Hendrik Rathke1, Ali Afshar-Oromieh2, Frederik Lars Giesel2, Christophe Kremer2, Paul Flechsig2, Sabine Haufe2, Walter Mier2, Tim Holland-Letz3, Maximilian De Bucourt4, Thomas Armor5, John W Babich6, Uwe Haberkorn2,7, Clemens Kratochwil2. 1. Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany hendrik.rathke@med.uni-heidelberg.de. 2. Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany. 3. Department of Biostatistics, German Cancer Research Center, Heidelberg, Germany. 4. Department of Radiology, Charité-University Medicine, Berlin, Germany. 5. Progenics Pharmaceuticals Inc., New York, New York. 6. Division of Radiopharmaceutical Sciences, Department of Radiology, Weill Cornell Medical College, New York, New York; and. 7. Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center, Heidelberg, Germany.
Abstract
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 99mTc-MIP-1427, as opposed to conventional bone scanning with 99mTc-methylene diphosphonate (99mTc-MDP), in a collective of patients with known advanced-stage osseous metastasized prostate cancer. Methods: 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 of 99mTc-MIP-1427 or 600-750 MBq of 99mTc-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. Results: 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 99mTc-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. Conclusion: 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.
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 99mTc-MIP-1427, as opposed to conventional bone scanning with 99mTc-methylene diphosphonate (99mTc-MDP), in a collective of patients with known advanced-stage osseous metastasized prostate cancer. Methods: 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 of 99mTc-MIP-1427 or 600-750 MBq of 99mTc-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. Results: 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 99mTc-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. Conclusion: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.
Authors: Hendrik Rathke; Clemens Kratochwil; Ralph Hohenberger; Frederik Lars Giesel; Frank Bruchertseifer; Paul Flechsig; Alfred Morgenstern; Matti Hein; Peter Plinkert; Uwe Haberkorn; Olcay Cem Bulut Journal: Eur J Nucl Med Mol Imaging Date: 2018-08-27 Impact factor: 9.236
Authors: Felix Preisser; Elio Mazzone; Sebastiano Nazzani; Michele Marchioni; Marco Bandini; Zhe Tian; Fred Saad; Denis Soulières; Shahrokh F Shariat; Francesco Montorsi; Hartwig Huland; Markus Graefen; Derya Tilki; Pierre I Karakiewicz Journal: Br J Cancer Date: 2018-11-14 Impact factor: 7.640
Authors: Marcin Czarniecki; Esther Mena; Liza Lindenberg; Marek Cacko; Stephanie Harmon; Jan Philipp Radtke; Frederick Giesel; Baris Turkbey; Peter L Choyke Journal: Transl Androl Urol Date: 2018-10