Total-Body 68Ga-PSMA-11 PET/CT for Bone Metastasis Detection in Prostate Cancer Patients: Potential Impact on Bone Scan Guidelines

The main aim of this study was to investigate the putative association among the presence of prostate cancer cells, defined as prostate osteoblast-like cells (POLCs), and showing the expression of typical morphological and molecular characteristics of osteoblasts, the development of bone metastasis within 5 years of diagnosis, and the uptake of 18F-choline evaluated by PET/CT analysis. To this end, prostate biopsies (n= 110) were collected comprising 44 benign lesions and 66 malignant lesions. Malignant lesions were further subdivided into two groups: biopsies from patients that had clinical evidence of bone metastasis (BM+,n= 23) and biopsies from patients that did not have clinical evidence of bone metastasis within 5 years (BM−,n= 43). Paraffin serial sections were obtained from each specimen to perform histological classifications and immunohistochemical (IHC) analysis. Small fragments of tissue were used to perform ultrastructural and microanalytical investigations. IHC demonstrated the expression of markers of epithelial-to-mesenchymal transition (VIM), bone mineralization, and osteoblastic differentiation (BMP-2, PTX-3, RUNX2, RANKL, and VDR) in prostate lesions characterized by the presence of calcium-phosphate microcalcifications and high metastatic potential. Ultrastructural studies revealed the presence of prostate cancer cells with osteoblast phenotype close to microcalcifications. Noteworthy, PET/CT analysis showed higher uptake of 18F-choline in BM+ lesions with high positivity (≥300/500 cells) for RUNX2 and/or RANKL immunostaining. Although these data require further investigations about the molecular mechanisms of POLCs generation and role in bone metastasis, our study can open new and interesting prospective in the management of prostate cancer patients. The presence of POLCs along with prostate microcalcifications may become negative prognostic markers of the occurrence of bone metastases.

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Comparison of PET/CT and MRI in the Diagnosis of Bone Metastasis in Prostate Cancer Patients: A Network Analysis of Diagnostic Studies

Frontiers in Oncology ◽

10.3389/fonc.2021.736654 ◽

2021 ◽

Vol 11 ◽

Author(s):

Fanxiao Liu ◽

Jinlei Dong ◽

Yelong Shen ◽

Canhua Yun ◽

Ruixiao Wang ◽

...

Keyword(s):

Prostate Cancer ◽

Bone Metastasis ◽

Cancer Patients ◽

Meta Analysis ◽

Diagnostic Value ◽

High Quality ◽

Psma Pet ◽

Pet Ct ◽

3.0 T ◽

Diagnosis Of Bone Metastasis

BackgroundAccurate diagnosis of bone metastasis status of prostate cancer (PCa) is becoming increasingly more important in guiding local and systemic treatment. Positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) have increasingly been utilized globally to assess the bone metastases in PCa. Our meta-analysis was a high-volume series in which the utility of PET/CT with different radioligands was compared to MRI with different parameters in this setting.Materials and MethodsThree databases, including Medline, Embase, and Cochrane Library, were searched to retrieve original trials from their inception to August 31, 2019 according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. The methodological quality of the included studies was assessed by two independent investigators utilizing Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). A Bayesian network meta-analysis was performed using an arm-based model. Absolute sensitivity and specificity, relative sensitivity and specificity, diagnostic odds ratio (DOR), and superiority index, and their associated 95% confidence intervals (CI) were used to assess the diagnostic value.ResultsForty-five studies with 2,843 patients and 4,263 lesions were identified. Network meta-analysis reveals that 68Ga-labeled prostate membrane antigen (68Ga-PSMA) PET/CT has the highest superiority index (7.30) with the sensitivity of 0.91 and specificity of 0.99, followed by 18F-NaF, 11C-choline, 18F-choline, 18F-fludeoxyglucose (FDG), and 18F-fluciclovine PET/CT. The use of high magnetic field strength, multisequence, diffusion-weighted imaging (DWI), and more imaging planes will increase the diagnostic value of MRI for the detection of bone metastasis in prostate cancer patients. Where available, 3.0-T high-quality MRI approaches 68Ga-PSMA PET/CT was performed in the detection of bone metastasis on patient-based level (sensitivity, 0.94 vs. 0.91; specificity, 0.94 vs. 0.96; superiority index, 4.43 vs. 4.56).Conclusions68Ga-PSMA PET/CT is recommended for the diagnosis of bone metastasis in prostate cancer patients. Where available, 3.0-T high-quality MRI approaches 68Ga-PSMA PET/CT should be performed in the detection of bone metastasis.

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11C-Choline PET-CT Detection of Osseous Metastases versus Bone Scan in Newly Diagnosed High Risk Prostate Cancer Patients-A Pilot Study

Journal of Nuclear Medicine & Radiation Therapy ◽

10.4172/2155-9619.s6-017 ◽

2013 ◽

Vol s6 (01) ◽

Author(s):

Nasarachi E Onyeuku

Keyword(s):

Prostate Cancer ◽

Pilot Study ◽

High Risk ◽

Cancer Patients ◽

Bone Scan ◽

Newly Diagnosed ◽

Choline Pet ◽

High Risk Prostate Cancer ◽

Pet Ct ◽

Risk Prostate Cancer

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Prospective Comparison of F-18 Choline PET/CT Scan Versus Axial MRI for Detecting Bone Metastasis in Biochemically Relapsed Prostate Cancer Patients

Diagnostics ◽

10.3390/diagnostics7040056 ◽

2017 ◽

Vol 7 (4) ◽

pp. 56 ◽

Cited By ~ 6

Author(s):

Wouter Huysse ◽

Frédéric Lecouvet ◽

Paolo Castellucci ◽

Piet Ost ◽

Valerie Lambrecht ◽

...

