Effects of furosemide and tracer selection on urinary activity and peri-bladder artefacts in PSMA PET/CT: a single-centre retrospective study
Abstract Background High urinary activity in urinary bladder and ureters may hamper interpretation of prostate cancer and regional nodal metastases in prostate-specific membrane antigen (PSMA) PET/CT. The goal of this study was to assess effects of furosemide and choice of tracer on urinary activity...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2022-07-01
|
| Series: | EJNMMI Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13550-022-00913-y |
| _version_ | 1818162862050246656 |
|---|---|
| author | Maarten L. Donswijk Maurits Wondergem Linda de Wit - van der Veen Natascha M. Bruin Pim J. van Leeuwen Henk G. van der Poel Marcel P. M. Stokkel Wouter V. Vogel |
| author_facet | Maarten L. Donswijk Maurits Wondergem Linda de Wit - van der Veen Natascha M. Bruin Pim J. van Leeuwen Henk G. van der Poel Marcel P. M. Stokkel Wouter V. Vogel |
| author_sort | Maarten L. Donswijk |
| collection | DOAJ |
| description | Abstract Background High urinary activity in urinary bladder and ureters may hamper interpretation of prostate cancer and regional nodal metastases in prostate-specific membrane antigen (PSMA) PET/CT. The goal of this study was to assess effects of furosemide and choice of tracer on urinary activity in the bladder and ureters, as well as on occurrence of peri-bladder artefacts in PET/CT. Methods Four cohorts with a total of 202 men staged with PSMA PET/CT for prostate cancer received either 68Ga-PSMA-11 as tracer, with (cohort G+) or without 10mg intravenous furosemide (G−) concurrent with tracer, or 18F-DCFPyL with (F+) or without furosemide (F−). SUVmax of bladder and ureters, presence, type, and severity of peri-bladder artefacts were compared between cohorts. The influence of furosemide and choice of tracer was determined while taking differences in biodistribution time into account. Results Median SUVmax bladder was 43,5; 14,8; 61,7 and 22,8 in cohorts G−, G+, F− and F+, respectively, resulting in significant overall (p < 0.001) and between cohort differences (p adjusted < 0.001 to 0.003) except between G− and F+. Median SUVmax ureter was 6.4; 4.5; 8.1 and 6.0 in cohorts G−, G+, F− and F+, respectively, resulting in significant overall (p < 0.001) and between cohort differences for G+ : F− and F− : F+ (p < 0.001, respectively, 0.019). Significant effects of furosemide and choice of tracer on SUVmax bladder (p < 0.001 resp. p = 0.001) and of furosemide on SUVmax ureter (p < 0.001) were found, whereas differences in biodistribution time had not impacted these results significantly. Peri-bladder artefacts were present in 42/202 (21%) patients and were significantly more frequent in the F− cohort, respectively, less frequent in the G+ cohort (p = 0.001 resp. p < 0.001). Peri-bladder artefacts had a direct positive correlation with SUVmax bladder (p = 0.033). Conclusions Increased urinary activity and higher incidence of peri-bladder artefacts were found in 18F-DCFPyL compared to 68Ga-PSMA-11 PET/CT. Effective reduction of urinary activity may be reached through forced diuresis using 10mg intravenous furosemide, which is especially advantageous in 18F-DCFPyL PET/CT. |
| first_indexed | 2024-12-11T16:40:24Z |
| format | Article |
| id | doaj.art-9b8e262db5ef405abbf80f3558197b68 |
| institution | Directory Open Access Journal |
| issn | 2191-219X |
| language | English |
| last_indexed | 2024-12-11T16:40:24Z |
| publishDate | 2022-07-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | EJNMMI Research |
| spelling | doaj.art-9b8e262db5ef405abbf80f3558197b682022-12-22T00:58:20ZengSpringerOpenEJNMMI Research2191-219X2022-07-0112111110.1186/s13550-022-00913-yEffects of furosemide and tracer selection on urinary activity and peri-bladder artefacts in PSMA PET/CT: a single-centre retrospective studyMaarten L. Donswijk0Maurits Wondergem1Linda de Wit - van der Veen2Natascha M. Bruin3Pim J. van Leeuwen4Henk G. van der Poel5Marcel P. M. Stokkel6Wouter V. Vogel7Department of Nuclear Medicine, Antoni van Leeuwenhoek Nederlands Kanker InstituutDepartment of Nuclear Medicine, Antoni van Leeuwenhoek Nederlands Kanker InstituutDepartment of Nuclear Medicine, Antoni van Leeuwenhoek Nederlands Kanker InstituutDepartment of Nuclear Medicine, Antoni van Leeuwenhoek Nederlands Kanker InstituutDepartment of Urology, Antoni van Leeuwenhoek Nederlands Kanker Instituut, Prostate Cancer Network AmsterdamDepartment of Urology, Antoni van Leeuwenhoek Nederlands Kanker Instituut, Prostate Cancer Network AmsterdamDepartment of Nuclear Medicine, Antoni van Leeuwenhoek Nederlands Kanker InstituutDepartment of Nuclear Medicine, Antoni van Leeuwenhoek Nederlands Kanker InstituutAbstract Background High urinary activity in