Aryana K, Aghaee A, Askari E, Fakhar Y, Raeisi N, Mottaghi M, Emadzadeh M, Ghorbani H, Barashki S
Nuclear Medicine Research Center, Mashhad University of Medical Science, Mashhad, Iran.
Nuclear Medicine Research Center, Mashhad University of Medical Science, Mashhad, Iran; Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.
Rev Esp Med Nucl Imagen Mol (Engl Ed). 2025 Jun 20:500157. doi: 10.1016/j.remnie.2025.500157.
Prostate-Specific Membrane Antigen is overexpressed in primary and metastatic prostate cancer tissues. While PSMA PET agents have gained their role in the prostate cancer guidelines, Technetium-based PSMA agents have left behind. Given the novelty of Tc-HYNIC-PSMA-11, we conducted this study to compare its detection rate in tracing skeletal metastases in comparison to bone scans and also compared the number of metastatic lesions which showed PSMA uptake in the diagnostic scan with those detected in post-treatment scans after radioligand therapy (RLT) with Lu-PSMA-617-617.
Bone and Tc-HYNIC-PSMA-11 scans with a maximum interval of 90 days were performed in thirty-nine patients with widespread bone metastases. If the PSMA scan was positive, patients were treated with Lu-PSMA-617 and post treatment scan was also obtained. For negative PSMA results, Ga-PSMA PET/CT was performed to compare its results with the bone scan. In patients with PSMA expression, detection of metastatic lesions in three consecutive whole-body scans in different regions were compared (Tc-HYNIC-PSMA-11 with bone and post treatment scans, separately).
37 (94.9%) showed adequate Tc-HYNIC-PSMA-11 uptake in the metastatic regions. Compared to bone scan, Tc-HYNIC-PSMA-11 showed additional lesions in 13 (35.1%) participants which were mostly located in the appendicular skeleton and pelvic bones. Inversely, the bone scan detected more lesions in 12 (32.4%) patients. Both scans in 12 (32.4%) patients showed the exact same results. Comparison between the Tc-HYNIC-PSMA-11 scan and Lu-PSMA-617 showed completely similar results in 29 (78.4%) patients; however, Lu-PSMA-617 detected more lesions in eight (21.6%) participants.
The Tc-HYNIC-PSMA-11 scan demonstrates comparable results to bone scans in evaluating skeletal metastases in prostate cancer patients. It serves as a cost-effective modality for identifying suitable candidates for radioligand therapy, particularly beneficial in resource-limited countries.
前列腺特异性膜抗原在原发性和转移性前列腺癌组织中过表达。虽然PSMA PET药物已在前列腺癌诊疗指南中占据一席之地，但基于锝的PSMA药物却被抛在后面。鉴于Tc-HYNIC-PSMA-11的新颖性，我们开展了本研究，以比较其在追踪骨转移方面的检测率与骨扫描相比如何，同时还比较了在诊断扫描中显示有PSMA摄取的转移病灶数量与用Lu-PSMA-617进行放射性配体治疗（RLT）后治疗后扫描中检测到的转移病灶数量。
对39例广泛骨转移患者进行了间隔最长90天的骨扫描和Tc-HYNIC-PSMA-11扫描。如果PSMA扫描呈阳性，患者接受Lu-PSMA-617治疗，并在治疗后进行扫描。对于PSMA结果为阴性的患者，进行Ga-PSMA PET/CT检查，以将其结果与骨扫描结果进行比较。在有PSMA表达的患者中，比较了在不同区域连续三次全身扫描中转移病灶的检测情况（分别将Tc-HYNIC-PSMA-11扫描结果与骨扫描结果以及治疗后扫描结果进行比较）。
37例（94.9%）在转移区域显示有足够的Tc-HYNIC-PSMA-11摄取。与骨扫描相比，Tc-HYNIC-PSMA-11在13例（35.1%）参与者中发现了额外的病灶，这些病灶大多位于四肢骨骼和骨盆。相反，骨扫描在12例（32.4%）患者中检测到了更多病灶。12例（32.4%）患者的两种扫描结果完全相同。Tc-HYNIC-PSMA-11扫描与Lu-PSMA-617扫描结果比较，29例（78.4%）患者结果完全相似；然而，Lu-PSMA-617在8例（21.6%）参与者中检测到了更多病灶。
Tc-HYNIC-PSMA-11扫描在评估前列腺癌患者骨转移方面显示出与骨扫描相当的结果。它是一种具有成本效益的方法，可用于识别放射性配体治疗的合适候选者，在资源有限的国家尤其有益。