Keyword(s):

Prostate Cancer ◽

Bone Metastasis ◽

Ct Scan ◽

Cancer Patients ◽

Choline Pet ◽

Prospective Comparison ◽

Pet Ct ◽

Pet Ct Scan

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PREDICTIVE VALUE OF SERUM PROSTATE SPECIFIC ANTIGEN IN DETECTING BONE METASTASIS IN PROSTATE CANCER

Indonesian Journal of Urology ◽

10.32421/juri.v28i2.570 ◽

2021 ◽

Vol 28 (2) ◽

pp. 116-119

Author(s):

Raden Danarto ◽

Indwiani Astuti ◽

Sofia Mubarika Haryana

Keyword(s):

Prostate Cancer ◽

Bone Metastasis ◽

Cancer Patients ◽

Prostate Specific Antigen ◽

Predictive Value ◽

Medical Records ◽

Bone Scan ◽

Specific Antigen ◽

Skeletal Metastasis ◽

Physical Burden

Objective: We determine the utility of Prostate Specific Antigen (PSA) for predicting the presence of skeletal metastasis on Bone Scan (BS) in prostate cancer patients. Material & Methods: Retrospective analysis of medical records of 70 consecutive prostate cancer patients subjected to bone scan during the last 2 years was done. 5 cases were excluded due to the following reasons: Serum PSA not available, hormonal or other therapy given prior to serum PSA measurement, and/or Bone Scan, and symptomatic for bone metastasis. In remaining 65 cases, PSA value and bone scan were evaluated. Results: BS was found to be positive in 20/65 (31%) and negative in 45(69%) patients. 24 (37%) had serum PSA > 100 ng/ml, 25 (38.5%) had PSA of 20‐100 ng/ml and only 16 (24.5%) had PSA < 20 ng/ml. Conclusion: Serum PSA < 20 ng/ml have high predictive value in ruling out skeletal metastasis. Our data are in corroboration with results from previous studies that BS should be performed only if PSA > 20 ng/ml. Using this cut‐off, unnecessary investigation can be avoided. Avoiding BS asymptomatic in this group of patients would translate into a significant cost‐saving and reduction in their psychological and physical burden.

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Interim PSMA PET/CT Response Is Predictive of Survival of Prostate Cancer Patients Treatedwith Lu-177 PSMA DKFZ 617

10.1055/s-0040-1708395 ◽

2020 ◽

Author(s):

V Prasad ◽

K Huang ◽

N Czech ◽

S Prasad ◽

MR Makowski ◽

...

Keyword(s):

Prostate Cancer ◽

Cancer Patients ◽

Psma Pet ◽

Pet Ct

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Faculty Opinions recommendation of Prospective Comparison of 18F-Fluoromethylcholine Versus 68Ga-PSMA PET/CT in Prostate Cancer Patients Who Have Rising PSA After Curative Treatment and Are Being Considered for Targeted Therapy.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726129005.793514252 ◽

2016 ◽

Author(s):

Badrinath Konety

Keyword(s):

Prostate Cancer ◽

Targeted Therapy ◽

Cancer Patients ◽

Curative Treatment ◽

Prospective Comparison ◽

Psma Pet ◽

Pet Ct

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Simple Stratification of Survival Using Bone Scan and Serum C-Reactive Protein in Prostate Cancer Patients with Metastases

Urologia Internationalis ◽

10.1159/000112601 ◽

2008 ◽

Vol 80 (2) ◽

pp. 129-133 ◽

Cited By ~ 14

Author(s):

Jun Nakashima ◽

Eiji Kikuchi ◽

Akira Miyajima ◽

Ken Nakagawa ◽

Mototsugu Oya ◽

...

Keyword(s):

Prostate Cancer ◽

Cancer Patients ◽

Bone Scan ◽

C Reactive Protein ◽

Reactive Protein

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Lesion-Based Bone Metastasis Detection in Chest Bone Scintigraphy Images of Prostate Cancer Patients Using Pre-Train, Negative Mining, and Deep Learning

Diagnostics ◽

10.3390/diagnostics11030518 ◽

2021 ◽

Vol 11 (3) ◽

pp. 518

Author(s):

Da-Chuan Cheng ◽

Te-Chun Hsieh ◽

Kuo-Yang Yen ◽

Chia-Hung Kao

Keyword(s):

Breast Cancer ◽

Prostate Cancer ◽

Deep Learning ◽

Bone Metastasis ◽

Cancer Patients ◽

Bone Scintigraphy ◽

Breast Cancer Patients ◽

Location Detection ◽

The Mean ◽

Mean Sensitivity

This study aimed to explore efficient ways to diagnose bone metastasis early using bone scintigraphy images through negative mining, pre-training, the convolutional neural network, and deep learning. We studied 205 prostate cancer patients and 371 breast cancer patients and used bone scintigraphy data from breast cancer patients to pre-train a YOLO v4 with a false-positive reduction strategy. With the pre-trained model, transferred learning was applied to prostate cancer patients to build a model to detect and identify metastasis locations using bone scintigraphy. Ten-fold cross validation was conducted. The mean sensitivity and precision rates for bone metastasis location detection and classification (lesion-based) in the chests of prostate patients were 0.72 ± 0.04 and 0.90 ± 0.04, respectively. The mean sensitivity and specificity rates for bone metastasis classification (patient-based) in the chests of prostate patients were 0.94 ± 0.09 and 0.92 ± 0.09, respectively. The developed system has the potential to provide pre-diagnostic reports to aid in physicians’ final decisions.

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