{"id":{"repo_id":"cape-town","oai_identifier":"oai:open.uct.ac.za:11427/39798"},"canonical_url":"https://search.dev.ndltd.org/etd/cape-town/oai:open.uct.ac.za:11427/39798","repository":{"repo_id":"cape-town","name":"University of Cape Town","base_url":"https://open.uct.ac.za/oai/request"},"display":{"title":"Evaluating the role of a 99mTc-HYNIC-PSMA SPECT scan following a negative bone scan in men with prostate cancer: a single-centre, retrospective cohort study","abstract":"Purpose: This study aimed to review the management of patients with high-risk and unfavourable intermediate-risk prostate cancer, who had a 99mTc-HYNIC-PSMA SPECT (technetium-99m hydrazine nicotinamide prostate-specific membrane antigen singlephoton emission computerised tomography) scan following a negative 99mTc-MDP (technetium-99m methylene diphosphonate) bone scan. Materials and methods: This study is a retrospective review of patients with high-risk and unfavourable intermediate-risk prostate cancer, who underwent a 99mTc-PSMA SPECT scan after a negative/equivocal bone scan between January 2018 and December 2020. Patients with a life expectancy of less than 10 years were excluded. Results: A total of 64 patients were investigated. The mean age was 63 years and the mean prostate-specific antigen (PSA) level was 40 ng/mL. The International Society of Urological Pathology (ISUP) scores were as follows: ISUP 1 in six patients, ISUP 2 in eight patients, ISUP 3 in 13 patients, and ISUP > 4 in 37 patients. A positive 99mTc-PSMA SPECT scan for disease metastases occurred in 20% of the patients who had a negative bone scan. Seven of the patients with a positive 99mTc-PSMA SPECT scan received a bilateral orchiectomy, while four patients received treatment with radical intent. Management of patients with both scans negative included external beam radiotherapy (EBRT) and androgen deprivation therapy (ADT) (n = 47), and radical prostatectomy with or without lymph node (LN) dissection (n = 4). A limiting factor was that not every patient underwent conventional cross-sectional imaging of the pelvis and prostate prior to intervention. Conclusion: A 99mTc-PSMA SPECT scan is a valuable diagnostic tool and was able to identify one in five men (20%) who are understaged by bone scan, allowing for their management plan to be tailored and sparing them morbid intervention.","abstract_html":"Purpose: This study aimed to review the management of patients with high-risk and unfavourable intermediate-risk prostate cancer, who had a 99mTc-HYNIC-PSMA SPECT (technetium-99m hydrazine nicotinamide prostate-specific membrane antigen singlephoton emission computerised tomography) scan following a negative 99mTc-MDP (technetium-99m methylene diphosphonate) bone scan. Materials and methods: This study is a retrospective review of patients with high-risk and unfavourable intermediate-risk prostate cancer, who underwent a 99mTc-PSMA SPECT scan after a negative/equivocal bone scan between January 2018 and December 2020. Patients with a life expectancy of less than 10 years were excluded. Results: A total of 64 patients were investigated. The mean age was 63 years and the mean prostate-specific antigen (PSA) level was 40 ng/mL. The International Society of Urological Pathology (ISUP) scores were as follows: ISUP 1 in six patients, ISUP 2 in eight patients, ISUP 3 in 13 patients, and ISUP > 4 in 37 patients. A positive 99mTc-PSMA SPECT scan for disease metastases occurred in 20% of the patients who had a negative bone scan. Seven of the patients with a positive 99mTc-PSMA SPECT scan received a bilateral orchiectomy, while four patients received treatment with radical intent. Management of patients with both scans negative included external beam radiotherapy (EBRT) and androgen deprivation therapy (ADT) (n = 47), and radical prostatectomy with or without lymph node (LN) dissection (n = 4). A limiting factor was that not every patient underwent conventional cross-sectional imaging of the pelvis and prostate prior to intervention. Conclusion: A 99mTc-PSMA SPECT scan is a valuable diagnostic tool and was able to identify one in five men (20%) who are understaged by bone scan, allowing for their management plan to be tailored and sparing them morbid intervention.","abstract_has_math":false,"creators":["Oppel, Cleve"],"institution":"Division of General Surgery","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Lazarus, John"],"committee_chairs":[],"committee_members":[],"year":2023,"date_issued":"2023","date_published":"2023","updated_at":"2026-07-22T22:23:45Z","subjects":["General Surgery"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/11427/39798","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Lazarus, John"]},{"key":"dc:creator","label":"Author","values":["Oppel, Cleve"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2024-05-31T11:08:19Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2024-05-31T11:08:19Z"]},{"key":"dc:date.issued","label":"Date","values":["2023"]},{"key":"dc:publisher.department","label":"Dc Publisher Department","values":["Division