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Purpose <p>The diagnostic performance of [<sup>99m</sup>Tc]Tc-PSMA SPECT/CT is contingent upon the individual attributes of the patients’ prostate cancer. The aim of the study was to analyse these relationships in order to suggest thresholds that may guide diagnostic decision-making regarding the appropriate use of [<sup>99m</sup>Tc]Tc-PSMA SPECT/CT imaging.&#xa0;</p> Methods <p>A total of 143 patients with recurrent prostate cancer were treated with 664.0 ± 43.9&#xa0;MBq of [<sup>99m</sup>Tc]Tc-MIP-1404 and imaged by SPECT/CT. Comparisons with PSA serum level, ISUP grade, PSA doubling time and PSA velocity were performed. It was ensured that a familywise error rate of α was maintained in multiple-group comparisons.&#xa0;</p> Results <p>Stratifying patients by ISUP grade revealed distinct PSA-dependent detection profiles. For patients with ISUP grade 1–3, the PSA-dependent detection rates at PSA ≤&#xa0;0.2&#xa0;ng/ml, &gt;&#xa0;0.2–0.5&#xa0;ng/ml,&gt;&#xa0;0.5–1.0&#xa0;ng/ml, &gt;&#xa0;1.0–2.0&#xa0;ng/ml,&gt;&#xa0;2.0–5.0&#xa0;ng/ml and &gt;&#xa0;5.0&#xa0;ng/ml were 15%, 25%, 50%, 60%, 60% and 94%, respectively. For patients with ISUP grade 4–5, these were 29%, 75%, 83%, 86%, 90%, and 100%. PSA velocity did not result in a sharper risk stratification for using [<sup>99m</sup>Tc]Tc-MIP-1404 SPECT/CT.&#xa0;</p> Conclusions <p>[<sup>99m</sup>Tc]Tc-MIP-1404 SPECT/CT is a valuable diagnostic option for patients with recurrent prostate cancer and ISUP grades 4–5 at PSA &gt;0.2&#xa0;ng/ml or PSA-DT ≤ 12 months and ISUP grades 1–3 at PSA&#xa0;&gt;&#xa0;0.5&#xa0;ng/ml or PSA-DT ≤ 6.0 months. If PSMA PET/CT is available, it should be preferred at ISUP grade 1 or PSA &lt; 0.2&#xa0;ng/ml.&#xa0;</p>

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The diagnostic accuracy of [99mTc]Tc-PSMA SPECT/CT for recurrent prostate cancer based on individual patient attributes

  • 期刊论文

  • 发表日期：

    2025年11月1日

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  • Knut Liepe,
  • Tony Matti Hoang,
  • Marcel Baehr

摘要

Purpose

The diagnostic performance of [99mTc]Tc-PSMA SPECT/CT is contingent upon the individual attributes of the patients’ prostate cancer. The aim of the study was to analyse these relationships in order to suggest thresholds that may guide diagnostic decision-making regarding the appropriate use of [99mTc]Tc-PSMA SPECT/CT imaging. 

Methods

A total of 143 patients with recurrent prostate cancer were treated with 664.0 ± 43.9 MBq of [99mTc]Tc-MIP-1404 and imaged by SPECT/CT. Comparisons with PSA serum level, ISUP grade, PSA doubling time and PSA velocity were performed. It was ensured that a familywise error rate of α was maintained in multiple-group comparisons. 

Results

Stratifying patients by ISUP grade revealed distinct PSA-dependent detection profiles. For patients with ISUP grade 1–3, the PSA-dependent detection rates at PSA ≤ 0.2 ng/ml, > 0.2–0.5 ng/ml,> 0.5–1.0 ng/ml, > 1.0–2.0 ng/ml,> 2.0–5.0 ng/ml and > 5.0 ng/ml were 15%, 25%, 50%, 60%, 60% and 94%, respectively. For patients with ISUP grade 4–5, these were 29%, 75%, 83%, 86%, 90%, and 100%. PSA velocity did not result in a sharper risk stratification for using [99mTc]Tc-MIP-1404 SPECT/CT. 

Conclusions

[99mTc]Tc-MIP-1404 SPECT/CT is a valuable diagnostic option for patients with recurrent prostate cancer and ISUP grades 4–5 at PSA >0.2 ng/ml or PSA-DT ≤ 12 months and ISUP grades 1–3 at PSA > 0.5 ng/ml or PSA-DT ≤ 6.0 months. If PSMA PET/CT is available, it should be preferred at ISUP grade 1 or PSA < 0.2 ng/ml.