Impact of 68GA-PSMA PET / CT on treatment of patients with recurrent / metastatic high risk prostate cancer - a multicenter study.

PURPOSE: The purpose of our study was to evaluate the clinical impact of 68Ga-PSMA PET / CT in the setting of biochemical recurrence of prostate cancer. MATERIALS AND METHODS: We retrospectively evaluated 125 prostate cancer patients submitted to the 68Ga-PSMA PET / CT due to biochemical recurrence. The parameters age, Gleason score, PSA levels, and the highest SUVmax were correlated to potential treatment changes. The highest SUVmax values were correlated with age and Gleason score. The median follow-up time was 24 months. RESULTS: 68Ga-PSMA PET / CT led to a treatment change in 66 / 104 (63.4%) patients (twenty-one patients were lost to follow-up). There was a significant change of treatment plan in patients with a higher Gleason score (P = 0.0233), higher SUVmax (p = 0.0306) and higher PSA levels (P < 0.0001; median PSA = 2.55 ng / mL). CONCLUSION: 68Ga-PSMA PET / CT in prostate cancer patients with biochemical recurrence has a high impact in patient management.

SPECT/CT with 99mTc-sestamibi for the evaluation of skeletal muscle perfusion after electrical muscle stimulation in athletes.

OBJECTIVE: The purpose of this study was to evaluate the effects of electrical muscle stimulation (EMS) on muscles, using 99mTc-sestamibi SPECT/CT. MATERIALS AND METHODS: We prospectively enrolled 20 consecutive male professional water polo players. The mean age was 25 years (range, 18-36 years). All athletes underwent 99mTc-sestamibi SPECT/CT of the thigh (rectus femoris and vastus medialis muscle groups) before and after EMS. Images were quantified to identify increases in perfusion after EMS. RESULTS: Before EMS, there were no significant differences between the right and left thigh (rectus femoris and vastus medialis muscles) in terms of perfusion (p = 0.4). However, the comparison between the pre- and post-EMS analyses of the same muscle groups showed significant differences in radiotracer uptake (p < 0.001), with a mean increase in perfusion of 128% for the rectus femoris muscle group (95% CI: 0.86-1.61) and 118% for the vastus medialis muscle group (95% CI: 0.96-1.79). CONCLUSION: 99mTc-sestamibi SPECT/CT is an objective means of evaluating blood flow in muscles submitted to EMS, which appears to promote significant increases in such blood flow.

OBJETIVO: O objetivo deste estudo foi avaliar o efeito da estimulação elétrica transcutânea na musculatura esquelética utilizando-se SPECT/CT com 99mTc- sestamibi. MATERIAIS E MÉTODOS: Foram prospectivamente avaliados 20 atletas masculinos de polo aquático (18-36 anos de idade; média de 25 anos). Todos os atletas foram submetidos a SPECT/CT com 99mTc- sestamibi das coxas antes e após estimulação elétrica transcutânea dos grupos musculares reto femoral e vasto medial. As imagens foram quantificadas para identificar aumento da perfusão. RESULTADOS: A comparação da perfusão dos grupos musculares (reto femoral e vasto medial) direito versus esquerdo durante o repouso não demonstrou diferença significativa (p = 0,4). Entretanto, quando comparados esses mesmos grupos musculares antes e após a estimulação elétrica, observou-se diferença significativa na captação do traçador (p < 0,001), com aumento perfusional médio de 128% do grupo reto femoral (IC 95%: 0,86-1,61) e 118% do grupo vasto medial (IC 95%: 0,96-1,79) no grupo estimulado. CONCLUSÃO: A SPECT/CT com 99mTc- sestamibi é capaz de demonstrar de forma objetiva que a estimulação elétrica transcutânea aumenta significativamente o fluxo sanguíneo muscular.

SPECT/CT with 99mTc-sestamibi for the evaluation of skeletal muscle perfusion after electrical muscle stimulation in athletes / SPECT/CT com sestamibi-99mTc para avaliação da perfusão após estímulo elétrico da musculatura esquelética em atletas

Abstract Objective: The purpose of this study was to evaluate the effects of electrical muscle stimulation (EMS) on muscles, using 99mTc-sestamibi SPECT/CT. Materials and Methods: We prospectively enrolled 20 consecutive male professional water polo players. The mean age was 25 years (range, 18-36 years). All athletes underwent 99mTc-sestamibi SPECT/CT of the thigh (rectus femoris and vastus medialis muscle groups) before and after EMS. Images were quantified to identify increases in perfusion after EMS. Results: Before EMS, there were no significant differences between the right and left thigh (rectus femoris and vastus medialis muscles) in terms of perfusion (p = 0.4). However, the comparison between the pre- and post-EMS analyses of the same muscle groups showed significant differences in radiotracer uptake (p < 0.001), with a mean increase in perfusion of 128% for the rectus femoris muscle group (95% CI: 0.86-1.61) and 118% for the vastus medialis muscle group (95% CI: 0.96-1.79). Conclusion: 99mTc-sestamibi SPECT/CT is an objective means of evaluating blood flow in muscles submitted to EMS, which appears to promote significant increases in such blood flow.

