{"title":"Diagnostic performance of <sup>99m</sup>Tc-PSMA SPECT/CT in primary prostate carcinoma.","authors":"Kanhaiyalal Agrawal, P Sai Sradha Patro, Tejasvini Singhal, Drishty Satpati, Prasant Nayak, Swarnendu Mandal, Navneet Kumar, Biswa Mohan Padhy, Mukund Sable, Bikash Ranjan Meher","doi":"10.12998/wjcc.v13.i24.107555","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong><sup>68</sup>Ga (gallium)-PSMA PET-CT (prostate-specific membrane antigen-directed Positron emission tomography-computed tomography) has established its role in prostate cancer management as targeted molecular imaging. However, limited studies are available on the diagnostic accuracy of <sup>99m</sup>Tc (Technetium)-PSMA-SPECT/CT. Due to its cost effectiveness and better feasibility, it needs to be explored more extensively for its incorporation into routine clinical practice.</p><p><strong>Aim: </strong>To analyse the diagnostic accuracy of <sup>99m</sup>Tc-PSMA-SPECT/CT for detection of primary prostate carcinoma.</p><p><strong>Methods: </strong>As a prospective study in a tertiary hospital, 99mTc-PSMA-SPECT/CT was performed in 29 outpatients with suspected prostate cancer, with a median age of 66 (range: 50-82) years. The findings were compared to histopathology as the gold standard.</p><p><strong>Results: </strong>Nineteen of twenty-nine patients were positive on <sup>99m</sup>Tc-PSMA-SPECT/CT, of which 16 (84.2%) had prostate cancer on histopathology, while the remaining ten were negative on imaging, of which three had prostate cancer, leading to an overall sensitivity, specificity, and accuracy of 84.2%, 70%, and 79.3%, respectively, on visual analysis. Prostate:background and prostate:liver ratios were 37.18 ± 48.85 and 5.35 ± 7.35 in the malignant group, while 6.65 ± 5.17 and 1.14 ± 0.56 in the benign group, respectively. The area under the curve values for prostate:background and prostate:liver ratios were 0.833 (95% confidence interval [CI]: 0.677-0.990, <i>P</i> = 0.005) and 0.767 (95%CI: 0.596-0.937, <i>P</i> = 0.024), respectively, on receiver operator curve analysis. A cut-off value > 10.45 for prostate:background ratio (sensitivity 85% and specificity 88.9%), and > 1.15 for prostate:liver ratio (sensitivity 75% and specificity of 77.8% respectively) was found to be pertinent to differentiate between the malignant <i>vs</i> benign groups.</p><p><strong>Conclusion: </strong><sup>99m</sup>Tc-PSMA-SPECT/CT shows a promising role in the diagnosis of primary prostate cancer.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 24","pages":"107555"},"PeriodicalIF":1.0000,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207555/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Clinical Cases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.12998/wjcc.v13.i24.107555","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background: 68Ga (gallium)-PSMA PET-CT (prostate-specific membrane antigen-directed Positron emission tomography-computed tomography) has established its role in prostate cancer management as targeted molecular imaging. However, limited studies are available on the diagnostic accuracy of 99mTc (Technetium)-PSMA-SPECT/CT. Due to its cost effectiveness and better feasibility, it needs to be explored more extensively for its incorporation into routine clinical practice.
Aim: To analyse the diagnostic accuracy of 99mTc-PSMA-SPECT/CT for detection of primary prostate carcinoma.
Methods: As a prospective study in a tertiary hospital, 99mTc-PSMA-SPECT/CT was performed in 29 outpatients with suspected prostate cancer, with a median age of 66 (range: 50-82) years. The findings were compared to histopathology as the gold standard.
Results: Nineteen of twenty-nine patients were positive on 99mTc-PSMA-SPECT/CT, of which 16 (84.2%) had prostate cancer on histopathology, while the remaining ten were negative on imaging, of which three had prostate cancer, leading to an overall sensitivity, specificity, and accuracy of 84.2%, 70%, and 79.3%, respectively, on visual analysis. Prostate:background and prostate:liver ratios were 37.18 ± 48.85 and 5.35 ± 7.35 in the malignant group, while 6.65 ± 5.17 and 1.14 ± 0.56 in the benign group, respectively. The area under the curve values for prostate:background and prostate:liver ratios were 0.833 (95% confidence interval [CI]: 0.677-0.990, P = 0.005) and 0.767 (95%CI: 0.596-0.937, P = 0.024), respectively, on receiver operator curve analysis. A cut-off value > 10.45 for prostate:background ratio (sensitivity 85% and specificity 88.9%), and > 1.15 for prostate:liver ratio (sensitivity 75% and specificity of 77.8% respectively) was found to be pertinent to differentiate between the malignant vs benign groups.
Conclusion: 99mTc-PSMA-SPECT/CT shows a promising role in the diagnosis of primary prostate cancer.
期刊介绍:
The World Journal of Clinical Cases (WJCC) is a high-quality, peer reviewed, open-access journal. The primary task of WJCC is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of clinical cases. In order to promote productive academic communication, the peer review process for the WJCC is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJCC are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in clinical cases.