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[68Ga]PSMA-HBED-CC Uptake in Osteolytic, Osteoblastic, and Bone Marrow Metastases of Prostate Cancer Patients

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Abstract

Purpose

The aim of this study was to evaluate potential differences in “Glu-NH-CO-NH-Lys” radio-labeled with [68Ga]gallium N,N-bis[2-hydroxy-5-(carboxyethyl)benzyl]ethylenediamine-N,N-diacetic acid ([68Ga]PSMA-HBED-CC) uptake in osteolytic, osteoblastic, mixed, and bone marrow metastases in prostate cancer (PC) patients.

Procedures

This retrospective study was approved by the local ethics committee. Patients who received [68Ga]PSMA-HBED-CC positron emission tomography/computed tomography ([68Ga]PSMA-PET/CT) with at least one positive bone metastasis were included in this study. Only patients who have not received systemic therapy for their PC were included. Bone metastases had to be confirmed by at least one other imaging modality or follow-up investigation. The maximum standardized uptake value (SUVmax) and mean Hounsfield units (HUmean) of each metastasis were measured. Based on CT, each metastasis was classified as osteolytic (OL), osteoblastic (OB), bone marrow (BM), or mixed (M).

Results

One hundred fifty-four bone metastases in 30 patients were evaluated. Eighty out of 154 (51.9%) metastases were classified as OB, 21/154 (13.6%) as OL, 23/154 (14.9%) as M, and 30/154 (19.5%) as BM. The SUVmax for the different types of metastases were 10.6 ± 7.07 (OB), 24.0 ± 19.3 (OL), 16.0 ± 21.0 (M), and 14.7 ± 9.9 (BM). The SUVmax of OB vs. OL and OB vs. BM metastases differed significantly (p ≤ 0.025). A significant negative correlation between HUmean and SUVmax (r = −0.23, p < 0.05) was measured.

Conclusions

[68Ga]PSMA-HBED-CC uptake is higher in osteolytic and bone marrow metastases compared to osteoblastic metastases. Information derived from [68Ga]PSMA-PET and CT complement each other for the reliable diagnosis of the different types of bone metastases in PC patients.

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Abbreviations

[68Ga]PSMA-HBED-CC:

“Glu-NH-CO-NH-Lys” radio-labeled with [68Ga]gallium N,N-bis[2-hydroxy-5-(carboxyethyl)benzyl]ethylenediamine-N,N-diacetic acid

[68Ga]PSMA-PET/CT:

[68Ga]PSMA-HBED-CC-based positron emission tomography/computed tomography

2D ROI:

Two-dimensional region of interest

OL:

Osteolytic

OB:

Osteoblastic

M:

Mixed

BM:

Bone marrow

SUVmax :

Maximum of standardized uptake value

SUV:

Standardized uptake value

BVC:

Best valuable comparator

PC:

Prostate cancer

[99mTc]DPD bone scan:

99mTechnetium-3,3-diphospho-1,2-propanedicarbonacid bone scan

CT:

Computed tomography

HU:

Hounsfield unit

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Acknowledgements

MRM is grateful for the financial support from the Deutsche Forschungsgemeinschaft (DFG, 5943/31/41/91).

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Authors and Affiliations

  1. Department of Radiology, Charité, Charitéplatz 1, 10117, Berlin, Germany

    Jan-Carlo Janssen, Sebastian Meißner, Gerd Diederichs, Bernd Hamm & Marcus R. Makowski

  2. Department of Nuclear Medicine, Charité, Charitéplatz 1, 10117, Berlin, Germany

    Nadine Woythal, Vikas Prasad & Winfried Brenner

Authors
  1. Jan-Carlo Janssen
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  2. Nadine Woythal
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  3. Sebastian Meißner
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Corresponding author

Correspondence to Jan-Carlo Janssen.

Ethics declarations

This retrospective study was approved by the institutional ethics review board of the Charité University Hospital, Berlin.

Informed Consent

In this retrospective study, written informed consent was waived by the Institutional Review Board.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Janssen, JC., Woythal, N., Meißner, S. et al. [68Ga]PSMA-HBED-CC Uptake in Osteolytic, Osteoblastic, and Bone Marrow Metastases of Prostate Cancer Patients. Mol Imaging Biol 19, 933–943 (2017). https://doi.org/10.1007/s11307-017-1101-y

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