Resumo Objetivo: O objetivo deste estudo foi avaliar o efeito da estimulação elétrica transcutânea na musculatura esquelética utilizando-se SPECT/CT com 99mTc- sestamibi. Materiais e Métodos: Foram prospectivamente avaliados 20 atletas masculinos de polo aquático (18-36 anos de idade; média de 25 anos). Todos os atletas foram submetidos a SPECT/CT com 99mTc- sestamibi das coxas antes e após estimulação elétrica transcutânea dos grupos musculares reto femoral e vasto medial. As imagens foram quantificadas para identificar aumento da perfusão. Resultados: A comparação da perfusão dos grupos musculares (reto femoral e vasto medial) direito versus esquerdo durante o repouso não demonstrou diferença significativa (p = 0,4). Entretanto, quando comparados esses mesmos grupos musculares antes e após a estimulação elétrica, observou-se diferença significativa na captação do traçador (p < 0,001), com aumento perfusional médio de 128% do grupo reto femoral (IC 95%: 0,86-1,61) e 118% do grupo vasto medial (IC 95%: 0,96-1,79) no grupo estimulado. Conclusão: A SPECT/CT com 99mTc- sestamibi é capaz de demonstrar de forma objetiva que a estimulação elétrica transcutânea aumenta significativamente o fluxo sanguíneo muscular.

68Ga-DOTATATE PET/CT, 99mTc-HYNIC-octreotide SPECT/CT, and whole-body MR imaging in detection of neuroendocrine tumors: a prospective trial.

UNLABELLED: There are different metabolic imaging methods, various tracers, and emerging anatomic modalities to stage neuroendocrine tumor (NET). We aimed to compare NET lesion detectability among (99m)Tc-hydrazinonicotinamide (HYNIC)-octreotide (somatostatin receptor scintigraphy [SSRS]) SPECT/CT, (68)Ga-DOTATATE PET/CT, and whole-body diffusion-weighted MR imaging (WB DWI). METHODS: Nineteen consecutive patients (34-77 y old; mean, 54.3 ± 10.4 y old; 10 men and 9 women) underwent SSRS SPECT/CT, (68)Ga-DOTATATE PET/CT, and WB DWI. Images were acquired with a maximum interval of 3 mo between them and were analyzed with masking by separate teams. Planar whole-body imaging and SPECT/CT were performed from thorax to pelvis using a double-head 16-slice SPECT/CT scanner 4 h after injection of 111-185 MBq of (99m)Tc-HYNIC-octreotide. (68)Ga-DOTATATE PET/CT was performed from head to feet using a 16-slice PET/CT scanner 45 min after injection of 185 MBq of tracer. WB DWI was performed in the coronal plane using a 1.5-T scanner and a body coil. The standard method of reference for evaluation of image performance was undertaken: consensus among investigators at the end of the study, clinical and imaging follow-up, and biopsy of suggestive lesions. RESULTS: McNemar testing was applied to evaluate the detectability of lesions using (68)Ga-DOTATATE PET/CT in comparison to SSRS SPECT/CT and WB DWI: a significant difference in detectability was noted for pancreas (P = 0.0455 and P = 0.0455, respectively), gastrointestinal tract (P = 0.0455 and P = 0.0455), and bones (P = 0.0082 and P = 0.0082). Two unknown primary lesions were identified solely by (68)Ga-DOTATATE PET/CT. (68)Ga-DOTATATE PET/CT, SSRS SPECT/CT, and WB DWI demonstrated, respectively, sensitivities of 0.96, 0.60, and 0.72; specificities of 0.97, 0.99, and 1.00; positive predictive values of 0.94, 0.96, and 1.00; negative predictive values of 0.98, 0.83, and 0.88; and accuracies of 0.97, 0.86, and 0.91. CONCLUSION: (68)Ga PET/CT seems to be more sensitive for detection of well-differentiated NET lesions, especially for bone and unknown primary lesions. NET can be staged with (68)Ga-DOTATATE PET/CT. WB DWI is an efficient new method with high accuracy and without ionizing radiation exposure. SSRS SPECT/CT should be used only when (68)Ga-DOTATATE PET/CT and WB DWI are not available.

Impact of 68GA-PSMA PET / CT on treatment of patients with recurrent / metastatic high risk prostate cancer - a multicenter study

ABSTRACT Purpose: The purpose of our study was to evaluate the clinical impact of 68Ga-PSMA PET / CT in the setting of biochemical recurrence of prostate cancer. Materials and Methods: We retrospectively evaluated 125 prostate cancer patients submitted to the 68Ga-PSMA PET / CT due to biochemical recurrence. The parameters age, Gleason score, PSA levels, and the highest SUVmax were correlated to potential treatment changes. The highest SUVmax values were correlated with age and Gleason score. The median follow-up time was 24 months. Results: 68Ga-PSMA PET / CT led to a treatment change in 66 / 104 (63.4%) patients (twenty-one patients were lost to follow-up). There was a significant change of treatment plan in patients with a higher Gleason score (P = 0.0233), higher SUVmax (p = 0.0306) and higher PSA levels (P < 0.0001; median PSA = 2.55 ng / mL). Conclusion: 68Ga-PSMA PET / CT in prostate cancer patients with biochemical recurrence has a high impact in patient management.