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. 2018 Oct 20;8(5):332-340.
eCollection 2018.

Head to head comparison performance of 99mTc-EDDA/HYNIC-iPSMA SPECT/CT and 68Ga-PSMA-11 PET/CT a prospective study in biochemical recurrence prostate cancer patients

Francisco Osvaldo García-Pérez  1 , Jenny Davanzo  1 , Sergio López-Buenrostro  1 , Clara Santos-Cuevas  2 , Guillermina Ferro-Flores  2 , Miguel A Jímenez-Ríos  3 , Anna Scavuzzo  3 , Zael Santana-Ríos  3 , Sevastián Medina-Ornelas  1
Affiliations

Head to head comparison performance of 99mTc-EDDA/HYNIC-iPSMA SPECT/CT and 68Ga-PSMA-11 PET/CT a prospective study in biochemical recurrence prostate cancer patients

Francisco Osvaldo García-Pérez et al. Am J Nucl Med Mol Imaging. .

Abstract

Positron emission tomography (PET) with prostate-specific membrane antigen (PSMA) has found widespread use for the diagnosis of biochemical recurrence of prostate cancer (PCa). Unfortunately, PET/CT is not as widely available; thus a PSMA-targeting compound for scintigraphy is of special interest. The aim of this study was to compare 99mTc-EDDA/HYNIC-iPSMA and 68Ga-PSMA-11 PET/CT qualitatively and semi-quantitatively. Twenty-three patients with metastatic PCa were underwent 99mTc-EDDA/HYNIC-iPSMA SPECT/CT followed by 68Ga-PSMA-11 PET/CT. Gleason score in all patients was obtained. Maximal standardized uptake value (SUVmax) and counts per organ, including the primary and metastatic tumor, were normalized and compared using Pearson's correlation test. Sites considered as positive have increased SUVmax and tumor-to-background ratio (TBR) in comparison with non-diseased organs/tissues (SUVmax =25.2±4.7, 18.4±1.6, 11.4±1.2 (P=0.037) from prostate, bone and lymph nodes versus TBR =35.9±45.2, 15.4±18.9, 19.1±51.7 (P=0.035) for prostate, bone and lymph nodes. 99mTc-HYNIC-iPSMA and 68Ga-PSMA-11 uptake values in the evaluation of the affected nodes were very similar, although their ranges ranged from 5-21 mm (12±7.6). Correlation coefficient was normalized between SUVmax and TBR, demonstrating r values for prostate of r2=0.731; for bone of r2=0.720; and lymph nodes of r2=0.864 (P<0.05 in all cases). Values and confidence interval at the 95% are supporting the equivalency of both parameters in primary tumor and metastases (prostate 95% CI=4.61, 4.38; bone tissue 95% CI=-2.21, 3.41 and lymph node 95% CI=4.67). We conclude that 68Ga-PSMA-11 PET/CT and 99mTc-EDDA/HYNIC-iPSMA SPECT/CT were comparable, supporting the use of 99mTc-EDDA/HYNIC-iPSMA in patients with progressive metastatic castration-resistant PCa.

Keywords: 68Ga-PSMA-11 PET/CT; 99mTc-HYNIC-PSMA; SPECT/CT; biochemical recurrence prostate cancer.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Sites considered as positive such as prostate gland, bone and lymph nodes have increased SUVmax and TBR in comparison with non-diseased organs/tissues (SUVmax =25.2±4.7, 18.4±1.6, 11.4±1.2 (P=0.037) from prostate, bone and lymph nodes (left) versus TBR =35.9±45.2, 15.4±18.9, 19.1±51.7 (P=0.035) for prostate, bone and lymph nodes (right).
Figure 2
Figure 2
(left) Maximum-intensity projection of 99mTc-HYNIC-PSMA SPECT/CT. (right) Maximum-intensity projection of 68Ga-HBED-CC PSMA.
Figure 3
Figure 3
Comparison between 68Ga-HBED-CC-PSMA PET/CT and 99mTc Hynic IPSMA SPECT/CT. A. Prostate tumor lesion that invades the wall of the bladder evaluate with 68Ga-HBED-CC-PSMA PET/CT. D. 99mTc Hynic IPSMA show better target/background than 68Ga-HBED-CC-PSMA PET/CT. B, C, E and F. Both methods detected retroperitoneal and pelvic lymph nodes, 68Ga-HBED-CC-PSMA PET/CT and 99mTc-EDDA/HYNIC-iPSMA SPECT/CT with equal diagnostic accuracy.
Figure 4
Figure 4
Scatter plot shows the correlation between normalized SUVmax of 68Ga-PSMA-11 and TBR of 99mTc-HYNIC-PSMA SPECT/CT related uptake in prostate gland, which reaches statistical significance (rSpearman =0.594; P<0.05).
Figure 5
Figure 5
Scatter plot shows the correlation between normalized SUVmax of 68Ga-PSMA-11 and TBR of 99mTc-HYNIC-PSMA SPECT/CT related uptake in bone metastatic disease, which reaches statistical significance (rSpearman =0.764; P<0.05).
Figure 6
Figure 6
Scatter plot shows the correlation between normalized SUVmax of 68Ga-PSMA-11 and TBR of 99mTc-HYNIC-PSMA SPECT/CT related uptake in lymph nodes, which reaches statistical significance (rSpearman =0.855; P<0.05).
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