Background: The occurrence of skeletal metastases in patients with prostate cancer has been found to be extremely high. Multiple focal hotspots in the skeletal tissue could indicate the existence of skeletal metastasis. Multiple lesions, asymmetric distribution, and increased tracer concentration indicated that the hotspots were metastatic. Metastatic existence could not be traced to the Solitary focal spot in the bone scan. The invasive biopsy technique may only confirm or rule out the presence of metastatic disease. It was suggested and tested a new non-invasive Scintimetric characterization and assessment of skeletal hot spots in bone scans of carcinoma prostate patients.
Materials and Methods: In 75 patients with biopsy proven carcinoma prostate, bone scans were performed 4 and 24 hours after intravenous injection of 15 to 25 mCi of Tc99m Methylene Di-Phosponate with sufficient hydration using the e-cam Siemens dual head gamma camera with e-cam whole body acquisition protocol using the e-cam Siemens dual head gamma camera with e-cam whole body acquisition protocol. In 53 patients, metastatic involvement was found, while 22 were found to be negative. The serum PSA levels were calculated using information from the patient's medical history. The temporal scintimetric approach was used to characterise 185 focal hotspots in 34 patients at different locations. The general display protocol was used to pick images from both the 4 and 24 hour bone scans. The 4 and 24 hour anterior and posterior images were then selected separately using the area ratio processing protocol. The highest counts in each of the chosen regions were then tabulated. The 4/24 hr Dr. V. Siva retention ratio was then calculated by dividing the 4 hr counts of the focal hotspots by 24 hr counts, as well as Israel's 24/4 hr ratio. Similarly, the 4/24 hour retention ratio of whole body scan total counts at 4 and 24 hr scans was determined by Dr. V. Siva. The data was analysed and compared.
For Focal hot spot assessment, the mean of 4/24hr Dr. V. Siva's retention ratio was found to be 12.32 3.3 and that of 24/4hr Israel's ratio was found to be 0.08 0.02. Dr. V. Siva's 4/24 hr retention ratio was calculated by dividing total whole body counts at 4 and 24 hr whole body bone scans. It was 12.21 2.78, which was closer to the Focal hot spot retention ratio. The Metastatic positive group's Total PSA, Free PSA, and percent PSA values were 61.8, 19.2, and 26.8, respectively, while the negative group's values were 34.5, 6.8, and 12.8.
Conclusion: Scintimetric characterization of skeletal hot spots offered a non-invasive method of defining the underlying pathology and allowing for proper management decisions. The 4/24hr retention ratio of Dr. V. Siva was clinically beneficial due to its entire integer value, as opposed to Israel's 24/4hr ratio, which was in decimal value. Biopsy of the affected site accompanied by histopathological analysis demonstrated the usefulness of scintimetric characterization in inferring the metastatic existence of the lesion. The non-invasive quantitative scintimetric characterization of skeletal metastasis in Carcinoma Prostate patients, it can be concluded, deserves a place in the proper management protocol.
Author (s) Details
V. Sivasubramaniyan
Department of Physics, Sri Sathya Sai Institute of Higher Learning, Vidyagiri, Prasanthinilayam, Andhra Pradesh, India
K. Venkataramaniah
Department of Physics, Sri Sathya Sai Institute of Higher Learning, Vidyagiri, Prasanthinilayam, Andhra Pradesh, India
View Book :- https://stm.bookpi.org/RTCMS-V10/article/view/707
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