Potential Causes of False-Negative Interpretations in 68Ga-PSMA PET/CT for the Detection of Local and Recurrent Prostate Cancer: An Underexposed Issue

We present 3 cases with false-negatives for local (recurrent) prostate cancer on 68Ga-PSMA PET/CT, using multiparametric MRI and histopathology as reference standard. Metal artifact of prostate gold markers placed for external beam radiation therapy, low level of PSMA uptake, and bladder spillover are potential causes of misinterpretation. Awareness of these diagnostic pitfalls may improve 68Ga-PSMA PET/CT interpretation.
Source: Clinical Nuclear Medicine - Category: Nuclear Medicine Tags: Interesting Images Source Type: research

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ConclusionDifferent medical physicists or dosimetrists, photon energies, treatment planning systems, and treatment machines have an impact on the resulting dose distribution. However, the differences only become apparent when comparing DVH, analysing dose values, comparing CI, HI, GI, as well as reviewing the dose distribution in every single plane. A  new score was introduced to identify treatment plans that simultaneously deliver a low dose to all OAR. Such inter- and intra-institutional comparison studies are needed to explore different treatment planning strategies; however, there is still no automatic soluti...
Source: Strahlentherapie und Onkologie - Category: Cancer & Oncology Source Type: research
AbstractBackgroundThe impact of different radiotherapy modalities on the development and characteristics of second primary bladder cancers (BCa) and BCa-specific mortality (BCa-SM) remains unclear. Thus, we evaluated the incidence and biological behavior of subsequent BCa and related survival in patients who underwent radiation therapy for prostate cancer (PCa).MethodsA total of 530,581 patients in the surveillance, epidemiology, and end results database with localized PCa between 1988 and 2013 were identified. PCa treatments included radical prostatectomy (RP), external beam radiotherapy (EBRT), radioactive implants (RI),...
Source: International Journal of Clinical Oncology - Category: Cancer & Oncology Source Type: research
Abstract External beam radiation therapy for prostate cancer can result in urinary, sexual, and rectal side effects, often impairing quality of life. A polyethylene glycol-based product, SpaceOAR© hydrogel (SOH), implanted into the connective tissue between the prostate gland and rectum can significantly reduce the dose received by the rectum and hence risk of rectal toxicity. The optimal way to manage the hydrogel and rectal structures for plan optimization is therefore of interest. In 13 patients, computerized tomography (CT) scans were taken pre- and post-SpaceOAR© implant. A prescription of 60 G...
Source: Journal of Applied Clinical Medical Physics - Category: Physics Authors: Tags: J Appl Clin Med Phys Source Type: research
Publication date: Available online 30 November 2018Source: European UrologyAuthor(s): Marco Moschini, Emanuele Zaffuto, Agostino Mattei, Pierre I. Karakiewicz, Shahrokh F. Shariat
Source: European Urology - Category: Urology & Nephrology Source Type: research
Publication date: Available online 27 November 2018Source: European UrologyAuthor(s): Alba Fiorentino, Angelo Errico, Marcello Scarcia
Source: European Urology - Category: Urology & Nephrology Source Type: research
Localized prostate cancer (PCa) is mainly treated with both radical prostatectomy (RP) and radiation therapy. Radiation-induced secondary cancers are possible late-onset adverse events of radiation therapy. The incidence of secondary cancer increases at 10 or more years after completion of the radiation therapy. The secondary cancer varies among the types of radiation therapy, and it has been generally considered that the incidence is lower after brachytherapy alone than that after either external beam radiotherapy (EBRT) alone or brachytherapy combined with EBRT.
Source: The Journal of Urology - Category: Urology & Nephrology Authors: Tags: Prostate Cancer: Localized: Radiation Therapy Source Type: research
Conclusions The tolerance to EBRT was good, and severe toxicity was uncommon. Baseline urinary symptoms constitute the predictor that most influenced the acute urinary toxicity. Rectal toxicity is related to the mean rectal dose and with anticoagulant/antiplatelet therapy. There were no significant differences in severe toxicity between radical versus postoperative radiation therapy.
Source: Actas Urologicas Espanolas - Category: Urology & Nephrology Source Type: research
Abstract In MR only radiation therapy planning, generation of the tissue specific HU map directly from the MRI may improve radiation therapy planning. The aim of the work is to generate and validate substitute CT (sCT) scans generated from standard T2 weighted MR pelvic scans in prostate radiation therapy dose planning. A Siemens Skyra 3T MRI scanner with laser bridge, flat couch and pelvic coil mounts was used to scan 39 patients scheduled for external beam radiation therapy for localized prostate cancer. For sCT generation a whole pelvis MRI was acquired. Patients received a routine planning CT scan. Co-register...
Source: Physics in Medicine and Biology - Category: Physics Authors: Tags: Phys Med Biol Source Type: research
, Calvo-Manuel FA Abstract OBJECTIVE: To determine rectal and urinary toxicity after external beam radiation therapy (EBRT), assessing the results of patients who undergo radical or postoperative therapy for prostate cancer (pancreatic cancer) and their correlation with potential risk factors. METHOD: A total of 333 patients were treated with EBRT. Of these, 285 underwent radical therapy and 48 underwent postoperative therapy (39 cases of rescue and 9 of adjuvant therapy). We collected clinical, tumour and dosimetric variable to correlate with toxicity parameters. We developed decision trees based on the degr...
Source: Actas Urologicas Espanolas - Category: Urology & Nephrology Authors: Tags: Actas Urol Esp Source Type: research
Prostate cancer (Partin, Yoo et al. 1993, Shen, Lao et al. 2004) is a common type of cancer among men worldwide. Clinically, external beam radiation therapy (EBRT) is one of the most efficient ways for treating prostate cancer. In EBRT (de Crevoisier, Tucker et al. 2005), Computed Tomography (CT) is of great importance as it provides Hounsfield unit (HU) values, which can be used for dose planning purpose. In the planning stage of EBRT, in order to deliver prescribed dose to the prostate volume, while spare nearby normal organs from the harmful radiation, three critical pelvic organs, i.e., prostate, bladder and rectum, ne...
Source: Medical Image Analysis - Category: Radiology Authors: Source Type: research
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