[18F]-PSMA-1007-PET for evaluation of kidney function

Rassek, Philipp; Schäfers, Michael; Rahbar, Kambiz; Backhaus, Philipp

doi:10.1055/a-2127-7880

Cited by 5 publications

(8 citation statements)

References 19 publications

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“…This suggests that 68 Ga-PSMA-derived split function can serve as a reliable alternative for assessing functional renal tissue. Our findings are in agreement with previously published data which showed a positive correlation between SRF derived by 68 GaPSMA PET and 99m Tc-MAG3 scintigraphy as shown in Table 3 [ 25 , 26 , 27 , 28 ]. In a study by Rassek et al, SRF MAG3 was strongly correlated with SRF PSMA (r = 0.872, p < 0.001) [ 28 ].…”

Section: Discussionsupporting

confidence: 94%

“…This is similar to the findings of a recent study by Rosar et al, who depicted reno-ureteral obstruction by PSMA PET/CT imaging in most cases (92.9%) [ 29 ]. A study by Rassek et al also demonstrated that relevant abnormalities of SRF MAG3 could be detected with sensitivities and specificities of 90% and 92% for SRF PSMA [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…PSMA is physiologically overexpressed in the proximal tubular cells of the kidneys and 68 Ga-PSMA is excreted via the renal system [ 24 ]. Several studies have shown the utility of PSMA in the imaging of renal function [ 25 , 26 , 27 , 28 ]; therefore, we hypothesised that 68 Ga-PSMA PET/CT imaging could be used as a surrogate for the determination of PSMA-PETderived split renal function (SRF) at baseline, to assess kidney function and detect changes during follow-up, and to rule out obstruction induced by tumour or renal dysfunction caused by PSMA-targeted radioligand treatment.…”

Section: Introductionmentioning

confidence: 99%

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A Comparison of 68Ga-PSMA PET/CT-Based Split Renal Function with 99mTc-MAG3 Renography in Patients with Metastatic Castration-Resistant Prostate Carcinoma Treated with 177Lu-PSMA

Gabela,

Mkhize,

Hadebe

et al. 2024

Diagnostics

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Background: Physiological PSMA expression in the cells of the proximal renal tubules and consecutive radiopharmaceutical binding and retention could potentially lead to radioligand-therapy-induced nephrotoxicity. Thus, patients with metastatic castration-resistant prostate cancer undergo 99mTc-Mercaptoacetyltriglycine (MAG3) renal scintigraphy to assess kidney function and to exclude renal obstruction as part of their workup for PSMA-targeted radioligand therapy (RLT). 99mTc-MAG-3 renal scintigraphy often requires an additional visit to the nuclear medicine department and patients spend 30–90 min in the department, which is inconvenient and takes up camera time. In addition, the patients are subjected to a baseline 68Ga-PSMA PET/CT to assess for PSMA-positive disease prior to targeted radioligand therapy. The aim of this retrospective cross-sectional study was to compare 99mTc-MAG-3-based split renal function (SRF) with 68Ga-PSMA-derived SRF. Methods: This retrospective cross-sectional study included 28 patients with histologically proven metastatic castration-resistant prostate cancer (mCRPC) who received 177Lu-PSMA617. A comparison between the split renal function using 68Ga-PSMA PET/CT and the 99mTc-MAG-3-derived split renal function was carried out in 56 kidneys (n = 56). The SRF on 68Ga-PSMA was calculated using the volume and the average standard uptake value (SUVmean) within each VOI calculated as previously described by Roser et al.: SRF = (VOLUMEright) ∗ SUVmeanright/(VOLUMEright ∗ SUVmeanright + VOLUMEleft ∗ SUVmeanleft). Paired tests and correlation coefficients were used to compare 68Ga-PSMA and 99mTc-MAG-3. A visual comparison of kidney morphology on both studies was also performed. Results: The median SRF of the right kidney was 49.9% (range: 3–91%) using 68Ga-PSMA PET/CT and 50.5% (range: 0–94%) with 99mTc-MAG3 scintigraphy. Notably, there was a strong correlation between SRF measurements obtained from PSMA and 99mTcMAG3, with a Pearson correlation coefficient of 0.957 (p < 0.001). Both 99mTc-MAG3 and 68Ga-PSMA PET/CT studies identified morphological renal abnormalities; there were nine hydronephrotic kidneys, four shrunken kidneys and one obstructed kidney, and there was a strong positive correlation between 68Ga-PSMA kidney morphology and 99mTcMAG3 renal scintigraphy kidney morphology, with a correlation coefficient of 0.93. Conclusions: PSMA-derived split function demonstrated a high correlation with renal function assessed on diuretic 99mTc-MAG3 renograms. PET-derived split renal function may, therefore, be considered an alternative to diuretic renogram-based split function. Furthermore, both 99mTc-MAG3 and 68Ga-PSMA PET/CT studies identified morphological renal abnormalities such as hydronephrosis, shrunken and obstructed kidneys. This correlation underscores the potential utility of 68Ga-PSMA imaging as a valuable tool for assessing kidney morphology as an alternative to renogram split function in clinical practice.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Comparison of 68Ga-PSMA PET/CT-Based Split Renal Function with 99mTc-MAG3 Renography in Patients with Metastatic Castration-Resistant Prostate Carcinoma Treated with 177Lu-PSMA

