False-negative bone scan and choline PET/CT study in a case of prostate cancer: The pitfall of the small cell prostate carcinoma variant

Tamimi, Ammad Shanoon Al; Tan, A.; Kwong, Sidney Yu Wing; Sam, Christopher Cheng Wai; Chong, Angela Pek Yoon; Tan, Cher Heng

doi:10.4103/1450-1147.103422

Cited by 8 publications

(4 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Rare variants of prostate carcinoma, such as small-cell subtype, should be considered as a possible source of false-negative findings on PET/CT using choline-derived radiopharmaceuticals 36. False-positive findings are usually related to nonspecific uptake of FCh or CCh by inflammatory cells; this could result in significant uptake by both actively remodeling pagetic bone and coexisting skeletal metastases from prostate cancer, as reported by Giovacchini et al37…”

Section: Fluorine-18-fluorocholine and Carbon-11-cholinementioning

confidence: 95%

When to perform positron emission tomography/computed tomography or radionuclide bone scan in patients with recently diagnosed prostate cancer

Caldarella¹,

Treglia²,

Giordano³

et al. 2013

CMAR

View full text Add to dashboard Cite

Skeletal metastases are very common in prostate cancer and represent the main metastatic site in about 80% of prostate cancer patients, with a significant impact in patients’ prognosis. Early detection of bone metastases is critical in the management of patients with recently diagnosed high-risk prostate cancer: radical treatment is recommended in case of localized disease; systemic therapy should be preferred in patients with distant secondary disease. Bone scintigraphy using radiolabeled bisphosphonates is of great importance in the management of these patients; however, its main drawback is its low overall accuracy, due to the nonspecific uptake in sites of increased bone turnover. Positron-emitting radiopharmaceuticals, such as fluorine-18-fluorodeoxyglucose, choline-derived drugs (fluorine-18-fluorocholine and carbon-11-choline) and sodium fluorine-18-fluoride, are increasingly used in clinical practice to detect metastatic spread, and particularly bone involvement, in patients with prostate cancer, to reinforce or substitute information provided by bone scan. Each radiopharmaceutical has a specific mechanism of uptake; therefore, diagnostic performances may differ from one radiopharmaceutical to another on the same lesions, as demonstrated in the literature, with variable sensitivity, specificity, and overall accuracy values in the same patients. Whether bone scintigraphy can be substituted by these new methods is a matter of debate. However, greater radiobiological burden, higher costs, and the necessity of an in-site cyclotron limit the use of these positron emission tomography methods as first-line investigations in patients with prostate cancer: bone scintigraphy remains the mainstay for the detection of bone metastases in current clinical practice.

show abstract

Section: Fluorine-18-fluorocholine and Carbon-11-cholinementioning

confidence: 95%

When to perform positron emission tomography/computed tomography or radionuclide bone scan in patients with recently diagnosed prostate cancer

Caldarella¹,

Treglia²,

Giordano³

et al. 2013

CMAR

View full text Add to dashboard Cite

show abstract

“…9 Thus, planar bone scanning is the current standard of care for the evaluation of skeletal metastases, despite its well-recognized limitations. 10 To determine if planar […”

Section: Introductionmentioning

confidence: 99%

“…9 Thus, planar bone scanning is the current standard of care for the evaluation of skeletal metastases, despite its well-recognized limitations. 10 To determine if planar 99m Tc-PSMA imaging successfully provides improved staging over planar technetium-99m labeled -methyl-diphosphonate ( 99m Tc-MDP) bone scans, we compared both scans in five cases of prostate cancer with different risk stratifications.…”

Section: Introductionmentioning

confidence: 99%

Planar 99mTc-PSMA Imaging of Prostate Cancer in a Low-Resource Setting: A Series Report

