PET/CT is extra correct than bone scintigraphy for detecting bone metastases in sufferers with prostate most cancers, in keeping with a examine revealed Could 20 within the Journal of Medical Imaging and Radiation Sciences.
A bunch at Dalhousie College in Halifax, Canada, reviewed current literature for research evaluating gallium-68 (Ga-68) prostate-specific membrane antigen (PSMA) PET/CT and technetium-99m (Tc-99m) methyl diphosphonate (MDP) bone scintigraphy in prostate most cancers sufferers. Findings counsel imaging departments ought to think about transitioning to Ga-68 PSMA-11 PET/CT, in keeping with the researchers.
“As a result of Ga-68 PSMA-PET/CT has been integrated into scientific follow earlier than a complete synthesis had been carried out, our examine sought to place this proverbial horse in entrance of the cart,” the group wrote.
Probably the most frequent locations for prostate most cancers cells to metastasize to is bone, particularly the axial skeleton (ribs, pelvis, and backbone, the place purple marrow is most considerable), the authors defined.
Bone scintigraphy has been the usual diagnostic method for many years for detecting prostate most cancers bone metastases, but quite a few research have advised that Ga-68 PSMA-PET/CT could also be superior, with the method shortly deployed clinically after its U.S. approval in 2020. Nevertheless, there have been no systematic evaluations evaluating the 2 approaches, in keeping with the authors.
To deal with this shortcoming, the group combed the literature for comparative research between September 2011 to July 2022. For inclusion, they targeted on research that reported accuracy knowledge (sensitivity, specificity, unfavourable predictive worth, and constructive predictive worth) in sufferers, with picture acquisitions between the 2 modalities carried out inside three months of one another.
The researchers recognized 5 single-centered research that met these standards. In whole, the research included 451 sufferers at various therapy and analysis phases. Throughout all measures of accuracy, Ga-68 PSMA PET/CT was superior to Tc-99m MDP bone scintigraphy within the detection of skeletal metastases, they discovered.
| Affected person-based sensitivities and specificities for detecting bone metastases | ||
| Tc-99m MDP bone scintigraphy | Ga-68 PSMA-PET/CT | |
| Sensitivity | 50%-91% | 91%-100% |
| Specificity | 19%-96% | 88%-100% |
“Ga-68 PSMA-PET/CT was extra correct than Tc-99m MDP bone scintigraphy within the detection of [prostate cancer] bone metastases,” the authors said.
In the end, prices related to PET/CT expertise are the primary limitation for utilizing the method in most healthcare facilities, in keeping with the authors. For instance, in Nova Scotia, there’s one PET/CT scanner to assist a inhabitants of greater than 1 million individuals, they famous.
Nonetheless, the query that must be answered is whether or not bone scintigraphy, with inferior accuracy, is a ample commonplace of care, they wrote.
“As the prevalence of Ga-68 PSMA-PET/CT turns into extra widely known, diagnostic imaging departments might think about a transition to this process,” the researchers concluded.
