In:
EJNMMI Research, Springer Science and Business Media LLC, Vol. 12, No. 1 ( 2022-12)
Abstract:
High urinary activity in urinary bladder and ureters may hamper interpretation of prostate cancer and regional nodal metastases in prostate-specific membrane antigen (PSMA) PET/CT. The goal of this study was to assess effects of furosemide and choice of tracer on urinary activity in the bladder and ureters, as well as on occurrence of peri-bladder artefacts in PET/CT. Methods Four cohorts with a total of 202 men staged with PSMA PET/CT for prostate cancer received either 68 Ga-PSMA-11 as tracer, with (cohort G+) or without 10mg intravenous furosemide (G−) concurrent with tracer, or 18 F-DCFPyL with (F+) or without furosemide (F−). SUVmax of bladder and ureters, presence, type, and severity of peri-bladder artefacts were compared between cohorts. The influence of furosemide and choice of tracer was determined while taking differences in biodistribution time into account. Results Median SUVmax bladder was 43,5; 14,8; 61,7 and 22,8 in cohorts G−, G+, F− and F+, respectively, resulting in significant overall ( p 〈 0.001) and between cohort differences ( p adjusted 〈 0.001 to 0.003) except between G− and F+. Median SUVmax ureter was 6.4; 4.5; 8.1 and 6.0 in cohorts G−, G+, F− and F+, respectively, resulting in significant overall ( p 〈 0.001) and between cohort differences for G+ : F− and F− : F+ ( p 〈 0.001, respectively, 0.019). Significant effects of furosemide and choice of tracer on SUVmax bladder ( p 〈 0.001 resp. p = 0.001) and of furosemide on SUVmax ureter ( p 〈 0.001) were found, whereas differences in biodistribution time had not impacted these results significantly. Peri-bladder artefacts were present in 42/202 (21%) patients and were significantly more frequent in the F− cohort, respectively, less frequent in the G+ cohort ( p = 0.001 resp. p 〈 0.001). Peri-bladder artefacts had a direct positive correlation with SUVmax bladder ( p = 0.033). Conclusions Increased urinary activity and higher incidence of peri-bladder artefacts were found in 18 F-DCFPyL compared to 68 Ga-PSMA-11 PET/CT. Effective reduction of urinary activity may be reached through forced diuresis using 10mg intravenous furosemide, which is especially advantageous in 18 F-DCFPyL PET/CT.
Type of Medium:
Online Resource
ISSN:
2191-219X
DOI:
10.1186/s13550-022-00913-y
Language:
English
Publisher:
Springer Science and Business Media LLC
Publication Date:
2022
detail.hit.zdb_id:
2619892-7
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