scholarly journals Comparison of Early Imaging and Imaging 60 min Post-Injection after Forced Diuresis with Furosemide in the Assessment of Local Recurrence in Prostate Cancer Patients with Biochemical Recurrence Referred for 68Ga-PSMA-11 PET/CT

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1191
Author(s):  
Steffen Bayerschmidt ◽  
Christian Uprimny ◽  
Alexander Stephan Kroiss ◽  
Josef Fritz ◽  
Bernhard Nilica ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Local Recurrence ◽  
Pet Imaging ◽  
Biochemical Recurrence ◽  
Whole Body ◽  
Post Injection ◽  
Forced Diuresis ◽  
Pet Ct ◽  
Negative Findings ◽  
Static Imaging

Background: 68Ga-PSMA-11 PET/CT is a promising method for the assessment of local recurrence (LR) in prostate cancer (PCa) patients. The aim of this study was to evaluate the diagnostic performance of early 68Ga-PSMA-11 PET imaging in comparison to 68Ga-PSMA-11 PET imaging 60 min post-injection (p.i.) in the detection of LR in patients with biochemical recurrence (BR) of prostate carcinoma. Materials and Methods: 190 image sets of patients with BR in PCa who underwent 68Ga-PSMA-11 PET/CT were assessed retrospectively (median prostate specific antigen (PSA) value, 0.70 ng/mL (range, 0.1–105.6 ng/mL)). Patients received an early static scan of the pelvic area (median, 248 s p.i. (range, 56–923 s)) and a whole-body scan 60 min p.i. (median, 64 min p.i. (range, 45–100 min)) with intravenous administration of 20 mg furosemide i.v. at the time of tracer application, followed by intravenous hydration with 500 mL of sodium chloride (NaCl 0.9%). Assessment was based on visual analysis and calculation of the maximum standardized uptake value (SUVmax) of the pathologic lesions present in the prostate fossa found in the early PET imaging and 60 min PET scans. The scans were characterized as negative, positive, or equivocal. The results were compared, and the combination of early and 60 min p.i. imaging was evaluated. Results: Image assessment resulted in 30 (15.8%) positive, 17 (8.9%) equivocal, and 143 (75.3%) negative findings in early scans, and 28 (14.7%) positive, 25 (13.2%) equivocal, and 137 (72.1%) negative findings of LR in 60 min p.i. images. For combined image analysis, 33 (17.4%) cases were positive and 20 (10.5%) were equivocal. There was no statistical significance between the number of positive (p = 0.815), negative (p = 0.327), and equivocal (p = 0.152) findings. Furthermore, the combination of both scans showed no statistically significant differences for the positive and negative findings (p = 0.063). The median SUVmax was 4.9 (range, 2.0–55.2) for positive lesions in the early scans and 8.0 (range, 2.1–139.9) in the scans 60 min p.i. The median SUVmax for bladder activity was 2.5 (range, 0.9–12.2) in the early scans and 8.2 (range, 1.8–27.6) in the scans 60 min p.i. Conclusion: Early static imaging additional to 68Ga-PSMA-11 PET images acquired 60 min p.i. has limited value in patients prepared with furosemide and hydration, and showed no statistically significant change in the detection rate (DR) of LR and the number of equivocal findings. Based on our results, in departments following a protocol with forced diuresis, including furosemide, additional early static imaging cannot be routinely recommended for the assessment of BR in PCa patients.

PET/CT WITH 68GA-PSMA-11 IN DETECTION OF PRIMARY TUMOR AND RECURRENCE OF PROSTATE CANCER

2018 ◽  
Vol 64 (6) ◽  
pp. 799-804
Author(s):  
Darya Ryzhkova ◽  
M. Poyda
Keyword(s):  
Prostate Cancer ◽  
Primary Tumor ◽  
Biochemical Recurrence ◽  
Whole Body ◽  
Negative Results ◽  
Primary Prostate Cancer ◽  
Pet Ct ◽  
The Relationship ◽  
Positive Results ◽  
T Category

