MATERIAL AND METHODS: A retrospective analysis of 295 PSMA PET CT scans spanning 3 years between 2020 and 2022 was undertaken.
RESULTS: Of 295 PET CT scans, 179 were positive, 66 were negative and 50 had indeterminate findings. In the positive group, 67 had radical prostatectomy and PSMA avid lesions were seen most commonly in pelvic lymph nodes. The remaining 112 positive scans were in the non-radical prostatectomy group; 25 had recurrence only in the prostate, 17 had recurrence involving the prostate bed; 28 had no recurrence in the prostate gland, while 42 had recurrence in the prostate as well as in extra-prostatic sites. Overall, in the non-prostatectomy group, 75% of the population was harboring a PSMA avid lesion in the prostate gland while in the remaining 25% of the population, recurrence did not involve the prostate gland. The majority of indeterminate findings were seen in small pelvic or retroperitoneal lymph nodes or skeletal regions (ribs/others) and in nine patients indeterminate focus was seen in the prostate bed only. Follow-up PSMA PET CT was helpful in prior indeterminate findings and unexplained PSA rise.
CONCLUSION: A higher recurrence in the prostate bed while evaluating biochemical recurrence prompts the following: question: should prostatectomy be offered more proactively? Follow-up PSMA PET CT is helpful for indeterminate findings; a PSA rise of 0.7 ng/mL in 6 months can result in positive PSMA PET CT while negative scans can be seen up to a 2 ng/mL PSA rise in 6 months.
METHODS: The clinical data and scintigraphic findings of consecutive patients referred to the Department of Nuclear Medicine, HKL for GES from July 2020 to December 2020 were retrospectively reviewed.
RESULTS: Thirteen patients underwent the study (6 males and 7 females) with a mean age of 47.9 years (age range of 25 to 72 years). The majority of patients (n=11) were diagnosed with either type I or type II diabetes mellitus. Ten patients reported abnormal scan findings with only 3 patients had normal GES findings. Scintigraphic findings from our patients, association of symptoms with abnormal GES as well as the challenges in implementing GES in Malaysia is discussed.
CONCLUSION: GES provides valuable information to the referring physician in the diagnosis and management of patients with gastric motility disorders. However, its use is limited because of limited availability, cost restriction, lack of familiarity among clinicians, and lack of understanding of the test. Further effort is thus needed to enhance the availability and usage of GES in Malaysia.