Orunmuyi A T, Oladeji A A, Azodoh E U, Omisanjo O A, Olapade-Olaopa E O
Department of Nuclear Medicine, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria.
Radiation Oncology Department, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria.
World J Nucl Med. 2022 Jun 28;21(2):142-147. doi: 10.1055/s-0042-1750336. eCollection 2022 Jun.
Technetium-99m labeled prostate-specific membrane antigen (PSMA) single-photon emission computed tomography/computed tomography (SPECT/CT) is a suitable alternative to prostate-specific membrane antigen-positron emission tomography (PSMA-PET) imaging. However, the availability of SPECT/CT in many developing countries is limited. To evaluate the utility of planar Tc-PSMA in the absence of SPECT/CT, we compared planar Tc-PSMA and routine bone scan imaging in low-, intermediate-, and high-risk prostate cancer in five patients with histologically confirmed prostate cancer who had both scans within a period of less than 4 days. The mean age of patients was 66.8 ± 5.24, and the median prostate-specific antigen level was 175 ng/mL (range: 0-778 ng/mL). Planar Tc-PSMA scan provided no additional benefit over bone scans in the low-risk prostate cancer cases. In the cases with intermediate-risk prostate cancers, planar Tc-PSMA indicated complete and partial response to treatment in oligometastatic and widespread metastatic disease, respectively. In one patient with high-risk prostate cancer, planar Tc-PSMA detected additional skeletal lesions that were not seen on bone scan. In the absence of SPECT/CT, planar Tc-PSMA was useful for confirming extent of disease in treated intermediate- and high-risk prostate cancer. It showed little value in low-risk prostate cancer, especially when bone scan is normal. It was particularly useful for treatment response assessment in oligometastatic disease, and its utility should be further explored.
锝-99m标记的前列腺特异性膜抗原（PSMA）单光子发射计算机断层扫描/计算机断层扫描（SPECT/CT）是前列腺特异性膜抗原正电子发射断层扫描（PSMA-PET）成像的合适替代方法。然而，SPECT/CT在许多发展中国家的可及性有限。 为了评估在没有SPECT/CT的情况下平面Tc-PSMA的效用，我们比较了5例经组织学证实患有前列腺癌且在不到4天的时间内进行了两种扫描的低、中、高风险前列腺癌患者的平面Tc-PSMA和常规骨扫描成像。患者的平均年龄为66.8±5.24，前列腺特异性抗原水平中位数为175 ng/mL（范围：0-778 ng/mL）。 在低风险前列腺癌病例中，平面Tc-PSMA扫描与骨扫描相比没有额外益处。在中度风险前列腺癌病例中，平面Tc-PSMA分别显示寡转移和广泛转移疾病对治疗的完全和部分反应。在1例高风险前列腺癌患者中，平面Tc-PSMA检测到骨扫描未发现的额外骨骼病变。 在没有SPECT/CT的情况下，平面Tc-PSMA有助于确认治疗后的中、高风险前列腺癌的疾病范围。它在低风险前列腺癌中价值不大，尤其是当骨扫描正常时。它在寡转移疾病的治疗反应评估中特别有用，其效用应进一步探索。
