Evaluation of 99mTc-labeled PSMA-SPECT/CT imaging in prostate cancer patients who have undergone biochemical relapse

• Published in: Asian journal of andrology 2017-05, Vol.19 (3), p.267-271
• Main Authors: Su, Heng-Chuan, Zhu, Yao, Ling, Guo-Wen, Hu, Si-Long, Xu, Xiao-Ping, Dai, Bo, Ye, Ding-Wei
• Format: Article
• Language: English
• Subjects: 99mTc; CT; prostate cancer; PSMA; SPECT; Antigens, Surface; Biopsy; Bone and Bones - diagnostic imaging; Care and treatment; CAT scans; Diagnosis; Glutamate Carboxypeptidase II; Humans; Lymphatic Metastasis - diagnostic imaging; Magnetic Resonance Imaging; Male; Neoplasm Grading; NMR; Nuclear magnetic resonance; Original; Prognosis; Prostate cancer; Prostatic Neoplasms - diagnostic imaging; Prostatic Neoplasms - therapy; Radiopharmaceuticals; Recurrence; Retrospective Studies; Single photon emission computed tomography; Tomography; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed
• ISSN: 1008-682X; 1745-7262
• DOI: 10.4103/1008-682x.192638

Using conventional imaging modalities, it is difficult to detect recurrent lesions in prostate cancer patients who have undergone biochemical relapse, especially in patients with low prostate-specific antigen （PSA） levels. We retrospectively reviewed the files of fifty patients with histopathologically confirmed prostate cancer who underwent 99mTc-labeled prostate-specific membrane antigen （PSMA） single-photon emission computed tomography （SPECT）/computed tomography （CT）, magnetic resonance imaging （MRI）, and bone scan within a 30-day period. PSMA-SPECT/CT indicated metastatic lesions in 39 patients and had a higher detection rate （78.0%） than bone scan （34.0%） or MRI （40.0%）. The diagnostic efficiency of PSMA-SPECT/CT imaging for bone and lymph node metastases （50.0% and 42.0%） was better than bone scan （34.0% and 0.0%） or MRI （24.0% and 20.0%）. PSMA-SPECT/CT provided a higher detection rate at serum PSA levels of 〈1 ng ml-1, 1-4 ng ml-1, 4-10 ng ml-1, and 〉10 ng ml-1. No correlation was found between Gleason score, PSA level, and the tracer tumor/background ratio of metastatic lesions. With the aid of PSMA-SPECT/CT imaging, the therapeutic strategy was changed for 31 patients, and this may have enhanced their clinical outcome. In conclusion, PSMA-SPECT/CT imaging could detect more metastatic lesions and achieve a higher detection rate than conventional imaging modalities at different serum PSA levels in prostate cancer patients who had undergone biochemical relapse.