Head-to-head comparison of 99m Tc-MIP-1404 CZT SPECT/CT and 68 Ga/PSMA-11 PET/CT for primary staging of high-risk prostate cancer: a phase II study.
Tc-MIP-1404 SPECT/CT therapy decisions matched PSMA PET/CT in 91% of prostate cancer patients
Head-to-head comparison of 99m Tc-MIP-1404 CZT SPECT/CT and 68 Ga/PSMA-11 PET/CT for primary staging of high-risk prostate cancer: a phase II study.
To evaluate whether 99m Tc-MIP-1404 CZT SPECT/CT is non-inferior to 68 Ga-PSMA-11 PET/CT for metastases detection in patients with newly diagnosed high risk prostate cancer (prostate cancer).
With newly diagnosed high-risk prostate cancer (age range 50-79 years, mean 66) underwent three imaging modalities: 99mTc-HDP CZT SPECT/CT, 68Ga-PSMA-11 PET/contrast-enhanced CT (contrast-enhanced CT), and 99mTc-MIP-1404 CZT SPECT/CT.
Sensitivity of 99m Tc-MIP-1404 CZT SPECT/CT for metastasis detection at the patient level was 81% for lymph nodes metastasis and 85% for bone metastases, compared with 57% for bone metastases by 99m Tc-HDP CZT SPECT/CT.
There were no false positive findings by 99m Tc-MIP-1404 CZT SPECT/CT; specificity was 100% compared to 68 Ga-PSMA-11 PET/contrast-enhanced CT.
At lesion level analysis, 99m Tc-MIP-1404 CZT SPECT/CT had significantly higher detection rate of lymph nodes metastases compared with contrast-enhanced CT (p = 0.026), but a lower detection rate compared to 68 Ga-PSMA-11 PET/contrast-enhanced CT (p = 0.003).
99m Tc-MIP-1404 CZT SPECT/CT demonstrates strong diagnostic capability for metastatic staging and therapy planning in newly diagnosed high-risk prostate cancer, outperforming conventional imaging.
While 68 Ga-PSMA-11 PET/contrast-enhanced CT identified more additional lesions, concordance in treatment decisions remained high.
Considering its broader accessibility, 99m Tc-MIP-1404 CZT SPECT/CT may represent a practical alternative for primary staging, especially in settings with limited PET/CT availability.