Purpose: To study the diagnostic value of PET-CT with 68Ga-PSMA-11 in the diagnosis of a primary prostate cancer, preoperative staging, and the detection of recurrence of prostate cancer (PCa). Methods: 28 patients aged 64.7 ± 8.74 years were included. 10 patients primary prostate cancer, and 18 patients with biochemical recurrence of the disease after radical treatment were examined. All patients underwent PET-CT with 68Ga-PSMA-11 according the whole body protocol. Interpretation of images was performed visually and quantitatively by calculation of SUL max. Results: High focal or diffuse 68Ga-PSMA-11 uptake was found in prostate parenchyma in patients with primary prostate cancer. Additionally metastases in regional lymph nodes were diagnosed in 4 patients and bone metastases were found in one patient. The correlation between 68Ga-PSMA-11 uptake level and Gleason index in the primary tumor (R Spearmen = 0.25, p = 0.57) was not observed. PET-positive results were obtained in 14 patients and PET-negative results in 4 patients with biochemical recurrence of PCa. The relationship between the frequency of PET-positive results and Gleason index was not revealed (R Spearmen = 0.2, p = 0.39). We found a weak but significant correlation between the frequency of PET-positive results and the prostate tumor stage according to the T category (R Spearmen = 0.49, p = 0.049). In patients with low values of PSA (less than 1.0 ng/ml) in 4 out of 9 cases, PET-negative results were obtained. In patients with PSA level more than 1.0 ng/ml PET-positive results were obtained in all cases. Conclusions: PET/CT with 68Ga-PSMA-11 allows to diagnose the primary prostate cancer, to establish the stage of the disease in categories N and M, and also to determine the localization and dissemination of the tumor in patients with biochemical recurrence of prostate cancer. The relationship between 68Ga-PSMA-11 uptake in primary tumor and Gleason index was not found. The probability of obtaining PET-positive results in cases of biochemical recurrence is affected by a PSA level above 1 ng/ml and a high stage of the disease according to the T category (T3-T4).

64Cu-PSMA-BCH: A New Radiotracer for Delayed PET Imaging of Prostate Cancer

2021 ◽  
Author(s):  
Teli Liu ◽  
Chen Liu ◽  
Zhongyi Zhang ◽  
Ning Zhang ◽  
Xiaoyi Guo ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Pet Imaging ◽  
Radiation Dosimetry ◽  
Whole Body ◽  
Post Injection ◽  
Human Organ ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Psma Pet

Abstract PurposeDevelop a 64Cu labeled radiopharmaceutical targeting prostate specific membrane antigen (PSMA) and investigate its application for prostate cancer imaging. Methods64Cu-PSMA-BCH was prepared and investigated for stability, PSMA specificity and micro-PET imaging. With the approval of Ethics Committee of Beijing Cancer Hospital (No. 2017KT97), PET/CT imaging in 4 patients with suspected prostate cancer was performed and the radiation dosimetry was estimated. Then, PSMA PET-ultrasound image-guided biopsies were performed on 3 patients and the fine needle aspirates were further performed for autoradiography and immunohistochemistry analysis. Results64Cu-PSMA-BCH was prepared with high radiochemical yield and stability. In vivo study showed higher uptake in PSMA (+) 22Rv1 cells than PSMA (-) PC-3 cells (5.59±0.36 and 1.97±0.22 IA%/106 cells at 1 h). It accumulated in 22Rv1 tumor with increasing radioactivity uptake and T/N ratios from 1 h to 24 h post-injection. In patients with suspected prostate cancer, SUVmax and T/N ratios increased within 24 h post-injection. Compared with image at 1 h post-injection, more tumor lesions were detected at 4 h and 24 h post-injection. The human organ radiation dosimetry showed gallbladder wall was most critical, liver and kidneys were followed, and the whole-body effective dose was 0.0292 mSv/MBq. Two fine needle aspirates obtained by PET-ultrasound guided targeted biopsy showed high radioactive signal by autoradiography, with 100% PSMA expression in cytoplasm and 30% expression in nucleus. Conclusion64Cu-PSMA-BCH was PSMA specific and showed high stability in vivo with lower uptake in liver than 64Cu-PSMA-617. Biodistribution in mice and PCa patients showed similar profile compared with other PSMA ligands and it was safe with moderate effective dosimetry. The increased tumor uptake and T/N ratios by delayed imaging may facilitate the detection of small lesions and guiding targeted biopsies.

scholarly journals Early injection of furosemide increases detection rate of local recurrence in prostate cancer patients with biochemical recurrence referred for 68Ga-PSMA-11 PET/CT.

