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Evaluating the role of a 99mTc-HYNIC-PSMA SPECT scan following a negative bone scan in men with prostate cancer: a single-centre, retrospective cohort study
Purpose: This study aimed to review the management of patients with high-risk and unfavourable intermediate-risk prostate cancer, who had a 99mTc-HYNIC-PSMA SPECT (technetium-99m hydrazine nicotinamide prostate-specific membrane antigen singlephoton emission computerised tomography) scan following a...
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| Format: | Thesis |
| Language: | English |
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Division of General Surgery
2024
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| _version_ | 1867614336860553216 |
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| access_status_str | Open Access |
| author | Oppel, Cleve |
| author2 | Lazarus, John |
| author_browse | Lazarus, John Oppel, Cleve |
| author_facet | Lazarus, John Oppel, Cleve |
| author_sort | Oppel, Cleve |
| collection | Thesis |
| description | Purpose: This study aimed to review the management of patients with high-risk and unfavourable intermediate-risk prostate cancer, who had a 99mTc-HYNIC-PSMA SPECT (technetium-99m hydrazine nicotinamide prostate-specific membrane antigen singlephoton emission computerised tomography) scan following a negative 99mTc-MDP (technetium-99m methylene diphosphonate) bone scan. Materials and methods: This study is a retrospective review of patients with high-risk and unfavourable intermediate-risk prostate cancer, who underwent a 99mTc-PSMA SPECT scan after a negative/equivocal bone scan between January 2018 and December 2020. Patients with a life expectancy of less than 10 years were excluded. Results: A total of 64 patients were investigated. The mean age was 63 years and the mean prostate-specific antigen (PSA) level was 40 ng/mL. The International Society of Urological Pathology (ISUP) scores were as follows: ISUP 1 in six patients, ISUP 2 in eight patients, ISUP 3 in 13 patients, and ISUP > 4 in 37 patients. A positive 99mTc-PSMA SPECT scan for disease metastases occurred in 20% of the patients who had a negative bone scan. Seven of the patients with a positive 99mTc-PSMA SPECT scan received a bilateral orchiectomy, while four patients received treatment with radical intent. Management of patients with both scans negative included external beam radiotherapy (EBRT) and androgen deprivation therapy (ADT) (n = 47), and radical prostatectomy with or without lymph node (LN) dissection (n = 4). A limiting factor was that not every patient underwent conventional cross-sectional imaging of the pelvis and prostate prior to intervention. Conclusion: A 99mTc-PSMA SPECT scan is a valuable diagnostic tool and was able to identify one in five men (20%) who are understaged by bone scan, allowing for their management plan to be tailored and sparing them morbid intervention. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/39798 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:50:26.016Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2024 |
| publishDateRange | 2024 |
| publishDateSort | 2024 |
| publisher | Division of General Surgery |
| publisherStr | Division of General Surgery |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/39798 Evaluating the role of a 99mTc-HYNIC-PSMA SPECT scan following a negative bone scan in men with prostate cancer: a single-centre, retrospective cohort study Oppel, Cleve Lazarus, John General Surgery Purpose: This study aimed to review the management of patients with high-risk and unfavourable intermediate-risk prostate cancer, who had a 99mTc-HYNIC-PSMA SPECT (technetium-99m hydrazine nicotinamide prostate-specific membrane antigen singlephoton emission computerised tomography) scan following a negative 99mTc-MDP (technetium-99m methylene diphosphonate) bone scan. Materials and methods: This study is a retrospective review of patients with high-risk and unfavourable intermediate-risk prostate cancer, who underwent a 99mTc-PSMA SPECT scan after a negative/equivocal bone scan between January 2018 and December 2020. Patients with a life expectancy of less than 10 years were excluded. Results: A total of 64 patients were investigated. The mean age was 63 years and the mean prostate-specific antigen (PSA) level was 40 ng/mL. The International Society of Urological Pathology (ISUP) scores were as follows: ISUP 1 in six patients, ISUP 2 in eight patients, ISUP 3 in 13 patients, and ISUP > 4 in 37 patients. A positive 99mTc-PSMA SPECT scan for disease metastases occurred in 20% of the patients who had a negative bone scan. Seven of the patients with a positive 99mTc-PSMA SPECT scan received a bilateral orchiectomy, while four patients received treatment with radical intent. Management of patients with both scans negative included external beam radiotherapy (EBRT) and androgen deprivation therapy (ADT) (n = 47), and radical prostatectomy with or without lymph node (LN) dissection (n = 4). A limiting factor was that not every patient underwent conventional cross-sectional imaging of the pelvis and prostate prior to intervention. Conclusion: A 99mTc-PSMA SPECT scan is a valuable diagnostic tool and was able to identify one in five men (20%) who are understaged by bone scan, allowing for their management plan to be tailored and sparing them morbid intervention. 2024-05-31T11:08:19Z 2024-05-31T11:08:19Z 2023 2024-05-31T11:00:58Z Thesis / Dissertation Masters MMed http://hdl.handle.net/11427/39798 eng application/pdf Division of General Surgery Faculty of Health Sciences |
| spellingShingle | General Surgery Oppel, Cleve Evaluating the role of a 99mTc-HYNIC-PSMA SPECT scan following a negative bone scan in men with prostate cancer: a single-centre, retrospective cohort study |
| thesis_degree_str | Master's |
| title | Evaluating the role of a 99mTc-HYNIC-PSMA SPECT scan following a negative bone scan in men with prostate cancer: a single-centre, retrospective cohort study |
| title_full | Evaluating the role of a 99mTc-HYNIC-PSMA SPECT scan following a negative bone scan in men with prostate cancer: a single-centre, retrospective cohort study |
| title_fullStr | Evaluating the role of a 99mTc-HYNIC-PSMA SPECT scan following a negative bone scan in men with prostate cancer: a single-centre, retrospective cohort study |
| title_full_unstemmed | Evaluating the role of a 99mTc-HYNIC-PSMA SPECT scan following a negative bone scan in men with prostate cancer: a single-centre, retrospective cohort study |
| title_short | Evaluating the role of a 99mTc-HYNIC-PSMA SPECT scan following a negative bone scan in men with prostate cancer: a single-centre, retrospective cohort study |
| title_sort | evaluating the role of a 99mtc hynic psma spect scan following a negative bone scan in men with prostate cancer a single centre retrospective cohort study |
| topic | General Surgery |
| url | http://hdl.handle.net/11427/39798 |
| work_keys_str_mv | AT oppelcleve evaluatingtheroleofa99mtchynicpsmaspectscanfollowinganegativebonescaninmenwithprostatecancerasinglecentreretrospectivecohortstudy |