Fabian Haupt1,2, Lotte Dijkstra1, Ian Alberts1, Christos Sachpekidis1, Viktor Fech1, Silvan Boxler3, Tobias Gross3, Tim Holland-Letz4, Helle D Zacho5, Uwe Haberkorn6,7, Kambiz Rahbar8, Axel Rominger1, Ali Afshar-Oromieh9. 1. Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. 2. Department of Radiology, Bern University Hospital, Bern, Switzerland. 3. Department of Urology, Bern University Hospital, Bern, Switzerland. 4. Department of Biostatistics, German Cancer Research Center, Heidelberg, Germany. 5. Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. 6. Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany. 7. Clinical Cooperation Unit Nuclear Medicine, DKFZ, Heidelberg, Germany. 8. Department of Nuclear Medicine, University Hospital Münster, Münster, Germany. 9. Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. a.afshar@gmx.de.
Abstract
PURPOSE: 68Ga-PSMA-11 PET/CT is commonly performed at 1 h post injection (p.i.). However, various publications have demonstrated that most prostate cancer (PC) lesions exhibit higher contrast at later imaging. The aim of this study was to compare the "common" protocol of 68Ga-PSMA-11 PET/CT with a modified protocol. METHODS: In 2017, we used the following scanning protocol for 68Ga-PSMA-11 PET/CT in patients with recurrent PC: acquisition at 1 h p.i. without further preparations. From 2018, all scans were conducted at 1.5 h p.i. In addition, patients were orally hydrated with 1 L of water 0.5 h p.i. and were injected with 20 mg of furosemide 1 h p.i. Both protocols including 112 patients (2017) and 156 (modified protocol in 2018) were retrospectively compared. Rates of pathologic scans, maximum standardized uptake values (SUVmax), and tumor contrast (ratio lesion-SUVmax/background-SUVmean) as well as average standardized uptake values (SUVmean) of urinary bladder were analyzed. RESULTS: Both tumor contrast and tracer uptake were significantly (p < 0.001) higher in the novel protocol. Although statistically not significant, the rates of pathologic scans were also higher in the modified protocol: 76.3% vs. 68.8% for all PSA values including 38.9% vs. 25.0% for PSA < 0.5 ng/ml and 60.0% vs. 56.7% for PSA > 0.5-≤ 2.0 ng/ml. Average SUVmean of the urinary bladder was significantly (p < 0.001) lower with the modified protocol. CONCLUSIONS: The modified protocol, which includes a combination of delayed image acquisition at 1.5 h p.i., hydration, and furosemide resulted in higher tumor contrast and seems to have the potential to increase the rates of pathological scans, especially at low PSA levels.
PURPOSE: 68Ga-PSMA-11 PET/CT is commonly performed at 1 h post injection (p.i.). However, various publications have demonstrated that most prostate cancer (PC) lesions exhibit higher contrast at later imaging. The aim of this study was to compare the "common" protocol of 68Ga-PSMA-11 PET/CT with a modified protocol. METHODS: In 2017, we used the following scanning protocol for 68Ga-PSMA-11 PET/CT in patients with recurrent PC: acquisition at 1 h p.i. without further preparations. From 2018, all scans were conducted at 1.5 h p.i. In addition, patients were orally hydrated with 1 L of water 0.5 h p.i. and were injected with 20 mg of furosemide 1 h p.i. Both protocols including 112 patients (2017) and 156 (modified protocol in 2018) were retrospectively compared. Rates of pathologic scans, maximum standardized uptake values (SUVmax), and tumor contrast (ratio lesion-SUVmax/background-SUVmean) as well as average standardized uptake values (SUVmean) of urinary bladder were analyzed. RESULTS: Both tumor contrast and tracer uptake were significantly (p < 0.001) higher in the novel protocol. Although statistically not significant, the rates of pathologic scans were also higher in the modified protocol: 76.3% vs. 68.8% for all PSA values including 38.9% vs. 25.0% for PSA < 0.5 ng/ml and 60.0% vs. 56.7% for PSA > 0.5-≤ 2.0 ng/ml. Average SUVmean of the urinary bladder was significantly (p < 0.001) lower with the modified protocol. CONCLUSIONS: The modified protocol, which includes a combination of delayed image acquisition at 1.5 h p.i., hydration, and furosemide resulted in higher tumor contrast and seems to have the potential to increase the rates of pathological scans, especially at low PSA levels.
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Authors: Christian Uprimny; Steffen Bayerschmidt; Alexander Stephan Kroiss; Josef Fritz; Bernhard Nilica; Hanna Svirydenka; Clemens Decristoforo; Elisabeth von Guggenberg; Wolfgang Horninger; Irene Johanna Virgolini Journal: J Nucl Med Date: 2021-03-12 Impact factor: 10.057
Authors: Ian Leigh Alberts; Svenja Elizabeth Seide; Clemens Mingels; Karl Peter Bohn; Kuangyu Shi; Helle D Zacho; Axel Rominger; Ali Afshar-Oromieh Journal: Eur J Nucl Med Mol Imaging Date: 2021-02-06 Impact factor: 9.236
Authors: Steffen Bayerschmidt; Christian Uprimny; Alexander Stephan Kroiss; Josef Fritz; Bernhard Nilica; Hanna Svirydenka; Clemens Decristoforo; Elisabeth von Guggenberg; Wolfgang Horninger; Irene Johanna Virgolini Journal: Diagnostics (Basel) Date: 2021-06-30
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