Orunmuyi

Oladeji

Azodoh³

et al. 2022

World J Nucl Med

View full text Add to dashboard Cite

Objective Technetium [Tc99m]-labeled prostate-specific membrane antigen (PSMA) single-photon emission computed tomography/computed tomography (SPECT/CT) is a suitable alternative to prostate-specific membrane antigen-positron emission tomography (PSMA-PET) imaging. However, the availability of SPECT/CT in many developing countries is limited. Materials and Methods To evaluate the utility of planar [Tc99m]Tc-PSMA in the absence of SPECT/CT, we compared planar [99mTc]Tc-PSMA and routine bone scan imaging in low-, intermediate-, and high-risk prostate cancer in five patients with histologically confirmed prostate cancer who had both scans within a period of less than 4 days. The mean age of patients was 66.8 ± 5.24, and the median prostate-specific antigen level was 175 ng/mL (range: 0–778 ng/mL). Results Planar [Tc99m]Tc-PSMA scan provided no additional benefit over bone scans in the low-risk prostate cancer cases. In the cases with intermediate-risk prostate cancers, planar [Tc99m]Tc-PSMA indicated complete and partial response to treatment in oligometastatic and widespread metastatic disease, respectively. In one patient with high-risk prostate cancer, planar [Tc99m]Tc-PSMA detected additional skeletal lesions that were not seen on bone scan. Conclusion In the absence of SPECT/CT, planar [Tc99m]Tc-PSMA was useful for confirming extent of disease in treated intermediate- and high-risk prostate cancer. It showed little value in low-risk prostate cancer, especially when bone scan is normal. It was particularly useful for treatment response assessment in oligometastatic disease, and its utility should be further explored.

show abstract

“…It has added diagnostic ability to detect early bone lesion changes anywhere with high sensitivity (more than 80%) (Manohar et al, 2017). However, a major drawback of superscans are the false negatives associated with bone scans demonstrating diffuse metastases, whereby these scintigraphs are almost indistinguishable on planar images (Agrawal et al, 2015;Al-Tamimi et al, 2012). In addition, superscans may produce inconclusive results and false interpretations due to metabolic bone diseases (Brenner et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Superscan: Superiority of xSPECT/CT over OSEM SPECT/CT in bone scans of prostate cancer patients.

Chen

Tan

Chew

2021

Radiation Physics and Chemistry

View full text Add to dashboard Cite

Prostate cancer is one of the most common cancers affecting men. Bone scan is part of the staging modality commonly used to evaluate bone metastasis. A bone scan with diffused increased skeletal tracer uptake relative to soft tissue, combined with faint renal activity is known as a superscan. However, a primary concern are false negatives associated with bone scans, where diffuse metastasis is indistinguishable on superscans. In this study, we performed xSPECT/CT Bone and standard OSEM SPECT/CT reconstruction algorithm in ten prostate cancer patients with high PSA levels, where they initially seem relatively unremarkable on planar images. All patients with extensive bone metastases showed either relatively unremarkable scans or did not demonstrate the true extent of metastatic burden as seen on planar images. Uptake was further confirmed by the correlative diffuse bone lesions on CT images. Our reports also indicated that xSPECT/CT reconstructed images were far superior in delineating focal areas of osteoblastic bone metastasis, when compared with whole body planar images or SPECT/CT images. The extent of metastatic evidence is delineated with excellent clarification by xSPECT/CT images. We propose that whole body xSPECT/CT image reconstruction, or at least SPECT/CT, should be performed in patients with high PSA levels, along with planar imaging, to improve diagnostic accuracy of bone scans in prostate cancer staging.

show abstract

False-negative bone scan and choline PET/CT study in a case of prostate cancer: The pitfall of the small cell prostate carcinoma variant

Cited by 8 publications

References 8 publications

When to perform positron emission tomography/computed tomography or radionuclide bone scan in patients with recently diagnosed prostate cancer

When to perform positron emission tomography/computed tomography or radionuclide bone scan in patients with recently diagnosed prostate cancer

Planar 99mTc-PSMA Imaging of Prostate Cancer in a Low-Resource Setting: A Series Report

Superscan: Superiority of xSPECT/CT over OSEM SPECT/CT in bone scans of prostate cancer patients.

Contact Info

Product

Resources

About