68Ga-PSMA PET/CT Replacing Bone Scan in the Initial Staging of Skeletal Metastasis in Prostate Cancer: A Fait Accompli?

Purpose

⁶⁸Ga ligands targeting prostate-specific membrane antigen (PSMA) are rapidly emerging as a significant step forward in the management of prostate cancer. PSMA is a type II transmembrane protein with high expression in prostate carcinoma cells. We prospectively evaluated the use of ⁶⁸Ga-PSMA positron emission tomography/computed tomography (PET/CT) in patients with prostate cancer and compared the results to those for technetium-99m (^99mTc)-10-metacyloyloxydecyl dihydrogen phosphate (MDP) bone scintigraphy (BS).

<Superscript>68</Superscript>Ga-PSMA-11 PET/CT in primary staging of prostate carcinoma: preliminary results on differences between black and white South-Africans

Purpose

The incidence of prostate cancer is 60% higher and the mortality rate is two- to three-times greater in black versus white men. We report on differences in ⁶⁸Ga-PSMA-11 PET/CT imaging findings in 77 black South-African (BSAs) and 18 white South-African (WSAs) treatment-naïve primary prostate carcinoma (PPC) patients.

Methods

⁶⁸Ga-PSMA-11 PET/CT imaging findings were compared to histological, biochemical and morphological imaging data. Patients were grouped into three Gleason grade groups (GG), GG 1 (scores 3 + 3 and 3 + 4), GG2 (scores 4 + 3 and 4 + 4) and GG3 (scores 9 and 10), and the PSA difference among the groups was determined. Inter-racial difference in SUVmax of the primary tumor as well as its correlation with serum PSA were also determined.

Results

Ninety-three out of 95 PPC where readily identified on ⁶⁸Ga-PSMA-11 PET/CT imaging. Median PPC SUVmax and serum PSA values proved significantly higher (p = 0.033 and p = 0.003) in GG3 patients (median 16.4 and 180 ng/ml) when compared to GG1 patients (median 9.6 and 25.1 ng/ml) or GG2 patients (median 8.8 and 46.2 ng/ml). SUVmax significantly correlated with serum PSA-values (r = 0.377 (p = 0.0001)). Age, frequency of lymph node involvement and distant metastases, and GGs (p ≥ 0.153) were similar in BSAs and WSAs, both median serum PSA-values as well as SUVmax values proved significantly higher in BSAs when compared to WSAs, respectively, 81.6 ng/ml versus 14.5 ng/ml (p = 0.0001) and 11.9 versus 4.38 (p = 0.004). Moreover, Gleason-score normalized median SUVmax values proved 2.5 times higher in BSAs when compared to WSAs (p = 0.005).

Conclusion

SUVmax values proved significantly related to GG and to be significantly higher in BSAs when compared to WSAs. Also, SUVmax significantly correlated with serum PSA values, which was significantly higher in BSAs when compared with WSAs.

     

Molecular imaging in musculoskeletal infections with <Superscript>99m</Superscript>Tc-UBI 29-41 SPECT/CT

Objective

To determine the added value of CT over planar and SPECT-only imaging in the diagnosis of musculoskeletal infection using ^99mTc-UBI 29-4.

Materials and methods

184 patients with suspected musculoskeletal infection who underwent planar and SPECT/CT imaging with ^99mTc-UBI 29-41 were included. Planar, SPECT-only and SPECT/CT images were reviewed by two independent analysts for presence of bone or soft tissue infection. Final diagnosis was confirmed with tissue cultures, surgery/histology or clinical follow-up.

Results

^99mTc-UBI 29-41 was true positive in 105/184 patients and true negative in 65/184 patients. When differentiating between soft tissue and bone infection, planar?+?SPECT-only imaging had a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 95.0, 74.3, 84.8, 91.3 and 86.9%, respectively, versus 99.0, 94.5, 92.5, 98.5 and 94.5% for SPECT/CT. SPECT/CT resulted in a change in reviewers’ confidence in the final diagnosis in 91/184 patients. Inter-observer agreement was better with SPECT/CT compared with planar?+?SPECT imaging (kappa 0.87, 95% CI 0.71–0.85 versus kappa 0.81, 95% CI 0.58–0.75).

Conclusion

Addition of CT to planar and SPECT-only imaging led to an increase in diagnostic performance and an improvement in reviewers’ confidence and inter-observer agreement in differentiating bone from soft tissue infection.

     

The role of the percentage free PSA in the diagnosis of prostate cancer in Blacks: Findings in indigenous West African men using TRUS guided biopsy

Introduction

In Western and Asian literature, the measurement of percentage free prostate specific antigen (%fPSA) has been known to enhance the predictive role of total prostate specific antigen (tPSA) in early prostate cancer (Ca-P) detection. Relationship between the tPSA and Ca-P are known to be influenced by race. To the best of our knowledge, the relationship between %fPSA and Ca-P has not been studied in sub-Saharan Africa using current established biopsy protocol.

A Systematic Literature Review on Waste-to-Resource Potential of Palm Oil Clinker for Sustainable Engineering and Environmental Applications

Several agro-waste materials have been utilized for sustainable engineering and environmental application over the past decades, showing different degrees of effectiveness. However, information concerning the wider use of palm oil clinker (POC) and its performance is still lacking. Therefore, as a solid waste byproduct produced in one of the oil palm processing stages, generating a huge quantity of waste mostly dumped into the landfill, the waste-to-resource potential of POC should be thoroughly discussed in a review. Thus, this paper provides a systematic review of the current research articles on the several advances made from 2005 to 2021 regarding palm oil clinker physical properties and performances, with a particular emphasis on their commitments to cost savings during environmental and engineering applications. The review begins by identifying the potential of POC application in conventional and geopolymer structural elements such as beams, slabs, and columns made of concrete, mortar, or paste for coarse aggregates, sand, and cement replacement. Aspects such as performance of POC in wastewater treatment processes, fine aggregate and cement replacement in asphaltic and bituminous mixtures during highway construction, a bio-filler in coatings for steel manufacturing processes, and a catalyst during energy generation are also discussed. This review further describes the effectiveness of POC in soil stabilization and the effect of POC pretreatment for performance enhancement. The present review can inspire researchers to find research gaps that will aid the sustainable use of agroindustry wastes. The fundamental knowledge contained in this review can also serve as a wake-up call for researchers that will motivate them to explore the high potential of utilizing POC for greater environmental benefits associated with less cost when compared with conventional materials.