2021 ◽  
pp. jnumed.120.261866
Author(s):  
Christian Uprimny ◽  
Steffen Bayerschmidt ◽  
Alexander Stephan Kroiss ◽  
Josef Fritz ◽  
Bernhard Nilica ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Local Recurrence ◽  
Cancer Patients ◽  
Biochemical Recurrence ◽  
Detection Rate ◽  
Pet Ct ◽  
Early Injection

scholarly journals 68Ga-DOTA-DiPSMA PET/CT Imaging: Biodistribution, Dosimetry and First Comparison with 68Ga-PSMA-11 in Prostate Cancer

2021 ◽  
Author(s):  
Jiaying Zhang ◽  
Zefang Lin ◽  
Xiaojun Zhang ◽  
Rong Lin ◽  
Mengchao Cui ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Healthy Volunteers ◽  
Bladder Wall ◽  
Prospective Trial ◽  
Whole Body ◽  
Post Injection ◽  
Diagnostic Efficacy ◽  
Organ Doses ◽  
Pet Ct ◽  
Effective Doses

Abstract PurposeThis prospective trial aimed to evaluate the safety, dosimetry, biodistribution, and diagnostic efficacy of a novel theranostic probe 68Ga-DOTA-DiPSMA. Also, we have performed the first comparison with 68Ga-PSMA-11 in prostate cancer (PCa) patients.MethodsFive healthy volunteers and ten PCa patients with a previous clinical 68Ga-PSMA-11 PET/CT were injected with an intravenous bolus of 68Ga-DOTA-DiPSMA with a dose of 1.85MBq/kg. Healthy volunteers received serial whole-body PET scans from the time of injection up to 60 min post-injection, with a second PET/CT scanning at 120 min post-injection. In PCa patients, low-dose CT scan, whole-body PET was performed with 2 min per bed position in 40 min post-injection. In addition, 68Ga-PSMA-11 scanning was performed on PCa patients within 10 days under the same acquisition procedure. Absorbed organ doses and effective doses were calculated using OLINDA/EXM. Normal organ uptake and tumor lesion uptake (SUVmax) were measured. A lesion-by-lesion analysis was performed.Results68Ga-DOTA-DiPSMA administration was safe and well-tolerated. The kidneys received the highest absorbed dose (114.46 ± 29.28 uSv/MBq), followed by the urinary bladder wall (100.82 ± 46.22 uSv/MBq) in accordance with the expected PSMA renal excretion of the tracer. The mean effective dose was 19.46 ± 1.73 μSv/MBq. The SUVmax of 68Ga-PSMA-11 and 68Ga-DOTA-DiPSMA PET/CT for PCa lesions, bone metastases, and lymph node metastases were 11.2 ± 10.76 vs. 4.41 ± 2.72, 7.6 ± 1.58 vs. 2.95 ± 1.11 and 4.86 ± 1.94 vs. 3.26 ± 1.2, respectively.ConclusionInjection of 68Ga-DOTA-DiPSMA is safe and associated with low absorbed and effective doses. Compared to 68Ga-PSMA-11, 68Ga-DOTA-DiPSMA shows comparable pharmacokinetics and detection ability in PCa patients that warrant further head-to-head comparison. Low non-specific uptake in salivary glands and kidneys of 68Ga-DOTA-DiPSMA indicates potential radioligand therapy (RLT) application when labeled with 177Lu, 90Y, or 225Ac.

