Comparison of bone scintigraphy and Ga-PSMA PET for skeletal staging in prostate cancer
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Comparison of bone scintigraphy and Ga-PSMA PET for skeletal staging in prostate cancer. / Pyka, Thomas; Okamoto, Shozo; Dahlbender, Marielena; Tauber, Robert; Retz, Margitta; Heck, Matthias; Tamaki, Nagara; Schwaiger, Markus; Maurer, Tobias; Eiber, Matthias.
in: EUR J NUCL MED MOL I, Jahrgang 43, Nr. 12, 11.2016, S. 2114-2121.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung
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TY - JOUR
T1 - Comparison of bone scintigraphy and Ga-PSMA PET for skeletal staging in prostate cancer
AU - Pyka, Thomas
AU - Okamoto, Shozo
AU - Dahlbender, Marielena
AU - Tauber, Robert
AU - Retz, Margitta
AU - Heck, Matthias
AU - Tamaki, Nagara
AU - Schwaiger, Markus
AU - Maurer, Tobias
AU - Eiber, Matthias
PY - 2016/11
Y1 - 2016/11
N2 - PURPOSE: The aim of our study was to compare the diagnostic performance of 68Ga-PSMA PET and 99mTc bone scintigraphy (BS) for the detection of bone metastases in prostate cancer (PC) patients.METHODS: One hundred twenty-six patients who received planar BS and PSMA PET within three months and without change of therapy were extracted from our database. Bone lesions were categorized into benign, metastatic, or equivocal by two experienced observers. A best valuable comparator (BVC) was defined based on BS, PET, additional imaging, and follow-up data. The cohort was further divided into clinical subgroups (primary staging, biochemical recurrence, and metastatic castration-resistant prostate cancer [mCRPC]). Additionally, subgroups of patients with less than 30 days delay between the two imaging procedures and with additional single-photon emission computed tomography (SPECT) were analyzed.RESULTS: A total of 75 of 126 patients were diagnosed with bone metastases. Sensitivities and specificities regarding overall bone involvement were 98.7-100 % and 88.2-100 % for PET, and 86.7-89.3 % and 60.8-96.1 % (p < 0.001) for BS, with ranges representing results for 'optimistic' or 'pessimistic' classification of equivocal lesions. Out of 1115 examined bone regions, 410 showed metastases. Region-based analysis revealed a sensitivity and specificity of 98.8-99.0 % and 98.9-100 % for PET, and 82.4-86.6 % and 91.6-97.9 % (p < 0.001) for BS, respectively. PSMA PET also performed better in all subgroups, except patient-based analysis in mCRPC.CONCLUSION: Ga-PSMA PET outperforms planar BS for the detection of affected bone regions as well as determination of overall bone involvement in PC patients. Our results indicate that BS in patients who have received PSMA PET for staging only rarely offers additional information; however, prospective studies, including a standardized integrated x-ray computed tomography (SPECT/CT) protocol, should be performed in order to confirm the presented results.
AB - PURPOSE: The aim of our study was to compare the diagnostic performance of 68Ga-PSMA PET and 99mTc bone scintigraphy (BS) for the detection of bone metastases in prostate cancer (PC) patients.METHODS: One hundred twenty-six patients who received planar BS and PSMA PET within three months and without change of therapy were extracted from our database. Bone lesions were categorized into benign, metastatic, or equivocal by two experienced observers. A best valuable comparator (BVC) was defined based on BS, PET, additional imaging, and follow-up data. The cohort was further divided into clinical subgroups (primary staging, biochemical recurrence, and metastatic castration-resistant prostate cancer [mCRPC]). Additionally, subgroups of patients with less than 30 days delay between the two imaging procedures and with additional single-photon emission computed tomography (SPECT) were analyzed.RESULTS: A total of 75 of 126 patients were diagnosed with bone metastases. Sensitivities and specificities regarding overall bone involvement were 98.7-100 % and 88.2-100 % for PET, and 86.7-89.3 % and 60.8-96.1 % (p < 0.001) for BS, with ranges representing results for 'optimistic' or 'pessimistic' classification of equivocal lesions. Out of 1115 examined bone regions, 410 showed metastases. Region-based analysis revealed a sensitivity and specificity of 98.8-99.0 % and 98.9-100 % for PET, and 82.4-86.6 % and 91.6-97.9 % (p < 0.001) for BS, respectively. PSMA PET also performed better in all subgroups, except patient-based analysis in mCRPC.CONCLUSION: Ga-PSMA PET outperforms planar BS for the detection of affected bone regions as well as determination of overall bone involvement in PC patients. Our results indicate that BS in patients who have received PSMA PET for staging only rarely offers additional information; however, prospective studies, including a standardized integrated x-ray computed tomography (SPECT/CT) protocol, should be performed in order to confirm the presented results.
KW - Aged
KW - Aged, 80 and over
KW - Antigens, Surface
KW - Bone Neoplasms
KW - Gallium Radioisotopes
KW - Glutamate Carboxypeptidase II
KW - Humans
KW - Male
KW - Middle Aged
KW - Neoplasm Staging
KW - Positron-Emission Tomography
KW - Prostatic Neoplasms
KW - Radiopharmaceuticals
KW - Reproducibility of Results
KW - Sensitivity and Specificity
KW - Comparative Study
KW - Controlled Clinical Trial
KW - Journal Article
U2 - 10.1007/s00259-016-3435-0
DO - 10.1007/s00259-016-3435-0
M3 - SCORING: Journal article
C2 - 27290607
VL - 43
SP - 2114
EP - 2121
JO - EUR J NUCL MED MOL I
JF - EUR J NUCL MED MOL I
SN - 1619-7070
IS - 12
ER -
