Superscan on 68Ga PSMA PET/CT in patients with metastatic prostate carcinoma: A case series

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Vol3Nr4Y2023
Published Dec 21, 2023
DOI: https://doi.org/10.22551/2023.41.1004.10267
Daniel Felipe Galindo Cortes Helen Mejia Efeer Sandra Caro Perdomo Nathalie Hernandez Hidalgo

Abstract

Prostate cancer is the second most common malignancy in men worldwide, with a good prognosis when is detected and treated in early stages, but, when it presents progression to castration-resistant metastatic prostate cancer, most of the cases will have bone metastasis, decreasing the quality of life and life expectancy. For the evaluation of the disease in the routinary clinical practice, 68Ga-PSMA PET/CT, among others is a valuable tool for the evaluation of the disease extension. 68Ga-PSMA PET/CT detects the presence of PSMA receptor in the tumoral tissue, but also has physiologic uptake in certain organs, such as liver, spleen, intestine, kidneys, lacrimal and salivary glands. Total or partial absence of uptake in those organs is rare and may be due to a high metastatic tumor burden, a phenomenon originally described in bone scintigraphy as super scan. We describe a case series of seven patients with prostate cancer from the National Institute of Cancerology in Colombia, in which a super scan pattern was found in the evaluation with 68Ga-PSMA PET/CT, proposing the suppression of uptake in the intestine, liver, spleen, lacrimal and salivary glands as the main criteria for its definition, and showing that renal uptake persists in most cases, considering that, unlike the super scan in conventional bone scintigraphy, this is not a criterion necessary for its definition in the study with 68Ga-PSMA.

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Keywords

68Ga-PSMA PET/CT, superscan, metastatic prostate carcinoma

References
1. Rawla P. Epidemiology of Prostate Cancer. World J Oncol. 2019;10(2):63-89. doi: 10.14740/wjon1191. PMID: 31068988; PMCID: PMC6497009.
2. Parra-Medina R, Barahona-Correa J, Chaves JJ, et al. Prevalencia y características demográficas de pacientes con cáncer de próstata en Colombia: datos del Registro de Salud Nacional de 2015 a 2019. Urologia Colombiana. 2021;30(3):E204-E209. doi: 10.1055/s-0041-1733844
3. Quiroz-Munoz M, Izadmehr S, Arumugam D, et al. Mechanisms of Osteoblastic Bone Metastasis in Prostate Cancer: Role of Prostatic Acid Phosphatase. J Endocr Soc. 2019;3(3):655-664. doi: 10.1210/js.2018-00425. PMID: 30842989; PMCID: PMC6397422.
4. Osmond JD 3rd, Pendergrass HP, Potsaid MS. Accuracy of 99mTC-diphosphonate bone scans and roentgenograms in the detection of prostate, breast and lung carcinoma metastases. Am J Roentgenol Radium Ther Nucl Med. 1975;125(4):972-77. doi: 10.2214/ajr.125.4.972. PMID: 1239961.
5. Koç ZP, Özcan PP, Erçolak V, Reyhan M. Superscan Appearance of 68Ga PSMA PET/CT in a Patient with Refractory Prostate Cancer. Mol Imaging Radionucl Ther. 2022;31(1):60-62. doi: 10.4274/mirt.galenos.2020.78800. PMID: 35114754; PMCID: PMC8814547.
6. Lawal I, Vorster M, Boshomane T, et al. Metastatic Prostate Carcinoma Presenting as a Superscan on 68Ga-PSMA PET/CT. Clin Nucl Med. 2015;40(9):755-756. doi: 10.1097/RLU.0000000000000870. PMID: 26053729.
7. Sahoo MK, Shah S. Super Scan in 68Ga-PSMA Ligand PET/CT in Prostate Cancer-Diagnostic Criteria and Its Significance. J Nucl Med Radiol Radiat Ther. 2018;3(1):1–2. doi: 10.24966/NMRR-7419/100010
8. Agarwal KK, Tripathi M, Kumar R, Bal C. Metastatic superscan in prostate carcinoma on gallium-68-prostate-specific membrane antigen positron emission tomography/computed tomography scan. Indian J Nucl Med. 2016;31(2):150-151. doi: 10.4103/0972-3919.178330. PMID: 27095868; PMCID: PMC4815392.
9. Schaeffer EM, Srinivas S, Adra N, et al. NCCN Guidelines® Insights: Prostate Cancer, Version 1.2023. J Natl Compr Canc Netw. 2022;20(12):1288-1298. doi: 10.6004/jnccn.2022.0063. PMID: 36509074.
10. Afshar-Oromieh A, Malcher A, Eder M, et al. PET imaging with a [68Ga] gallium-labelled PSMA ligand for the diagnosis of prostate cancer: biodistribution in humans and first evaluation of tumour lesions. Eur J Nucl Med Mol Imaging. 2013;40(4):486-495. doi: 10.1007/s00259-012-2298-2. Erratum in: Eur J Nucl Med Mol Imaging. 2013;40(5):797-798. PMID: 23179945.
11. Heinrich D, Bruland Ø, Guise TA, Suzuki H, Sartor O. Alkaline phosphatase in metastatic castration-resistant prostate cancer: reassessment of an older biomarker. Future Oncol. 2018;14(24):2543-2556. doi: 10.2217/fon-2018-0087. PMID: 29925281.
12. Armstrong AJ, Eisenberger MA, Halabi S, et al. Biomarkers in the management and treatment of men with metastatic castration-resistant prostate cancer. Eur Urol. 2012;61(3):549-559. doi: 10.1016/j.eururo.2011.11.009. PMID: 22099611; PMCID: PMC3445625.
13. Li F, Xiang H, Pang Z, et al. Association between lactate dehydrogenase levels and oncologic outcomes in metastatic prostate cancer: A meta-analysis. Cancer Med. 2020;9(19):7341-7351. doi: 10.1002/cam4.3108. PMID: 32452656; PMCID: PMC7541156.
14. Ertürk SA, Şalk İ, Yücel B, Ulaş Babacan Ö, Hasbek Z. The Relationship between the SUVmax Value Obtained in Ga-68 PSMA PET/CT and Lactate Dehydrogenase and Alkaline Phosphatase in Prostate Cancer. Arch Esp Urol. 2022;75(6):552-558. doi: 10.37554/en-j.arch.esp.urol-20210903-3536-35. PMID: 36138505.
How to Cite
Galindo Cortes, D. F., Mejia Efeer, H., Caro Perdomo, S., & Hernandez Hidalgo, N. (2023). Superscan on 68Ga PSMA PET/CT in patients with metastatic prostate carcinoma: A case series. Archive of Clinical Cases, 10(4), Arch Clin Cases. 2023;10(4):164-170. https://doi.org/10.22551/2023.41.1004.10267
Issue
Vol. 10 No. 4 (2023)
Section
Case Reports

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How to Cite

Galindo Cortes, D. F., Mejia Efeer, H., Caro Perdomo, S., & Hernandez Hidalgo, N. (2023). Superscan on 68Ga PSMA PET/CT in patients with metastatic prostate carcinoma: A case series. Archive of Clinical Cases, 10(4), Arch Clin Cases. 2023;10(4):164-170. https://doi.org/10.22551/2023.41.1004.10267