Gabela,

Mkhize,

Hadebe

et al. 2024

Diagnostics

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“…But even if the intensity of [ 68 Ga]Ga-PSMA-11 uptake does not depict glomerular kidney function, conclusions on local impairments of kidney function or loss of function of a single kidney might be drawn. Also, regarding the assessment of partial kidney function, PSMA ligand PET/CT showed comparable results with standard techniques like [ 99m Tc]Tc-DMSA or [ 99m Tc]Tc-MAG3 scintigraphy [16,37,43].…”

Section: Results and Comparison To The Literaturementioning

confidence: 78%

“…The best correlation was found by these authors using the product of SUV mean and segmented volume, similar to the TRCU used in this study, which had less dependence than segmented volume in our data. In contrast, other studies investigated poor correlations between renal [ 18 F]PSMA-1007 uptake and eGFR [37]. Moreover, the [ 18 F]PSMA-1007 uptake within the bladder also showed no correlation with kidney function [38].…”

Section: Results and Comparison To The Literaturementioning

confidence: 90%

Dependence of Renal Uptake on Kidney Function in [68Ga]Ga-PSMA-11 PET/CT Imaging

Gühne,

Schilder,

Seifert

et al. 2024

Diagnostics

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(1) Background: PSMA ligand PET/CT is increasingly important for diagnostics of prostate cancer and other tumor diseases. In particular, the radiopharmaceutical [68Ga]Ga-PSMA-11 is widely used. Besides its tumor-specific binding, the uptake within the kidneys is dominant and seems to visualize the renal cortex specifically. Kidney diseases may alter the uptake of radiopharmaceuticals. Therefore, the correlation between renal uptake in PET/CT imaging and renal function should be investigated. (2) Methods: A group of 103 male patients were retrospectively evaluated for eGFR according to the CKD-EPI equation, tracer uptake intensity (SUVmax, SUVpeak, SUVmean), the molecular volume of the renal cortex, morphological kidney size, and total renal uptake. Manual and three different computer-assisted contouring methods (thresholds at 50% of SUVmax, 30% of SUVmax, and absolute SUV of 20) were used for measurements. Correlations between parameters were calculated using linear regression models. (3) Results: Renal SUVmax, SUVpeak, and SUVmean do not correlate with eGFR for manual or computer-assisted measurements. In contrast, molecular cortex volume shows a moderate correlation with eGFR (R2 = 0.231, p < 0.001), superior to morphological kidney size. A contouring threshold of 30% of SUVmax outperformed the other settings for renal cortex volume and total renal uptake. (4) Conclusions: Renal uptake of [68Ga]Ga-PSMA-11 cannot predict eGFR, but the functional renal cortex can be quantified by PET/CT imaging.

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Determination of the optimal imaging protocol for [18F]PSMA-PET-CT for the detection of bone metastases in prostate cancer patients

Bredensteiner,

Ventura,

Rassek

et al. 2024

Nuklearmedizin

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Aim Prostate-specific membrane antigen-positron emission tomography (PSMA-PET) is a widely used diagnostic tool in patients with prostate cancer (PC). However, due to the limited availability of PET scanners and relevant acquisition costs, it is important to consider the indications and acquisition time. The aim of this investigation was to determine whether a PET scan from the skull base to the proximal thigh is sufficient to detect the presence of bone metastases. Methods A retrospective analysis was conducted on 1050 consecutive [18F]PSMA-1007-PET-CT scans from the head to the proximal lower leg. The PET scans were categorised according to the presence and amount of bone metastases: (1) 1–5, (2) 6–19 and (3) ≥20. Additionally, the PET scans were evaluated for the presence of bone metastases below the proximal thigh as well as bone metastases above the skull base. Imaging results were compared to patients PSA values. Results Of the 391 patients with bone metastases, 146 (37.3%) exhibited metastases located below the proximal thigh and 104 (26.6%) above the skull base. The majority of bone metastases located below the proximal thigh (145, 99.3%) and above the skull base (94, 90.4%) were identified in patients with more than five bone metastases. No solitary distal metastasis was detected. The PSA value correlated significantly with number of bone metastases (e. g., 1–5 vs. ≥20 bone metastases, P < 0.001) and was significantly higher in patients with distal bone metastases (P < 0.001). ROC analysis showed that a PSA value of 11.15 ng/mL is the optimal cut-off for detecting bone metastases located below the proximal thigh, with an AUC of 0.919 (95% CI: 0.892–0.945, sensitivity 87%, specificity 86%). Similarly, the PSA value of 12.86 ng/mL is the optimal cut-off for detecting bone metastases above the skull base with an AUC of 0.904 (95% CI: 0.874–0.935, sensitivity 87%, specificity 83%). Conclusion PSMA-PET acquisition protocols from the skull base to the proximal femur may be sufficient to accurately detect bone metastatic disease in PC. PSA values can provide decision support for individual PET acquisition protocols.

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[18F]-PSMA-1007-PET for evaluation of kidney function

Cited by 5 publications

References 19 publications

A Comparison of 68Ga-PSMA PET/CT-Based Split Renal Function with 99mTc-MAG3 Renography in Patients with Metastatic Castration-Resistant Prostate Carcinoma Treated with 177Lu-PSMA

A Comparison of 68Ga-PSMA PET/CT-Based Split Renal Function with 99mTc-MAG3 Renography in Patients with Metastatic Castration-Resistant Prostate Carcinoma Treated with 177Lu-PSMA

Dependence of Renal Uptake on Kidney Function in [68Ga]Ga-PSMA-11 PET/CT Imaging

Determination of the optimal imaging protocol for [18F]PSMA-PET-CT for the detection of bone metastases in prostate cancer patients

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