The impact of patient hydration and forced diuresis on [F]PSMA-1007 urinary bladder uptake in PET/CT imaging.

BACKGROUND

[F]PSMA-1007 has minimal renal excretion, allowing for better assessment of the pelvic area in patients with prostate cancer (PCa). Nevertheless, there have been instances of notably high [F]PSMA-1007 uptake in the urinary bladder. The purpose of this study was to assess the impact of preliminary patient hydration and forced diuresis on [F]PSMA-1007 urinary bladder uptake.

RESULTS

А prospective single-center study included 185 patients with PCa, who underwent [F]PSMA-1007 PET/CT. Patients were divided into 11 groups: a control group with no specific preparation ( = 35) and 10 experimental groups ( = 15 in each) with different preparation protocols, that included oral or IV hydration and/or furosemide administration. LBM SUVmean was used to quantify [F]PSMA-1007 bladder uptake. The differences in bladder SUVmean among the different preparation groups, as well as compared to the control group, were evaluated. A p-value < 0.001 was considered statistically significant. Additionally, the variability of bladder SUVmean was assessed by evaluating the interquartile ranges (IQRs). The results indicate that the application of furosemide significantly reduced the median and variability of bladder SUVmean ( < 0.001), 30 min time interval of furosemide application prior to PET scan is preferable compared to 90 min interval ( < 0.001). Hydration alone, without furosemide, was insufficient for effectively reducing the median and variability of bladder SUVmean ( = 0.5). There was no significant difference between the groups with different routes and volumes of hydration ( = 0.03 and 0.45).

CONCLUSION

Forced diuresis is an effective tool for reducing the [F]PSMA-1007 urinary bladder uptake and its variability when it is routinely increased.

CLINICAL TRIAL NUMBER

Not applicable.