Single photon emission computerized tomography with capromab pendetide plus computerized tomography image set co-registration independently predicts biochemical failure.

Purpose: We evaluate the usefulness of pretreatment (111)Indium capromab pendetide (ProstaScint) planar imaging (immunoscintigraphy) plus single photon emission tomography co-registration with computerized tomography scans to detect occult metastatic disease and predict for biochemical failure, in a cohort of patients with a clinical diagnosis of localized adenocarcinoma of the prostate referred for primary radiotherapy.

Materials And Methods: Patients were followed after radiotherapy for evidence of biochemical failure using 2 criteria of prostate specific antigen clinical nadir +2 ng/ml and American Society for Therapeutic Radiology and Oncology Consensus definitions. Median followup was 58.

Rectal morbidity after permanent prostate brachytherapy with dose escalation to biologic target volumes identified by SPECT/CT fusion.

Purpose: To evaluate rectal morbidity after dose escalation to biologic target volumes identified by capromab pendetide (ProstaScint) single-photon emission tomography images coregistered with computed tomography (SPECT/CT).

Methods And Materials: Two hundred thirty-nine consecutive patients diagnosed with T1c-T3b NxM0 adenocarcinoma of the prostate were treated with brachytherapy seed implant (SI) dose escalation to SPECT/CT-identified biologic target volumes, from February 1997 through December 2002. Patients received SI (n=150) or external beam radiation therapy plus SI (n=89).

Synergistic value of single-photon emission computed tomography/computed tomography fusion to radioimmunoscintigraphic imaging of prostate cancer.

The rationale on which positron emission tomography/computed tomography (PET/CT) imaging is based, combining the functional features of PET with the anatomic detail of CT, provides many advantages that are easily transferable to single-photon emission computed tomography (SPECT)/CT imaging. Our efforts have focused on applying fused SPECT/CT imaging to identify prostate cancer and its metastasis and recurrence through radioimmunoscintigraphy (RIS). This application of RIS to imaging prostate cancer requires 2 key components: (1) a well-defined target associated with the cancer and (2) a "magic bullet" to seek that target.

Fused SPECT/CT imaging of Peri-iliopsoas infection using Indium-111-labeled leukocytes.

Nuclear imaging with In-111-labeled leukocytes has become an instrumental tool in localizing sites of infection and is superior to Ga-67 in localizing abdominal and pelvic abscesses resulting from absence of a normal bowel excretory pathway. Labeled white blood cells (WBCs) localize at sites of infection through diapedesis, chemotaxis, and enhanced vascular permeability and can thus be used to identify infection. The accuracy of this functional imaging modality can be enhanced by fusing SPECT images of labeled WBC with CT images that provide anatomic detail to facilitate reading as illustrated in the case described.

The impact of a negative (111)indium-capromab pendetide scan before salvage radiotherapy.

Purpose: We determined the prognostic role, if any, of the ProstaScint (111)indium-capromab pendetide scan before salvage radiotherapy for biochemical recurrence after RP for localized prostate cancer.

Materials And Methods: We reviewed the records of 649 patients who underwent a ProstaScint scan from 1998 to 2004. A total of 44 patients were identified who had biochemical recurrence after RP and underwent a ProstaScint scan immediately before salvage radiotherapy.

Semiautomatic nonrigid registration for the prostate and pelvic MR volumes.

Rationale And Objectives: Three-dimensional (3D) nonrigid image registration for potential applications in prostate cancer treatment and interventional magnetic resonance (iMRI) imaging-guided therapies were investigated.

Materials And Methods: An almost fully automated 3D nonrigid registration algorithm using mutual information and a thin plate spline (TPS) transformation for MR images of the prostate and pelvis were created and evaluated. In the first step, an automatic rigid body registration with special features was used to capture the global transformation.

Multimodal and three-dimensional imaging of prostate cancer.

Accurate characterization of prostate cancer is crucial for treatment planning and patient management. Non-invasive SPECT imaging using a radiolabeled monoclonal antibody, 111In-labeled capromab pendetide, offers advantage over existing means for prostate cancer diagnosis and staging. However, there are difficulties associated with the interpretation of these SPECT images.

Update on fused capromab pendetide imaging of prostate cancer.

The primary objective of this overview is to apprise clinical urologists and oncologists of the current state of fused multimodality imaging of prostate cancer, which can be applied to optimize treatment by ensuring that a patient's disease is characterized as well as current imaging technology permits. The focus of this study is the monoclonal antibody capromab pendetide, which targets prostate specific membrane antigen (PSMA), a type II membrane glycoprotein strongly associated with prostate cancer. Identifying where capromab pendetide uptake occurs can be done accurately if this functional imaging modality is combined with a modality that provides anatomic detail, such as computed tomography (CT) or magnetic resonance imaging (MRI).

Automatic registration of MR and SPECT images for treatment planning in prostate cancer.

Rationale And Objectives: To aid in surgical and radiation therapy planning for prostate adenocarcinoma, a general-purpose automatic registration method that is based on mutual information was used to align magnetic resonance (MR) images and single photon emission computed tomographic (SPECT) images of the pelvis and prostate.

