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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) 99mTc-MIP-1404 CZT SPECT/CT versus 68Ga/PSMA-11 PET/CT: Imaging of prostate canc...
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Vol. 42. Issue 6.
Pages 413-415 (November - December 2023)
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Vol. 42. Issue 6.
Pages 413-415 (November - December 2023)
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99mTc-MIP-1404 CZT SPECT/CT versus 68Ga/PSMA-11 PET/CT: Imaging of prostate cancer metastasis
99mTc-MIP-1404 CZT SPECT/TC versus 68Ga-PSMA-11 PET/TC: diagnóstico por imagen de las metástasis en el cáncer de próstata
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A. Saudia, P. Takharb, F. Aljaberya, M. Ochoa-Figueroab,c,d,
Corresponding author
a Division of Urology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
b Department of Radiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
c Department of Clinical Physiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
d Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
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72-year-old male with prostate cancer cT3b, Gleason 7b and PSA level of 23 µg/l. Two weeks after diagnosis, a 99mTc-HDP whole body bone CZT SPECT/CT scan (Fig. 1) and a computed tomography (CT) scan (no image) were performed to investigate metastases, both scans were negative. Radical prostatectomy was performed and confirmed the finding of pT3b, Gleason score 7b with negative margins, but the PSA level after surgery remained elevated at 22 µg/l. A 68Ga-PSMA-11 PET/CT (Fig. 2) and a 99mTc-MIP-1404 CZT SPECT/CT (Fig. 3) scan were performed postoperatively to investigate possible metastasis and both scans reveal hypermetabolic activity in a 9 mm lymph node in the perirectal fat and in the right scapula with obvious clinical suspicion of metastasis. Previous studies have investigated 99mTc-MIP-1404 and conventional SPECT/CT for staging prostate cancer with promising results [1,2]. Furthermore, general-purpose CZT SPECT/CT cameras have shown high sensitivity and might be a good alternative to conventional cameras [3]. In this case, 68Ga-PSMA-11 PET/CT using a GE Discovery D710 (GE Healthcare; Milwaukee, WI, USA) and 99mTc-MIP-1404 CZT SPECT/CT using a CZT Veriton (Spectrum Dynamics, Caesaria, Israel) have shown comparable findings without inferiority with high lesion uptake in the metastatic lesions compared to the background, which raises the question of whether 99mTc-MIP-1404 CZT SPECT/CT could be an alternative to conventional imaging (99mTc-HDP whole body bone scan and CT) and possibly to 68Ga-PSMA-11 PET/CT for prostate cancer staging, emphasizing the need for further studies. To the authors knowledge this the first prostate cancer patient undergoing the combination of 99mTc-MIP-1404 and CZT SPECT/CT in the scientific literature.

Figure 1.

CZT SPECT/CT whole body bone scan performed after the intravenous administration of 500 MBq 99mTc-HDP, showing no uptake suspicious for skeletal metastases. The axial CZT SPECT/CT shows no signs of metastases in the right scapula.

(0.21MB).
Figure 2.

PET/CT performed after the administration of 220 MBq of 68Ga-PSMA-11 showing high uptake in the right scapula (red arrow) and in a 9 mm lymph node in the perirectal fat (green arrow), suggesting metastases.

(0.37MB).
Figure 3.

CZT SPECT-CT scan performed after the intravenous administration of 750 MBq 99mTc-MIP-1404 showing high uptake in the right scapula (red arrow) and in a 9 mm lymph node in the perirectal fat (green arrow), suggesting metastases.

(0.42MB).
Funding

Department of Urology and Department of Clinical Physiology, Linköping University Hospital, Region Östergötland. Faculty of Medicine and Health Sciences, LinkÖping University, Sweden.

Ethics approval

The study was approved by the Swedish Ethical Review Authority (approval number 2021-01642) and the Swedish Medical Products Agency (EudraCT-number 2021-001059-15).

Consent to participate

Written consent was obtained from the patient.

Conflicts of interest/Competing interests

The authors have no conflicts of interest to declare.

Acknowledgments

None.

References
[1]
C. Schmidkonz, C. Hollweg, M. Beck, J. Reinfelder, T.I. Goetz, J.C. Sanders, et al.
99mTc-MIP-1404-SPECT/CT for the detection of PSMA-positive lesions in 225 patients with biochemical recurrence of prostate cancer.
Prostate, 78 (2018), pp. 54-63
[2]
C. Schmidkonz, M. Cordes, M. Beck, T.I. Goetz, D. Schmidt, O. Prante, et al.
SPECT/CT with the PSMA ligand 99mTc-MIP-1404 for whole-body primary staging of patients with prostate cancer.
Clin Nucl Med, 43 (2018), pp. 225-231
[3]
P. Ritt.
Recent developments in SPECT/CT.
Semin Nucl Med, 52 (2022), pp. 276-285
Copyright © 2023. The Authors
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