Abstract
ObjectiveTo evaluate the effect that external cooling of the salivary glands (ECSG) has on the uptake of gallium-68-labeled prostate-specific membrane antigen (68Ga-PSMA), as an indirect assessment of the capacity of ECSG to reduce the local dose in lutetium-177-PSMA-617 radioligand therapy.Materials and MethodsTen patients with prostate cancer were submitted to 68Ga-PSMA positron emission tomography/computed tomography with unilateral ECSG. The ECSG was started at 30 min before the injection of the radiotracer and maintained until the end of image acquisition (1 h after injection). Each salivary gland was assessed by determining the maximum, mean, and peak standardized uptake values (SUVmax, SUVmean, and SUVpeak, respectively). The volume of each gland was determined in a volume of interest delineated by a threshold SUVmax of 10%. Paired Student’s t-tests were used in order to compare the results.ResultsIn terms of the SUV parameters, there were no statistically significant differences between the cooled and contralateral salivary glands. However, the mean volume was 27% lower in the cooled parotid glands than in the contralateral parotid glands (p = 0.004).ConclusionThe use of ECSG does not appear to reduce 68Ga-PSMA uptake by the salivary glands. In addition, there is yet no evidence that ECSG is effective in preventing salivary gland toxicity.
Highlights
Prostate cancer is one of the most prevalent types of cancer among men in Brazil and worldwide, second only to nonmelanoma skin cancer, and accounts for up to a quarter of newly diagnosed cases of cancer[1,2]
Objective: To evaluate the effect that external cooling of the salivary glands (ECSG) has on the uptake of gallium-68-labeled prostate-specific membrane antigen (68Ga-PSMA), as an indirect assessment of the capacity of ECSG to reduce the local dose in lutetium-177-PSMA-617 radioligand therapy
We evaluated the effect of unilateral cooling of the parotid and submandibular salivary glands in ten patients undergoing 68Ga-PSMA Positron emission tomography/computed tomography (PET/CT)
Summary
Prostate cancer is one of the most prevalent types of cancer among men in Brazil and worldwide, second only to nonmelanoma skin cancer, and accounts for up to a quarter of newly diagnosed cases of cancer[1,2]. Junqueira MZ et al / Effect of salivary gland cooling on 68Ga-PSMA uptake. One of the major adverse effects of this therapy is the salivary gland toxicity associated with the uptake of PSMA-targeted radiopharmaceuticals, leading to xerostomia, halitosis, and poor quality of life[7,8]. Techniques to reduce salivary gland toxicity constitute a topic of interest for groups involved in research and in the clinical use of PSMA therapy[7]. One such technique is external cooling of the salivary glands (ECSG) with ice packs, similar to the scalp cooling applied for the prevention of alopecia during some chemotherapy regimens.
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