Materials And Methods: The authors assessed the effects of various factors on alignment between pairs of MR and SPECT images, including the use of particular pulse sequences in MR imaging, image voxel intensity scaling, the use of different regions on the MR-SPECT histogram, spatial masking of nonoverlapping visual data between images, and multiresolution optimization. A mutual information algorithm was used as the cost function for automatic registration.

Radioimmunoguided imaging of prostate cancer foci with histopathological correlation.

Purpose: We have previously presented a technique that fuses ProstaScint and pelvic CT images for the purpose of designing brachytherapy that targets areas at high risk for treatment failure. We now correlate areas of increased intensity seen on ProstaScint-CT fusion images to biopsy results in a series of 7 patients to evaluate the accuracy of this technique in localizing intraprostatic disease.

Methods And Materials: The 7 patients included in this study were evaluated between June 1998 and March 29, 1999 at Metrohealth Medical Center and University Hospitals of Cleveland in Cleveland, Ohio.

Feasibility and acute toxicities of radioimmunoguided prostate brachytherapy.

Purpose: We present a technique that fuses pelvic CT scans and ProstaScint images to localize areas of disease within the prostate gland to customize prostate implants. Additionally, the acute toxicity results from the first 43 patients treated with this technique are reviewed.

Methods And Materials: Between 2/97 and 8/98, 43 patients with clinical stage II prostate adenocarcinoma received ultrasound-guided transperineal implantation of I-125 or Pd-103 seeds.

Multicenter ProstaScint imaging findings in 2154 patients with prostate cancer. The ProstaScint Imaging Centers.

Objectives: To report the results of a retrospective study of 2290 ProstaScint scans of 2154 patients with prostate carcinoma done at 15 institutions.

Methods: The results were analyzed by logistic regression after stratification of the patients into four groups: group 1, newly diagnosed; group 2, after radical prostatectomy with a rising prostate-specific antigen (PSA) level; group 3, after radiation therapy with a rising PSA level; and group 4, after hormonal therapy.

Results: The PSA level and ProstaScint scans positive in the prostate bed (P <0.

Prostate cancer and prostate bed SPECT imaging with ProstaScint: semiquantitative correlation with prostatic biopsy results.

Background: ProstaScint (Cytogen Corporation, Princeton, NJ) murine monoclonal antibody imaging is FDA-approved for imaging of prostate cancer patients at high risk for metastatic disease and patients postprostatectomy with a rising serum prostate-specific antigen (PSA) level. ProstaScint is a murine monoclonal antibody which targets prostate-specific membrane antigen (PSMA). PSMA expression is upregulated in primary and metastatic prostate cancer.

Preliminary imaging results using In-111 labeled CYT-356 (Prostascint) in the detection of recurrent prostate cancer.

To evaluate whether In-111 capromab pendetide (an antibody conjugate directed to a glycoprotein found primarily on the cell membrane of prostate tissue) radioimmunoscintigraphy can localize residual or metastatic prostatic carcinoma in 15 patients after prostatectomy and lymphadenectomy for prostatic carcinoma with rising serum prostate-specific antigen. One patient with 0.6 ng/ml serum prostate-specific antigen had normal imaging results and 14 patients had scintigraphic evidence of residual prostatic bed or metastatic prostatic carcinoma.

Prospective comparison of dual-phase technetium-99m-sestamibi scintigraphy and high resolution ultrasonography in the evaluation of abnormal parathyroid glands.

Technetium-99m-sestamibi (MIBI) is a new radionuclide for imaging parathyroid tissue. The purpose of this study was to evaluate parathyroid localization using single radiotracer, dual-phase MIBI scintigraphy and to compare the results to ultrasonography. Twenty-one patients with hyperparathyroidism underwent dual-phase scintigraphy using 25 mCi MIBI and high resolution ultrasonography before parathyroidectomy.

Use of Tc-99m sestamibi infusion for detection of hibernating myocardium. A preliminary report.

To evaluate whether a prolonged infusion of Tc-99m sestamibi allows for visualization of viable myocardium in areas of hypoperfused myocardium, 25 patients were prospectively studied. Each patient was imaged four times in two consecutive days in the following manner: day 1:1) immediately after injection of Tl-201 at rest, 2) 1 hour after a bolus injection of Tc-99m sestamibi at rest; and day 2: 1) imaging in the Tl-201 window for 24 hour redistribution, 2) imaging after a 1-hour infusion of Tc-99m sestamibi. The two Tc-99m sestamibi and two Tl-201 studies were evaluated for presence of redistribution.

Diagnostic accuracy of nuclear medicine SPECT imaging.

SPECT imaging was utilized in 1052 liver/spleen and 338 brain imaging evaluations. In a quality assurance retrospective analysis with clinical and tissue diagnoses, SPECT liver images had a higher correlation than CT or ultrasound. In brain imaging, SPECT matched MRI in correlation and was more sensitive than CT in evaluating the posterior fossa.