of General Surgery"]},{"key":"dc:type","label":"Dc Type","values":["Thesis / Dissertation"]},{"key":"dc:type.qualificationlevel","label":"Dc Type Qualificationlevel","values":["Masters","MMed"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["General Surgery"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["http://hdl.handle.net/11427/39798"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Purpose: This study aimed to review the management of patients with high-risk and unfavourable intermediate-risk prostate cancer, who had a 99mTc-HYNIC-PSMA SPECT (technetium-99m hydrazine nicotinamide prostate-specific membrane antigen singlephoton emission computerised tomography) scan following a negative 99mTc-MDP (technetium-99m methylene diphosphonate) bone scan. Materials and methods: This study is a retrospective review of patients with high-risk and unfavourable intermediate-risk prostate cancer, who underwent a 99mTc-PSMA SPECT scan after a negative/equivocal bone scan between January 2018 and December 2020. Patients with a life expectancy of less than 10 years were excluded. Results: A total of 64 patients were investigated. The mean age was 63 years and the mean prostate-specific antigen (PSA) level was 40 ng/mL. The International Society of Urological Pathology (ISUP) scores were as follows: ISUP 1 in six patients, ISUP 2 in eight patients, ISUP 3 in 13 patients, and ISUP > 4 in 37 patients. A positive 99mTc-PSMA SPECT scan for disease metastases occurred in 20% of the patients who had a negative bone scan. Seven of the patients with a positive 99mTc-PSMA SPECT scan received a bilateral orchiectomy, while four patients received treatment with radical intent. Management of patients with both scans negative included external beam radiotherapy (EBRT) and androgen deprivation therapy (ADT) (n = 47), and radical prostatectomy with or without lymph node (LN) dissection (n = 4). A limiting factor was that not every patient underwent conventional cross-sectional imaging of the pelvis and prostate prior to intervention. Conclusion: A 99mTc-PSMA SPECT scan is a valuable diagnostic tool and was able to identify one in five men (20%) who are understaged by bone scan, allowing for their management plan to be tailored and sparing them morbid intervention."]},{"key":"dc:title","label":"Title","values":["Evaluating the role of a 99mTc-HYNIC-PSMA SPECT scan following a negative bone scan in men with prostate cancer: a single-centre, retrospective cohort study"]}]}],"canonical_facts":{"dc:contributor.advisor":["Lazarus, John"],"dc:creator":["Oppel, Cleve"],"dc:date.accessioned":["2024-05-31T11:08:19Z"],"dc:date.available":["2024-05-31T11:08:19Z"],"dc:date.issued":["2023"],"dc:description.abstract":["Purpose: This study aimed to review the management of patients with high-risk and unfavourable intermediate-risk prostate cancer, who had a 99mTc-HYNIC-PSMA SPECT (technetium-99m hydrazine nicotinamide prostate-specific membrane antigen singlephoton emission computerised tomography) scan following a negative 99mTc-MDP (technetium-99m methylene diphosphonate) bone scan. Materials and methods: This study is a retrospective review of patients with high-risk and unfavourable intermediate-risk prostate cancer, who underwent a 99mTc-PSMA SPECT scan after a negative/equivocal bone scan between January 2018 and December 2020. Patients with a life expectancy of less than 10 years were excluded. Results: A total of 64 patients were investigated. The mean age was 63 years and the mean prostate-specific antigen (PSA) level was 40 ng/mL. The International Society of Urological Pathology (ISUP) scores were as follows: ISUP 1 in six patients, ISUP 2 in eight patients, ISUP 3 in 13 patients, and ISUP > 4 in 37 patients. A positive 99mTc-PSMA SPECT scan for disease metastases occurred in 20% of the patients who had a negative bone scan. Seven of the patients with a positive 99mTc-PSMA SPECT scan received a bilateral orchiectomy, while four patients received treatment with radical intent. Management of patients with both scans negative included external beam radiotherapy (EBRT) and androgen deprivation therapy (ADT) (n = 47), and radical prostatectomy with or without lymph node (LN) dissection (n = 4). A limiting factor was that not every patient underwent conventional cross-sectional imaging of the pelvis and prostate prior to intervention. Conclusion: A 99mTc-PSMA SPECT scan is a valuable diagnostic tool and was able to identify one in five men (20%) who are understaged by bone scan, allowing for their management plan to be tailored and sparing them morbid intervention."],"dc:identifier.uri":["http://hdl.handle.net/11427/39798"],"dc:publisher.department":["Division of General Surgery"],"dc:subject":["General Surgery"],"dc:title":["Evaluating the role of a 99mTc-HYNIC-PSMA SPECT scan following a negative bone scan in men with prostate cancer: a single-centre, retrospective cohort study"],"dc:type":["Thesis / Dissertation"],"dc:type.qualificationlevel":["Masters","MMed"]},"updated_at":"2026-07-22T22:23:45Z"}