66 yrs old male. H/O Radicle prostectomy for cancer prostate- 4 years ago HP - Adeno-carcinoma prostate invading directly into normal glandular elements of the prostate, peri-neural lymphatics & wall of the vascular channels ( tumor did not infiltrate the whole thickness of the capsule). Gleason score = 65.12.2015 7.5.2016 8.11.2017 27.12.2017PSA (0.22-6.16) 0.987 1.173 2.340 (Casodex 50 mgm) 0.454 (on medication)
Ref for 99mTc PSMA WHOLE BODY AND SPECT-CT scan for prostate cancer evaluation in view of PSA of 0.454.
99mTc- PSMA whole body AND SPECT-CT scan showed Abnormal PSMA tracer accumulation in left prostatic bed (Better appreciated in SPECT-CT FUSED images at 5 & 20 hours images).Rest of the whole body images were unremarkable.
PSMA AVID SMALL TISSUE ABNORMALITY SEEN IN LEFT PROSTATIC BED,WHICH REPRESENT RECURRANCE OF THE DISEASE PROCESS.
PSMA (Prostate Specific Membrane Antigen) is a membrane glycoprotein which is overexpressed manifold on prostate cancers. The expression increases with tumor aggressiveness, androgen independence, metastatic disease, and disease recurrence. PSMA is an excellent target for radionuclide imaging and therapy of prostate cancer for several reasons. It is mainly expressed in prostate cancer in all stages of the disease, up-regulated in androgen refractory or metastatic disease, expressed on the cell surface as an integral membrane protein, not released into the circulation, and It is mainly expressed in prostate cancer in all stages of the disease, up-regulated in androgen refractory or metastatic disease, expressed on the cell surface as an integral membrane protein, not released into the circulation, and internalized after antibody binding (receptor-mediated endocytosis)
99mTc PSMA SPECT/CT Imaging identifies tumor cells expressing PSMA antigen with excellent sensitivity & specificity, thereby detecting lesions remaining unidentified by conventional methods. (Asian J Androl. 2017 May-Jun; 19(3): 267–271.Published online 2016 Dec 13. doi: 10.4103/1008682X.192638. Evaluation of 99mTc-labeled PSMA-SPECT/CT imaging in prostate cancer patients who have undergone biochemical relapse.
PMSA studies are able to determine the extent of prostate cancer and whether it has spread to the lymph nodes or other parts of the body and provided a higher detection rate than conventional imaging modalities and is helpful in clinical diagnosis and treatment.