additional SPECT or SPECT/CT ( two bed positions ) 3h after injection of either 500-750 MBq 99mTc-MIP1427 or 600-750 MBq 99mTc-MDP. Lesions were scored: diffuse bone marrow infiltration vs. focal tumor vs. equivocal vs. benign lesion vs. normal, within a standard reporting schema divided into defined anatomical regions. A consensus read unblinding complementary imaging modalities such as CT and MRI and 6 month of clinical follow-up served as standard of reference.Results: In 16 patients PSMA-imaging had superior detection rates than MDP bone scan. One of these patients had only faint tumor uptake in the bone, however a soft tissue lesion in the liver was detectable with PSMA-scintigraphy which was predictably not diagnosed with conventional bone scan. Three patients had 'match-lesions' with equally tumor spread with both tracers. In two patients, a PSMA-negative tumor with increased MDP positive bone lesions were detected. 8 patients had PSMA-positive visceral metastases additionally to bone lesions and 4 patients had extended MDP negative bone marrow lesions.Conclusion: The PSMA scintigraphy demonstrated a reduction of the number of equivocal findings in comparison to bone scan. With MDP bone scan a higher amount of the lesions were scored equivocal or presumably benign while PSMA more often resulted in tumor typical appearance. However, SPECT or SPECT/CT was mandatory to differentiate between bone metastases and extra-osseous tumor lesions. Research Support: