Early differences in dynamic uptake of 68Ga-PSMA-11 in primary prostate cancer: A test-retest study

Introduction Dynamic PET/CT allows visualization of pharmacokinetics over the time, in contrast to static whole body PET/CT. The objective of this study was to assess 68Ga-PSMA-11 uptake in pathological lesions and benign tissue, within 30 minutes after injection in primary prostate cancer (PCa) patients in test-retest setting. Materials and methods Five patients, with biopsy proven PCa, were scanned dynamically in list mode for 30 minutes on a digital PET/CT-scanner directly after an intravenous bolus injection of 100 MBq 68Ga-PSMA-11. Approximately 45 minutes after injection a static whole body scan was acquired, followed by a one bed position scan of the pelvic region. The scans were repeated approximately four weeks later, without any intervention in between. Semi-quantitative assessment was performed using regions-of-interest in the prostate tumor, bladder, gluteal muscle and iliac artery. Time-activity curves were extracted from the counts in these regions and the intra-patient variability between both scans was assessed. Results The uptake of the iliac artery and gluteal muscle reached a plateau after 5 and 3 minutes, respectively. The population fell apart in two groups with respect to tumor uptake: in some patients the tumor uptake reached a plateau after 5 minutes, whereas in other patients the uptake kept increasing, which correlated with larger tumor volumes on PET/CT scan. Median intra-patient variation between both scans was 12.2% for artery, 9.7% for tumor, 32.7% for the bladder and 14.1% for the gluteal muscle. Conclusion Dynamic 68Ga-PSMA-11 PET/CT scans, with a time interval of four weeks, are reproducible with a 10% variation in uptake in the primary prostate tumor. An uptake plateau was reached for the iliac artery and gluteal muscle within 5 minutes post-injection. A larger tumor volume seems to be related to continued tumor uptake. This information might be relevant for both response monitoring and PSMA-based radionuclide therapies.

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PET/CT WITH 68GA-PSMA-11 IN DETECTION OF PRIMARY TUMOR AND RECURRENCE OF PROSTATE CANCER

Problems in oncology ◽

10.37469/0507-3758-2018-64-6-799-804 ◽

2018 ◽

Vol 64 (6) ◽

pp. 799-804

Author(s):

Darya Ryzhkova ◽

M. Poyda

Keyword(s):

Prostate Cancer ◽

Primary Tumor ◽

Biochemical Recurrence ◽

Whole Body ◽

Negative Results ◽

Primary Prostate Cancer ◽

Pet Ct ◽

The Relationship ◽

Positive Results ◽

T Category

Purpose: To study the diagnostic value of PET-CT with 68Ga-PSMA-11 in the diagnosis of a primary prostate cancer, preoperative staging, and the detection of recurrence of prostate cancer (PCa). Methods: 28 patients aged 64.7 ± 8.74 years were included. 10 patients primary prostate cancer, and 18 patients with biochemical recurrence of the disease after radical treatment were examined. All patients underwent PET-CT with 68Ga-PSMA-11 according the whole body protocol. Interpretation of images was performed visually and quantitatively by calculation of SUL max. Results: High focal or diffuse 68Ga-PSMA-11 uptake was found in prostate parenchyma in patients with primary prostate cancer. Additionally metastases in regional lymph nodes were diagnosed in 4 patients and bone metastases were found in one patient. The correlation between 68Ga-PSMA-11 uptake level and Gleason index in the primary tumor (R Spearmen = 0.25, p = 0.57) was not observed. PET-positive results were obtained in 14 patients and PET-negative results in 4 patients with biochemical recurrence of PCa. The relationship between the frequency of PET-positive results and Gleason index was not revealed (R Spearmen = 0.2, p = 0.39). We found a weak but significant correlation between the frequency of PET-positive results and the prostate tumor stage according to the T category (R Spearmen = 0.49, p = 0.049). In patients with low values of PSA (less than 1.0 ng/ml) in 4 out of 9 cases, PET-negative results were obtained. In patients with PSA level more than 1.0 ng/ml PET-positive results were obtained in all cases. Conclusions: PET/CT with 68Ga-PSMA-11 allows to diagnose the primary prostate cancer, to establish the stage of the disease in categories N and M, and also to determine the localization and dissemination of the tumor in patients with biochemical recurrence of prostate cancer. The relationship between 68Ga-PSMA-11 uptake in primary tumor and Gleason index was not found. The probability of obtaining PET-positive results in cases of biochemical recurrence is affected by a PSA level above 1 ng/ml and a high stage of the disease according to the T category (T3-T4).

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Head-to-head intra-individual comparison of biodistribution and tumor uptake of 68Ga-FAPI and 18F-FDG PET/CT in cancer patients

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-021-05307-1 ◽

2021 ◽

Author(s):

Frederik L. Giesel ◽

Clemens Kratochwil ◽

Joel Schlittenhardt ◽

Katharina Dendl ◽

Matthias Eiber ◽

...

Keyword(s):

Fdg Pet ◽

Standard Of Care ◽

Blood Pool ◽

Tracer Uptake ◽

Time Interval ◽

Tumor Uptake ◽

Primary Tumors ◽

Individual Comparison ◽

Pet Ct ◽

Fdg Pet Ct

Abstract Purpose FAPI ligands (fibroblast activation protein inhibitor), a novel class of radiotracers for PET/CT imaging, demonstrated in previous studies rapid and high tumor uptake. The purpose of this study is the head-to-head intra-individual comparison of 68Ga-FAPI versus standard-of-care 18F-FDG in PET/CT in organ biodistribution and tumor uptake in patients with various cancers. Material and Methods This international retrospective multicenter analysis included PET/CT data from 71 patients from 6 centers who underwent both 68Ga-FAPI and 18F-FDG PET/CT within a median time interval of 10 days (range 1–89 days). Volumes of interest (VOIs) were manually drawn in normal organs and tumor lesions to quantify tracer uptake by SUVmax and SUVmean. Furthermore, tumor-to-background ratios (TBR) were generated (SUVmax tumor/ SUVmax organ). Results A total of 71 patients were studied of, which 28 were female and 43 male (median age 60). In 41 of 71 patients, the primary tumor was present. Forty-three of 71 patients exhibited 162 metastatic lesions. 68Ga-FAPI uptake in primary tumors and metastases was comparable to 18F-FDG in most cases. The SUVmax was significantly lower for 68Ga-FAPI than 18F-FDG in background tissues such as the brain, oral mucosa, myocardium, blood pool, liver, pancreas, and colon. Thus, 68Ga-FAPI TBRs were significantly higher than 18F-FDG TBRs in some sites, including liver and bone metastases. Conclusion Quantitative tumor uptake is comparable between 68Ga-FAPI and 18F-FDG, but lower background uptake in most normal organs results in equal or higher TBRs for 68Ga-FAPI. Thus, 68Ga-FAPI PET/CT may yield improved diagnostic information in various cancers and especially in tumor locations with high physiological 18F-FDG uptake.

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OC-0208: Comparison between 68Ga-PSMA-PET/CT and mpMRI for radiotherapy planning in primary prostate cancer

Radiotherapy and Oncology ◽

10.1016/s0167-8140(21)00232-2 ◽

2020 ◽

Vol 152 ◽

pp. S104

Author(s):

S. Spohn ◽

C. Jaegle ◽

A.S. Bettermann ◽

S. Kiefer ◽

C.A. Jilg ◽

...

Keyword(s):

Prostate Cancer ◽

Radiotherapy Planning ◽

Primary Prostate Cancer ◽

Psma Pet ◽

Pet Ct

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Voxel-based comparison of [68Ga]Ga-RM2-PET/CT and [68Ga]Ga-PSMA-11-PET/CT with histopathology for diagnosis of primary prostate cancer

EJNMMI Research ◽

10.1186/s13550-020-00652-y ◽

2020 ◽

Vol 10 (1) ◽

Cited By ~ 1

Author(s):

Thomas Franz Fassbender ◽

Florian Schiller ◽

Constantinos Zamboglou ◽

Vanessa Drendel ◽

Selina Kiefer ◽

...

Keyword(s):

Prostate Cancer ◽

Primary Prostate Cancer ◽

Pet Ct

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[18F]fluoroethylcholine-PET/CT imaging for radiation treatment planning of recurrent and primary prostate cancer with dose escalation to PET/CT-positive lymph nodes

Radiation Oncology ◽

10.1186/1748-717x-6-44 ◽

2011 ◽

Vol 6 (1) ◽

Cited By ~ 77

Author(s):

Florian Würschmidt ◽

Cordula Petersen ◽

Andreas Wahl ◽

Jörg Dahle ◽

Matthias Kretschmer

Keyword(s):

Prostate Cancer ◽

Lymph Nodes ◽

Treatment Planning ◽

Dose Escalation ◽

Radiation Treatment ◽

Ct Imaging ◽

Radiation Treatment Planning ◽

Primary Prostate Cancer ◽

Pet Ct ◽

Positive Lymph Nodes

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Impact of sodium 18F-fluoride PET/CT, 18F-fluorocholine PET/CT and whole-body diffusion-weighted MRI on the management of patients with prostate cancer suspicious for metastasis: a prospective multicentre study

World Journal of Urology ◽

10.1007/s00345-018-2547-5 ◽

2018 ◽

Vol 37 (8) ◽

pp. 1587-1595 ◽

Cited By ~ 1

Author(s):

Mathieu Gauthé ◽

Cyrielle Aveline ◽

Frédéric Lecouvet ◽

Laure Michaud ◽

Caroline Rousseau ◽

...

Keyword(s):

Prostate Cancer ◽

Multicentre Study ◽

Whole Body ◽

Diffusion Weighted Mri ◽

Prospective Multicentre Study ◽

Diffusion Weighted ◽

Pet Ct ◽

18F Fluoride

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Kezdeti tapasztalatok a 99mTc-PSMA-SPECT/CT-vel prosztatarákos betegekben

Orvosi Hetilap ◽

10.1556/650.2018.31128 ◽

2018 ◽

Vol 159 (35) ◽

pp. 1433-1440

Author(s):

István Farkas ◽

Zsuzsanna Besenyi ◽

Anikó Maráz ◽

Zoltán Bajory ◽

András Palkó ◽

...

Keyword(s):

Prostate Cancer ◽

Bone Metastases ◽

Bone Scintigraphy ◽

Transmembrane Protein ◽

Tracer Uptake ◽

Whole Body ◽

Primary Prostate Cancer ◽

Cancer Tumor ◽

Visceral Metastases ◽

Male Patients

Abstract: Introduction: The prostate-specific membrane antigen (PSMA) is a transmembrane protein, that is highly expressed on the surface of prostate cancer cells. In the last few years, several PSMA-specific ligands have been developed, that can be successfully used to detect primary prostate cancer, tumor recurrences and metastases as well. Aim: The goal of our work was to examine the clinical application of a 99mtechnetium-labeled PSMA-radiopharmaceutical as part of the routine diagnostics of prostate cancer. Method: We examined 15 male patients with verified prostate adenocarcinoma with suspicion of progression or recurrence of the disease. We performed whole-body PSMA-SPECT/CTs and multiparametric MRIs of the prostate and the pelvic regions within a week. We used 99mTc-mas3-y-nal-k(Sub-KuE) for the PSMA-SPECT scans. The images were visually evaluated by independent observers. The results were compared with the follow-up bone scintigraphies as well. Results: Twenty-two PSMA-positive lesions were found. Nine of them were localized outside, 13 were within the MRI’s field of view. From these 13 lesions, 7 matched with the SPECT/CT results and in 5 cases the MRI images showed no abnormalities. In one case, bone metastasis was suspected on the MRI scan but there was no corresponding pathological tracer uptake on the SPECT images. In two patients, none of the examinations showed signs of prostate malignancy. Four patients had PSMA-positive bone metastases. One of them had a matching PSMA/SPECT and bone scintigraphy result and in one case the PSMA examination showed metastasis in contrast to the negative bone scintigraphy. Conclusion: PSMA-SPECT/CT with 99mTc-mas3-y-nal-k(Sub-KuE) is a promising diagnostic tool. This technique is capable of visualizing bone metastases and it can detect local recurrences and visceral metastases as well. Orv Hetil. 2018; 159(35): 1433–1440.

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