scholarly journals F18 NaF PET/CT and whole body MRI for the detection of metastases in patients with biochemical recurrence of prostate cancer

2016 ◽  
Vol 27 ◽  
pp. vi260
Author(s):  
P. Twardowski ◽  
S.K. Pal ◽  
C. Stein ◽  
P. Frankel ◽  
H. Chen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Biochemical Recurrence ◽  
Whole Body ◽  
Whole Body Mri ◽  
Pet Ct

scholarly journals Detection Rate of 18F-Fluorethylcholine-PET/CT in relation to PSA Value in PCA Patients Referred with Biochemical Relapse

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Mustafa Takesh ◽  
Khaldoun Odat Allh ◽  
Christian M. Zechmann
Keyword(s):  
Prostate Cancer ◽  
Biochemical Recurrence ◽  
Detection Rate ◽  
Local Relapse ◽  
Initial Therapy ◽  
Diagnostic Methods ◽  
Biochemical Relapse ◽  
Pet Ct ◽  
Significant Difference ◽  
Negative Findings

Attempts to predict the likelihood of positive morphological imaging related with PSA value in patients referred with biochemical recurrence were the focus of many studies. Using nuclear medicine modalities, numerous studies likewise had been performed for the same purpose, however mostly using C-11-labeled choline. For this purpose, we selected 193 prostate cancer patients from our database between 2006 and 2010. They had been referred to our department to undergo 18F-fluorethylcholine (FECH)-PET/CT due to biochemical recurrence after potentially curative procedures. As a result, in 84 out of 193 patients, 18F-FECH-PET demonstrated positive findings with an overall detection rate of 44%. Statistically, there was a significant difference in PSA values in positive findings vs. negative findings (p<0.001), and there was a linear correlation between the detection rate and PSA value (r = 0.91). Moreover, there was a relation between initial therapy and recurrence type. So, the local relapse was the most frequent recurrence (>70%) after radiation therapy alone. By contrast, patients after radical prostatectomy followed by salvage radiotherapy showed a low likelihood of local recurrence. In conclusion, PSA value was confirmed to have a determinant role in 18F-FECH-PET outcome. Moreover, there was a link between recurrence type and initial therapy, which—if prospectively confirmed—may play a guiding role in selecting the appropriate diagnostic methods.

Evaluation of whole-body tumor burden with 68Ga-PSMA PET/CT in the biochemical recurrence of prostate cancer

2019 ◽  
Vol 33 (5) ◽  
pp. 344-350 ◽  
Author(s):  
A. E. T. Brito ◽  
F. A. Mourato ◽  
R. P. M. de Oliveira ◽  
A. L. G. Leal ◽  
P. J. A. Filho ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Biochemical Recurrence ◽  
Tumor Burden ◽  
Whole Body ◽  
Psma Pet ◽  
Pet Ct

Experience of 1,000 patients.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 294-294
Author(s):  
Julieta Iorio ◽  
Martin Eleta ◽  
Florencia Bambacci ◽  
Lucrecia Cuneo ◽  
David Polillo
Keyword(s):  
Prostate Cancer ◽  
Local Recurrence ◽  
The Other ◽  
Emission Tomography ◽  
Whole Body ◽  
Dual Phase ◽  
Positron Emission ◽  
Pet Ct ◽  
Frequent Site ◽  
Biochemical Progression

