Year: 2025
Type: article
Abstract: Introduction 99m Tc-HYNIC-iPSMA SPECT or SPECT/CT has potential to improve detection and staging of prostate cancer (PrCa) patients, and better direct appropriate therapies in those patients where cost or availability of PET/CT is prohibitive. Furthermore, without the targeted molecular imaging afforded by 99m Tc-HYNIC-iPSMA, rural patients are also disadvantaged with respect to access to theranostic treatment options. The primary objective of this prospective investigation was to assess the safety and clinical impact of 99m Tc-HYNIC-iPSMA SPECT imaging among PrCa patients in remote Western Australia. Methods Twenty-seven rural Western Australian patients with confirmed PrCa were enrolled in this prospective observational study. Imaging was performed 2–4 h after intravenous administration of 650–800 MBq 99m Tc-HYNIC-iPSMA. Planar whole-body images, static images and SPECT/CT acquisitions (chest, abdomen and pelvis) were performed. Treatment-related adverse events were collected, and patients' follow-up data were collected from medical records. Results No adverse reactions or events were observed in any patient. Normal physiologic biodistribution of 99m Tc-HYNIC-iPSMA was observed in 26 (96.3 %) patients. The mean radiochemical purity was 92.5 % (±1.7) with a range of 90 %–96 % and median of 92. At least one PSMA-positive lesion was detected in 81.5 % (n = 22) of patients. The 99m Tc-HYNIC-iPSMA findings altered patient management in 11 (40.7 %) patients. Conclusion These findings support 99m Tc-HYNIC-iPSMA as a reliable alternative to existing imaging modalities, enhancing the diagnostic pipeline and informing patient management. Beyond detection rate, patient management was changed based on the 99m Tc-HYNIC-iPSMA findings in 41 % of patients who would otherwise not have had access to molecular imaging. Implications for practice SPECT may extend advantage where PET is not accessible due to geographic and socioeconomic factors. 99m Tc-HYNIC-iPSMA provides reliable imaging, narrowing the equity gap among PrCa patients.
Source: Radiography
Authors: G. Currie, P. Tually, L. Groombridge, J. Meadows, S. Tagore, N. Lenzo
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $2,990
OpenAlex ID: W4411084808