urinary bladder and ureters may hamper interpretation of prostate cancer and regional nodal metastases in prostate-specific membrane antigen (PSMA) PET/CT. The goal of this study was to assess effects of furosemide and choice of tracer on urinary activity in the bladder and ureters, as well as on occurrence of peri-bladder artefacts in PET/CT. Methods Four cohorts with a total of 202 men staged with PSMA PET/CT for prostate cancer received either 68Ga-PSMA-11 as tracer, with (cohort G+) or without 10mg intravenous furosemide (G−) concurrent with tracer, or 18F-DCFPyL with (F+) or without furosemide (F−). SUVmax of bladder and ureters, presence, type, and severity of peri-bladder artefacts were compared between cohorts. The influence of furosemide and choice of tracer was determined while taking differences in biodistribution time into account. Results Median SUVmax bladder was 43,5; 14,8; 61,7 and 22,8 in cohorts G−, G+, F− and F+, respectively, resulting in significant overall (p < 0.001) and between cohort differences (p adjusted < 0.001 to 0.003) except between G− and F+. Median SUVmax ureter was 6.4; 4.5; 8.1 and 6.0 in cohorts G−, G+, F− and F+, respectively, resulting in significant overall (p < 0.001) and between cohort differences for G+ : F− and F− : F+ (p < 0.001, respectively, 0.019). Significant effects of furosemide and choice of tracer on SUVmax bladder (p < 0.001 resp. p = 0.001) and of furosemide on SUVmax ureter (p < 0.001) were found, whereas differences in biodistribution time had not impacted these results significantly. Peri-bladder artefacts were present in 42/202 (21%) patients and were significantly more frequent in the F− cohort, respectively, less frequent in the G+ cohort (p = 0.001 resp. p < 0.001). Peri-bladder artefacts had a direct positive correlation with SUVmax bladder (p = 0.033). Conclusions Increased urinary activity and higher incidence of peri-bladder artefacts were found in 18F-DCFPyL compared to 68Ga-PSMA-11 PET/CT. Effective reduction of urinary activity may be reached through forced diuresis using 10mg intravenous furosemide, which is especially advantageous in 18F-DCFPyL PET/CT.https://doi.org/10.1186/s13550-022-00913-yPSMAFurosemideSensitivityProstate cancer |
| spellingShingle | Maarten L. Donswijk Maurits Wondergem Linda de Wit - van der Veen Natascha M. Bruin Pim J. van Leeuwen Henk G. van der Poel Marcel P. M. Stokkel Wouter V. Vogel Effects of furosemide and tracer selection on urinary activity and peri-bladder artefacts in PSMA PET/CT: a single-centre retrospective study EJNMMI Research PSMA Furosemide Sensitivity Prostate cancer |
| title | Effects of furosemide and tracer selection on urinary activity and peri-bladder artefacts in PSMA PET/CT: a single-centre retrospective study |
| title_full | Effects of furosemide and tracer selection on urinary activity and peri-bladder artefacts in PSMA PET/CT: a single-centre retrospective study |
| title_fullStr | Effects of furosemide and tracer selection on urinary activity and peri-bladder artefacts in PSMA PET/CT: a single-centre retrospective study |
| title_full_unstemmed | Effects of furosemide and tracer selection on urinary activity and peri-bladder artefacts in PSMA PET/CT: a single-centre retrospective study |
| title_short | Effects of furosemide and tracer selection on urinary activity and peri-bladder artefacts in PSMA PET/CT: a single-centre retrospective study |
| title_sort | effects of furosemide and tracer selection on urinary activity and peri bladder artefacts in psma pet ct a single centre retrospective study |
| topic | PSMA Furosemide Sensitivity Prostate cancer |
| url | https://doi.org/10.1186/s13550-022-00913-y |
| work_keys_str_mv | AT maartenldonswijk effectsoffurosemideandtracerselectiononurinaryactivityandperibladderartefactsinpsmapetctasinglecentreretrospectivestudy AT mauritswondergem effectsoffurosemideandtracerselectiononurinaryactivityandperibladderartefactsinpsmapetctasinglecentreretrospectivestudy AT lindadewitvanderveen effectsoffurosemideandtracerselectiononurinaryactivityandperibladderartefactsinpsmapetctasinglecentreretrospectivestudy AT nataschambruin effectsoffurosemideandtracerselectiononurinaryactivityandperibladderartefactsinpsmapetctasinglecentreretrospectivestudy AT pimjvanleeuwen effectsoffurosemideandtracerselectiononurinaryactivityandperibladderartefactsinpsmapetctasinglecentreretrospectivestudy AT henkgvanderpoel effectsoffurosemideandtracerselectiononurinaryactivityandperibladderartefactsinpsmapetctasinglecentreretrospectivestudy AT marcelpmstokkel effectsoffurosemideandtracerselectiononurinaryactivityandperibladderartefactsinpsmapetctasinglecentreretrospectivestudy AT woutervvogel effectsoffurosemideandtracerselectiononurinaryactivityandperibladderartefactsinpsmapetctasinglecentreretrospectivestudy |