294 Background: The aim of this study is to present our experience between the correlation of 18 fluorocholine (FCH) positron emission tomography (PET)/computed tomography (CT) findings and PSA levels in detecting local recurrence, lymphatic/haematogenous involvement in patients with prostate carcinoma. Methods: 1075 patients with prostate cancer were enrolled between July 2012 and August 2017. Patients were separated in two main groups: biochemical progression 913 (85%) and 162 (15%) staging. Each group was divided in three subgroups according to PSA levels: ≤1 ng/ml; ≥ 1-5ng/ml and > 5 ng/ml. All of them underwent “Dual phase” PET-CT consisting of intial pelvis starting 20 minutes after the injection of 18 F-Choline followed by 1 hour delayed PET-CT of the whole body. Results: 1641 lesions showed increased uptake on FCH-PET and were interpretated as local recurrence or metastases .According to biochemical progression we identified for each subgroup: 118 patients (13%) (≤1 ng/ml); 265 patients (29%) (≥ 1-5ng/ml); 530 patients (58%) ( > 5 ng/ml) and for staging we identified for each subgroup: 81 patients (50%) (≤1 ng/ml); 47 patients (29%) (≥ 1-5ng/ml); 20 patients (34%) ( > 5 ng/ml). The results are shown on table 1: Patients presenting biochemical progression the majority of them have PSA levels of 5 ng/ml or more and the most frequent site of metastases were pelvic lymph nodes, on the other hand, for staging patients we have found that most of them have PSA levels of ≤1 ng/ml and we detected that they most commonly have local compromise. Conclusions: In our experience 18 FCH PET/CT is a useful tool to detect lesions in patients with biochemical progression but it seems to have limited value for staging. [Table: see text]

scholarly journals Optimized Application of 68Ga-Prostate-Specific Membrane Antigen-617 Whole-Body PET/CT and Pelvic PET/MR in Prostate Cancer Initial Diagnosis and Staging

2021 ◽  
Vol 8 ◽  
Author(s):  
Chunxia Qin ◽  
Yongkang Gai ◽  
Qingyao Liu ◽  
Weiwei Ruan ◽  
Fang Liu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diagnostic Performance ◽  
Distant Metastases ◽  
Initial Diagnosis ◽  
Whole Body ◽  
Post Injection ◽  
Pet Ct ◽  
Significant Difference ◽  
Prostate Diseases ◽  
Benign Prostate

Purpose: To analyze 68Ga-PSMA-617 PET/CT or PET/MR and delayed PET/MR images in patients diagnosed with or suspicion of prostate cancer, and to explore the optimal use of PET/CT and PET/MR for initial diagnosis and staging in prostate cancer.Methods: Images from conventional scan by 68Ga-PSMA whole-body PET/CT or PET/MR followed by delayed pelvic PET/MR were retrospectively analyzed. Prostatic 68Ga-PSMA uptake was measured as SUVmax1 (conventional scan 1 h post injection) and SUVmax2 (delayed scan 3 h post injection). Age, PSA levels, and SUVmax were compared between benign and malignant cases. The correlation of SUVmax1 and SUVmax2 was analyzed. Diagnostic performance was evaluated by ROC analysis.Results: Fifty-six patients with 41 prostate cancers and 15 benign prostate lesions were enrolled. Fifty-three patients had paired conventional and delayed scans. Age, tPSA, fPSA levels, and SUVmax were significantly different between benign and malignant cases. A good correlation was found between SUVmax1 and SUVmax2. There was significant difference between SUVmax1 and SUVmax2 in the malignant group (p = 0.001). SUVmax1 had superior diagnostic performance than SUVmax2, SUVmax difference and PSA levels, with a sensitivity of 85.4%, a specificity of 100% and an AUC of 0.956. A combination of SUVmax1 with nodal and/or distant metastases and MR PI-RADS V2 score had a sensitivity and specificity of 100%. Delayed pelvic PET/MR imaging in 33 patients were found to be redundant because these patients had nodal and/or distant metastases which can be easily detected by PET/CT. PET/MR provided incremental value in 8 patients at early-stage prostate cancer based on precise anatomical localization and changes in lesion signal provided by MR.Conclusion: Combined 68Ga-PSMA whole-body PET/CT and pelvic PET/MR can accurately differentiate benign prostate diseases from prostate cancer and accurately stage prostate cancer. Whole-body PET/CT is sufficient for advanced prostate cancer. Pelvic PET/MR contributes to diagnosis and accurate staging in early prostate cancer. Imaging at about 1 h after injection is sufficient in most patients.ClinicalTrials.gov: NCT03756077. Registered 27 November 2018—Retrospectively registered, https://clinicaltrials.gov/show/NCT03756077.

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