Comparison of 99mTc-HYNIC-PSMA-11, bone scan and post radioligand therapy images in mCRPC patients: A single center experience.

K Aryana, A Aghaee, E Askari, Y Fakhar, N Raeisi, M Mottaghi, M Emadzadeh, H Ghorbani, S Barashki
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Abstract

Background: Prostate-Specific Membrane Antigen is overexpressed in primary and metastatic prostate cancer tissues. While PSMA PET agents have gained their role in the prostate cancer guidelines, Technetium-based PSMA agents have left behind. Given the novelty of 99mTc-HYNIC-PSMA-11, we conducted this study to compare its detection rate in tracing skeletal metastases in comparison to bone scans and also compared the number of metastatic lesions which showed PSMA uptake in the diagnostic scan with those detected in post-treatment scans after radioligand therapy (RLT) with 177Lu-PSMA-617-617.

Methods: Bone and 99mTc-HYNIC-PSMA-11 scans with a maximum interval of 90 days were performed in thirty-nine patients with widespread bone metastases. If the PSMA scan was positive, patients were treated with 177Lu-PSMA-617 and post treatment scan was also obtained. For negative PSMA results, 68Ga-PSMA PET/CT was performed to compare its results with the bone scan. In patients with PSMA expression, detection of metastatic lesions in three consecutive whole-body scans in different regions were compared (99mTc-HYNIC-PSMA-11 with bone and post treatment scans, separately).

Results: 37 (94.9%) showed adequate 99mTc-HYNIC-PSMA-11 uptake in the metastatic regions. Compared to bone scan, 99mTc-HYNIC-PSMA-11 showed additional lesions in 13 (35.1%) participants which were mostly located in the appendicular skeleton and pelvic bones. Inversely, the bone scan detected more lesions in 12 (32.4%) patients. Both scans in 12 (32.4%) patients showed the exact same results. Comparison between the 99mTc-HYNIC-PSMA-11 scan and 177Lu-PSMA-617 showed completely similar results in 29 (78.4%) patients; however, 177Lu-PSMA-617 detected more lesions in eight (21.6%) participants.

Conclusion: The 99mTc-HYNIC-PSMA-11 scan demonstrates comparable results to bone scans in evaluating skeletal metastases in prostate cancer patients. It serves as a cost-effective modality for identifying suitable candidates for radioligand therapy, particularly beneficial in resource-limited countries.

mCRPC患者99mTc-HYNIC-PSMA-11、骨扫描和放射治疗后图像的比较:单中心经验
背景:前列腺特异性膜抗原在原发性和转移性前列腺癌组织中过表达。虽然PSMA PET制剂已经在前列腺癌指南中发挥了作用,但基于锝的PSMA制剂却落在了后面。鉴于99mtc - hylic -PSMA-11的新颖性,我们进行了这项研究,比较了它在追踪骨骼转移方面的检出率与骨扫描的比较,并比较了在诊断扫描中显示PSMA摄取的转移病灶数量与使用177Lu-PSMA-617-617放射配体治疗(RLT)后的治疗后扫描中发现的转移病灶数量。方法:对39例广泛骨转移患者进行骨和99mTc-HYNIC-PSMA-11扫描,最长间隔为90天。如果PSMA扫描呈阳性,则患者接受177Lu-PSMA-617治疗,并获得治疗后扫描。对于PSMA阴性结果,进行68Ga-PSMA PET/CT与骨扫描结果进行比较。在PSMA表达的患者中,比较了连续三次全身扫描在不同区域的转移病灶检测(99mTc-HYNIC-PSMA-11分别与骨扫描和治疗后扫描)。结果:37例(94.9%)在转移区显示99mTc-HYNIC-PSMA-11摄取充足。与骨扫描相比,99mTc-HYNIC-PSMA-11在13名(35.1%)参与者中显示额外的病变,主要位于阑尾骨骼和骨盆骨。相反,在12例(32.4%)患者中,骨扫描检测到更多病变。12例(32.4%)患者的两次扫描结果完全相同。99mTc-HYNIC-PSMA-11扫描与177Lu-PSMA-617的比较显示,29例(78.4%)患者的结果完全相似;然而,177Lu-PSMA-617在8名(21.6%)参与者中检测到更多病变。结论:99mTc-HYNIC-PSMA-11扫描在评估前列腺癌患者骨骼转移方面的结果与骨扫描相当。它是一种具有成本效益的方式,用于确定放射治疗的合适候选人,在资源有限的国家特别有益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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