BONY LESION ANALYSIS IN CARCINOMA PROSTATE: M.D.P. BONE SCAN VS. GALLIUM-68 PSMA-11 PET/CT

Authors

  • Haider Ali Department of nuclear medicine and molecular imaging, Sindh Institute of Urology & Transplantation, Karachi https://orcid.org/0000-0002-4758-8708
  • Syed Rashid Ul Amin Department of nuclear medicine and molecular imaging, Sindh Institute of Urology & Transplantation, Karachi
  • Abdul Hai Department of nuclear medicine and molecular imaging, Sindh Institute of Urology & Transplantation, Karachi
  • Noureen Nizar Department of nuclear medicine and molecular imaging, Sindh Institute of Urology & Transplantation, Karachi

DOI:

https://doi.org/10.55519/JAMC-03-12049

Keywords:

Keywords: Prostate carcinoma, bone metastases, PSMA-PET/CT, Bone scintigraphy

Abstract

Background: Prostate cancer is the cause of the highest cancer-related death in males, 5-year survival is 31% in metastatic disease, and bone is a common site of metastases. Bone scintigraphy is a routinely used imaging modality for detecting skeletal metastases. It has variable sensitivity of 52–100%, whereas PSMA PET/CT scans have better sensitivity approaching 100%, so we determined the diagnostic accuracy, sensitivity, and specificity of planar M.D.P. (methylene diphosphonate) bone scintigraphy. Methods: This analytical cross-sectional study was conducted at the N.M. & molecular imaging department of S.I.U.T. Karachi. Bone scans and PSMA-PET/CT scans of all patients who were visited from Janury-2018 to January 2023 were reviewed and interpreted by a nuclear physician& radiologist team. Inclusion criteria were histopathology-proven prostate cancer patients who had a bone scan and PSMA PET/CT scan within one month and had not received any treatment between scans. Results: Among 70 scans, 38 (54.2%) were positive for bone lesions. A total of 18 (47%) patients had positive bony lesions on both PSMA-PET/CT and Bone scintigraphy. Among 38 bone lesions positive patients, in eleven patients, bone lesions were detected only on PET/CT scans, whereas nine were positive only on Bone scans. The mean S.U.V. max of all bony lesions was 19.15 (range 3.2–57.5). The bone scan's sensitivity, specificity, and accuracy were 62.07%, 78.05%, and 62.87%, respectively. Conclusion:  PSMA-PET/CT is better than bone Scintigraphy for detecting skeletal metastases. However, outcomes of bone scintigraphy may be improved when Tc-PSMA receptor bone scintigraphy is used.

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Published

2023-07-09