| Title |
99mTc-labelled PSMA ligand for radio-guided surgery in nodal metastatic prostate cancer: proof of principle
|
|---|---|
| Published in |
EJNMMI Research, March 2021
|
| DOI | 10.1186/s13550-021-00762-1 |
| Pubmed ID | |
| Authors |
Michael Mix, Wolfgang Schultze-Seemann, Moritz von Büren, August Sigle, Mohamed A. Omrane, Markus T. Grabbert, Martin Werner, Christian Gratzke, Philipp T. Meyer, Cordula A. Jilg |
| Abstract |
Intraoperative identification of prostate cancer (PCa) lymph node (LN) metastases (LNM) detected by preoperative PSMA PET/CT may be facilitated by PSMA radio-guided surgery (RGS) with use of a γ-probe. Earlier we demonstrated excellent performance of the 111In-labelled PSMA ligand DKFZ-617 ([111In]In-PSMA-617) in RGS for ex situ distinction of LN vs LNM at lymphadenectomy (LA) at a single LN level. In comparison with indium-111, technetium-99m has better physical properties for γ-probe measurements, better availability and lower radiation exposure for patients and medical personnel. Against this background, we evaluated the uptake of 99mTc-PSMA-I&S ligand at the level of single LN and its power to discriminate between unaffected LN and LNM. Six patients with PCa with the suspicion of LNM on preoperative PSMA-PET/CT underwent [99mTc]Tc-PSMA-I&S RGS (4 salvage LA, 2 primary LA) with intravenous injection of [99mTc]Tc-PSMA-I&S 24 h prior to surgery. Resected samples were isolated manually aiming at the level of single LN. Uptake measurements were done ex situ with a high-purity germanium detector. Receiver operating characteristic (ROC) analysis was performed based on [99mTc]Tc-PSMA-I&S uptake expressed as lean body mass standard uptake value (SUL). Separation of the tissue samples from 73 subregions resulted in 498 single samples. After final histopathology 356 LN, 160 LNM und 11 non-nodal PCa samples were identified. Median SUL of tumor-free samples (0.26) and samples with cancer (3.5) was significantly different (p < 0.0001). ROC analysis revealed an area under the curve (AUC) of 0.917 (95% CI 0.89-0.95). Using a SUL cutoff of 1.1, sensitivity, specificity, positive predictive value, and negative predictive values were 76.6%, 94.4%, 89.4% and 86.9%. Ex situ analysis of [99mTc]Tc-PSMA-I&S uptake at single LN level showed good diagnostic performance for the ex situ distinction of tumor-bearing vs tumor-free LN during RGS. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 23 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 23 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 4 | 17% |
| Student > Master | 4 | 17% |
| Researcher | 2 | 9% |
| Student > Bachelor | 1 | 4% |
| Student > Doctoral Student | 1 | 4% |
| Other | 1 | 4% |
| Unknown | 10 | 43% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 6 | 26% |
| Physics and Astronomy | 3 | 13% |
| Biochemistry, Genetics and Molecular Biology | 1 | 4% |
| Nursing and Health Professions | 1 | 4% |
| Decision Sciences | 1 | 4% |
| Other | 1 | 4% |
| Unknown | 10 | 43% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 March 2021.
All research outputs
#20,688,655
of 23,287,285 outputs
Outputs from EJNMMI Research
#401
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Outputs of similar age
#361,500
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Outputs of similar age from EJNMMI Research
#8
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