Imaging Pearls ❯ Musculoskeletal ❯ PET/CT
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- BACKGROUND. Bone scintigraphy (BS) using 99mTc-labeled methylene diphosphonate(99mTc-MDP) remains the recommended imaging modality for the detection of bone metastases in patients with prostate cancer (PCa). However, PET/CT using prostate-specific membrane antigen (PSMA) ligands is increasingly recognized as a means of evaluating disease extent in patients with PCa, including use as a possible stand-alone test in high-risk patients.
OBJECTIVE. The purpose of this study is to compare the diagnostic performance of68Ga-PSMA-11 PET/CT with that of 99mTc-MDP BS for the detection of bone metastases inpatients with PCa.
Head-To-Head Comparison of 68Ga-PSMA-11 PET/CT and 99mTc-MDP Bone Scintigraphy for the Detection of Bone Metastases in Patients With Prostate Cancer: A Meta-Analysis
Gege Zhao, Bin Ji
AJR 2022; 219:1–11 - EVIDENCE SYNTHESIS. Six studies with 546 patients were included. Pooled sensitivity and specificity, respectively, were 98% (95% CI, 94–99%) and 97% (95% CI, 91–99%)for 68Ga-PSMA-11 PET/CT versus 83% (95% CI, 69–91%) and 68% (95% CI, 41–87%) for99mTc-MDP BS. The AUC was 0.99 (95% CI, 0.96–1.00) for 68Ga-PSMA-11 PET/CT and 0.85(95% CI, 0.81–0.87) for 99mTc-MDP BS. Among 408 patients from five included studies,68Ga-PSMA-11 PET/CT correctly identified bone metastases in 43 of 193 patients (22.3%)with negative 99mTc-MDP BS results, whereas 99mTc-MDP BS correctly identified bone metastases in four of 210 patients (1.9%) with negative 68Ga-PSMA-11 PET/CT results.
CONCLUSION. On a per-patient basis, the diagnostic performance of 68Ga-PSMA-11PET/CT is superior to that of 99mTc-MDP BS for the detection of PCa bone metastases. Furthermore,99mTc-MDP BS offers limited additional information in patients with negative68Ga-PSMA-11 PET/CT results.
CLINICAL IMPACT. According to current evidence, 99mTc-MDP BS is highly unlikely to be additive to 68Ga-PSMA-11 PET/CT in identifying bone metastases in patients with PCa.
Head-To-Head Comparison of 68Ga-PSMA-11 PET/CT and 99mTc-MDP Bone Scintigraphy for the Detection of Bone Metastases in Patients With Prostate Cancer: A Meta-Analysis
Gege Zhao, Bin Ji
AJR 2022; 219:1–11 - CONCLUSION. On a per-patient basis, the diagnostic performance of 68Ga-PSMA-11PET/CT is superior to that of 99mTc-MDP BS for the detection of PCa bone metastases. Furthermore,99mTc-MDP BS offers limited additional information in patients with negative68Ga-PSMA-11 PET/CT results.
CLINICAL IMPACT. According to current evidence, 99mTc-MDP BS is highly unlikely to be additive to 68Ga-PSMA-11 PET/CT in identifying bone metastases in patients with PCa.
Head-To-Head Comparison of 68Ga-PSMA-11 PET/CT and 99mTc-MDP Bone Scintigraphy for the Detection of Bone Metastases in Patients With Prostate Cancer: A Meta-Analysis
Gege Zhao, Bin Ji
AJR 2022; 219:1–11