Browsing by Author "A/p Arumugam, Kavita"

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    The Utility Of Early Gallium-68 Psma Pet/ct Imaging In Locoregional Disease Detection Rate In Prostate Cancer: A Single Centre Experience
    (2023)
    A/p Arumugam, Kavita
    Introduction: 68Ga-PSMA PET/CT imaging have shown promising results in staging and restaging of prostate cancer (PCa) patient. Many published literatures have shown, 68Ga-PSMA PET/CT has greater diagnostic accuracy when compared to conventional imaging. Standard whole-body imaging protocol of 68Ga-PSMA PET/CT is performed at approximately 60 minutes interval after radiotracer administration. Standard imaging involves the assessment of whole-body 68Ga-PSMA uptake, however, high physiological tracer excretion in the urinary bladder may obscure locoregional lesions in the pelvis, specifically in prostate gland / prostatic bed, adjacent organs (i.e., urinary bladder, rectum, seminal vesicles) as well as regional nodes. Some studies have proposed early pelvic imaging to help improve the detection rate of PCa in this region. Nevertheless, the data is sparse with no definite consensus of implementing it into available 68Ga-PSMA PET/CT imaging guidelines. Therefore, this study was conducted to evaluate the locoregional detection rate of PCa in standard whole-body 68Ga-PSMA PET/CT imaging compared to early pelvic imaging. Methodology: A retrospective study was conducted on PCa patients who were referred to Institut Kanser Negara for 68Ga-PSMA PET/CT scans from February 2020 to December 2021. The scan protocol involved early pelvic imaging (immediately post radiotracer injection) and whole-body imaging (approximately 60 minutes post radiotracer injection). Assessment was done at the pelvic region based on visual. analysis and SUVmax values of pathological locoregional lesions in early and standard imaging. Results: A total of 210 PCa patients who underwent 68Ga-PSMA PET/CT scans were assessed. Locoregional lesions detected in early pelvic imaging was 68.6% (144/210), whereas, in standard imaging was 70.5% (148/210). Standard imaging has a higher detection rate as compared to early imaging, however this did not reach statistical significance (p=0.344). Conclusion: There is no statistically significant improvement in the locoregional detection rate of PCa by including early pelvic imaging. Therefore, routine application of early pelvic imaging may not have added value for all patients and is impractical in the local settings given the heavy workload.