AI Article Synopsis
- Prostate-specific membrane antigen (PSMA) shows potential as a diagnostic tool for aggressive thyroid cancer due to its expression in the cancer's microvasculature.
- In a study involving 11 thyroid cancer patients, PSMA PET/MRI detected 65.1% of lesions compared to a 95.3% detection rate for the traditional FDG PET scan, indicating lower effectiveness for PSMA.
- While PSMA uptake varied among patients and was not predictable based on cancer subtype, 8 out of 11 participants might qualify for future PSMA radioligand therapy based on existing prostate cancer guidelines.
Article Abstract
Background: Prostate-specific membrane antigen (PSMA) is expressed in the microvasculature of thyroid cancer. This suggests the potential use of PSMA as a diagnostic agent in patients with aggressive forms of thyroid cancer. The purpose of the current study was to determine the feasibility and utility of [Ga]Ga-PSMA-11 PET/MRI in thyroid cancer patients.
Methods: Eligible patients for this prospective pilot study were adults with a history of pathology-proven thyroid cancer who had abnormal radiotracer uptake on an 2-[F]FDG PET and/or I scintigraphy performed in the 12 months prior to study enrollment. Patients underwent a [Ga]Ga-PSMA-11 PET/MRI, and comparison was made to the prior qualifying 2-[F]FDG PET CT/MRI for lesion location and relative intensity.
Results: Twelve patients underwent [Ga]Ga-PSMA-11 PET/MRI, one of which was excluded from analysis due to debulking surgery prior to the PSMA PET. Of the remaining patients, 7/11 had differentiated disease (3 papillary, 2 follicular, 2 Hurthle cell) and 4/11 had dedifferentiated disease (2 poorly differentiated papillary, 2 anaplastic). Out of 43 lesions, 41 were visually 2-[F]FDG positive (uptake greater than background, detection rate 95.3%) and 28 were PSMA positive (uptake greater than background, detection rate 65.1%). Uptake was heterogeneous between patients, and in some cases within patients. 3/11 patients (1 poorly differentiated papillary, 2 follicular) had PSMA uptake which was greater than FDG uptake. For the remaining 8 patients, 2-[F]FDG uptake was greater than PSMA. Using one eligibility guideline in the prostate cancer literature for PSMA radioligand therapy (RLT), 8/11 could be considered eligible for possible future PSMA RLT. This was not predictable based on thyroid cancer subtype.
Conclusions: [Ga]Ga-PSMA-11 PET demonstrated lower detection rate when compared to 2-[F]FDG PET for thyroid cancer lesion visualization. Thyroid cancer subtype alone may not be sufficient to predict PSMA uptake, and radiotracer uptake may vary between patients and even within patients.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7581659 | PMC |
| http://dx.doi.org/10.1186/s13550-020-00720-3 | DOI Listing |
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