An Analysis of the Diagnostic Performance of Tc-99m PSMA SSPECT/CT in Biochemically Recurrent Prostate Cancer Compared with Ga-68 PSMA PET/CT: A Single-center, Prospective Study
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View abstract on PubMed
Summary
This summary is machine-generated.Technetium-99m-labeled prostate-specific membrane antigen (99mTc-PSMA) SPECT/CT shows good concordance with Gallium-68-labeled PSMA PET/CT for detecting recurrent prostate cancer, even with low PSA levels. While it may miss small lymph nodes, 99mTc-PSMA offers a cost-effective alternative.
Area Of Science
- Nuclear Medicine
- Radiopharmacy
- Oncology Imaging
Background
- Biochemical recurrence (BCR) is common after prostate cancer (PC) treatment, necessitating accurate staging for subsequent interventions.
- Gallium-68-labeled prostate-specific membrane antigen positron emission tomography/computed tomography (68Ga-PSMA PET/CT) is a valuable tool for detecting BCR.
- The limited availability of 68Ga necessitates exploring alternative imaging agents.
Purpose Of The Study
- To compare the diagnostic performance of 99mTc-PSMA SPECT/CT with 68Ga-PSMA PET/CT in patients with BCR and low serum prostate-specific antigen (PSA) levels.
- To evaluate the concordance in disease distribution and metastatic burden between the two imaging modalities.
- To assess the potential of 99mTc-PSMA as a cost-effective and accessible alternative for PC recurrence imaging.
Main Methods
- A prospective study involving 25 patients with BCR and at least one lesion on 68Ga-PSMA PET/CT.
- All patients underwent both 99mTc-PSMA SPECT/CT and 68Ga-PSMA PET/CT.
- Comparison of disease localization, metastatic burden, maximum standardized uptake value (SUVmax), and tumor-to-background ratio (TBR) between the two modalities.
Main Results
- Both modalities demonstrated concordance in detecting recurrent disease in the prostate, prostatic bed, bone, and lung lesions.
- 99mTc-PSMA SPECT/CT successfully localized pelvic lymph nodes in most patients (76.9%).
- Site-specific sensitivity and specificity were not significantly different (P > 0.05), though 99mTc-PSMA understaged 16% of patients due to missing subcentimeter lymph nodes.
Conclusions
- 99mTc-PSMA SPECT/CT exhibits good concordance with 68Ga-PSMA PET/CT for staging prostate cancer recurrence, even at low PSA levels.
- The lower resolution of 99mTc-PSMA may lead to the omission of small lymph node metastases.
- 99mTc-PSMA SPECT/CT presents a viable, cost-effective, and readily available alternative imaging option for BCR detection.
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