Thomas J W Klein Nulent1, Matthijs H Valstar2, Bart de Keizer3, Stefan M Willems4, Laura A Smit5, Abrahim Al-Mamgani6, Ludwig E Smeele2, Robert J J van Es7, Remco de Bree8, Wouter V Vogel9. 1. Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: T.j.w.kleinnulent@umcutrecht.nl. 2. Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Oral and Maxillofacial Surgery, Academic Medical Centre, University of Amsterdam, The Netherlands. 3. Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands. 4. Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. 5. Department of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. 6. Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands. 7. Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. 8. Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands. 9. Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Nuclear Medicine, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Abstract
OBJECTIVES: Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) is used for detection and (re)staging of prostate cancer. However, healthy salivary, seromucous, and lacrimal glands also have high PSMA-ligand uptake. This study aimed to describe physiologic PSMA-ligand uptake distribution characteristics in the head and neck to aid in PSMA PET/CT interpretation and to identify possible new clinical applications for PSMA-ligand imaging. STUDY DESIGN: Thirty consecutive patients who underwent PSMA PET/CT for prostate cancer were evaluated. Tracer maximum standardized uptake values (SUVmax) in the salivary, seromucous, and lacrimal glands were determined visually and quantitatively. Overall and intraindividual variations were reported. RESULTS: All gland locations had increased tracer uptake. The mean SUVmax ± standard deviation varied: parotid 12.3 ± 3.9; submandibular 11.7 ± 3.5; sublingual 4.5 ± 1.9; soft palate 2.4 ± 0.5; pharyngeal wall 4.3 ± 1.3; nasal mucosa 3.4 ± 0.9; supraglottic larynx 2.7 ± 0.7; and lacrimal 6.2 ± 2.2. The parotid had the largest overall variation in SUVmax (5.2-22.9), and the sublingual glands had the largest mean intraindividual difference (18.1%). CONCLUSIONS: Major and minor salivary and seromucous glands consistently have high PSMA-ligand uptake. Minor gland locations can be selectively visualized by this technique for the first time. This provides potential new applications such as quantification of present salivary gland tissues and individualization of radiotherapy for head and neck cancer or lutetium-177-PSMA radionuclide treatment.
OBJECTIVES:Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) is used for detection and (re)staging of prostate cancer. However, healthy salivary, seromucous, and lacrimal glands also have high PSMA-ligand uptake. This study aimed to describe physiologic PSMA-ligand uptake distribution characteristics in the head and neck to aid in PSMA PET/CT interpretation and to identify possible new clinical applications for PSMA-ligand imaging. STUDY DESIGN: Thirty consecutive patients who underwent PSMA PET/CT for prostate cancer were evaluated. Tracer maximum standardized uptake values (SUVmax) in the salivary, seromucous, and lacrimal glands were determined visually and quantitatively. Overall and intraindividual variations were reported. RESULTS: All gland locations had increased tracer uptake. The mean SUVmax ± standard deviation varied: parotid 12.3 ± 3.9; submandibular 11.7 ± 3.5; sublingual 4.5 ± 1.9; soft palate 2.4 ± 0.5; pharyngeal wall 4.3 ± 1.3; nasal mucosa 3.4 ± 0.9; supraglottic larynx 2.7 ± 0.7; and lacrimal 6.2 ± 2.2. The parotid had the largest overall variation in SUVmax (5.2-22.9), and the sublingual glands had the largest mean intraindividual difference (18.1%). CONCLUSIONS: Major and minor salivary and seromucous glands consistently have high PSMA-ligand uptake. Minor gland locations can be selectively visualized by this technique for the first time. This provides potential new applications such as quantification of present salivary gland tissues and individualization of radiotherapy for head and neck cancer or lutetium-177-PSMA radionuclide treatment.
Authors: Jyoti Roy; Blake M Warner; Falguni Basuli; Xiang Zhang; Karen Wong; Thomas Pranzatelli; Anita T Ton; John A Chiorini; Peter L Choyke; Frank I Lin; Elaine M Jagoda Journal: Cancer Biother Radiopharm Date: 2020-02-19 Impact factor: 3.099
Authors: Frédéric Bois; Camille Noirot; Sébastien Dietemann; Ismini C Mainta; Thomas Zilli; Valentina Garibotto; Martin A Walter Journal: Am J Nucl Med Mol Imaging Date: 2020-12-15
Authors: Thomas J W Klein Nulent; Matthijs H Valstar; Laura A Smit; Ludwig E Smeele; Nicolaas P A Zuithoff; Bart de Keizer; Remco de Bree; Robert J J van Es; Stefan M Willems Journal: BMC Cancer Date: 2020-06-05 Impact factor: 4.430
Authors: Ludwike W M van Kalmthout; Marnix G E H Lam; Bart de Keizer; Gerard C Krijger; Tessa F T Ververs; Rememrt de Roos; Arthur J A T Braat Journal: EJNMMI Res Date: 2018-07-03 Impact factor: 3.138