68Ga-PSMA-617 PET/CT: a promising new technique for predicting risk stratification and metastatic risk of prostate cancer patients

Liu, Chen; Liu, Teli; Zhang, Ning; Liu, Yiqiang; Li, Nan; Du, Peng; Yang, Yong; Liu, Ming; Gong, Kan; Yang, Xing; Zhu, Hua; Yan, Kun

doi:10.1007/s00259-018-4037-9

Cited by 55 publications

(46 citation statements)

References 32 publications

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“…In general, the SUL max values of normal tissues found in the literature for PSMA PET/CT scans are comparable to ours [ 16 , 25 – 27 ]. The differences between the two scans are largest in the ureter and bladder, which can be explained by variations in urine volume and radiotracer activity in the bladder.…”

Section: Discussionsupporting

confidence: 89%

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Day-to-day variability of [68Ga]Ga-PSMA-11 accumulation in primary prostate cancer: effects on tracer uptake and visual interpretation

et al. 2020

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Purpose Prostate-specific membrane antigen (PSMA) agents, such as [68Ga]Ga-PSMA-11, have an unprecedented accuracy in staging prostate cancer (PCa) and detecting disease recurrence. PSMA PET/CT may also be used for response monitoring by displaying molecular changes, instead of morphological changes alone. However, there are still limited data available on the variability in biodistribution and intra-prostatic uptake of PSMA targeting radiotracers. Therefore, the aim of this study was to assess the repeatability of [68Ga]Ga-PSMA-11 uptake in primary PCa patients in a 4-week interval. Methods Twenty-four primary PCa patients were prospectively included, who already were scheduled for [68Ga]Ga-PSMA-11 PET/CT scan on clinical indication (≥ cT3, Gleason score ≥ 7 or PSA ≥ 20 ng/mL). These patients received two [68Ga]Ga-PSMA-11 PET/CT scans with a 4-week interval. No treatment was started in between the scans. Semiquantitative measurements (SULmax, SULmean, and SULpeak) were determined in the prostate tumor, normal tissues, and blood pool. The repeatability coefficient of every region was determined. All scans were visually analyzed by two nuclear medicine physicians. Results Within-subject coefficient of variation of [68Ga]Ga-PSMA-11 uptake between the two scans was on average 10% in the prostate tumor, normal tissues (liver, kidney, parotid), and blood pool. The repeatability coefficient of the prostate tumor was 18% for SULpeak and 22% for SULmax. Lesion uptake was visually different in 5 patients, though not clinically relevant. Conclusion Results of test-retest [68Ga]Ga-PSMA-11 PET/CT scans in a 4-week interval show that [68Ga]Ga-PSMA-11 uptake is repeatable, with a clinical irrelevant variation in tumor and physiological distribution. Based on the presented repeatable uptake, [68Ga]Ga-PSMA-11 PET/CT scans can potentially be used for disease surveillance and therapy response monitoring. Changes in uptake larger than the RC are therefore likely to reflect actual biological changes in PSMA expression. Trial registration NL8263 at Trialregister.nl retrospectively registered on 03-01-2020. https://www.trialregister.nl/trial/8263

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Section: Discussionsupporting

confidence: 89%

“…If present, [ 68 Ga]Ga-PSMA-11 positive metastatic bone lesions or lymph nodes were included in the analysis. The blood pool was used as reference value [ 12 , 16 ] . The standard uptake value corrected for lean body mass (SUL) was used for quantitative analyses [ 17 , 18 ].…”

Section: Methodsmentioning

confidence: 99%

Day-to-day variability of [68Ga]Ga-PSMA-11 accumulation in primary prostate cancer: effects on tracer uptake and visual interpretation

et al. 2020

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“…Because all lesions visualized at 1 h after injection were also visible at 2 h after injection and the SUV max and contrast were higher on the images of most patients at 2 h after injection, imaging at a later time point may be a better option. The SUV max was significantly higher for patients with high-risk prostate cancer (Gleason score $ 8) than for patients with intermediate-risk prostate cancer-similar to the findings of a previous study on 68 Ga-PSMA-617 conducted by our group (41). The effective dose was calculated to be 0.016 6 0.002 mSv/ MBq, indicating that the effective dose of Al 18 F-PSMA-BCH was within a reasonable range (14).…”

Section: Discussionsupporting

confidence: 85%

Preclinical Evaluation and Pilot Clinical Study of Al¹⁸F-PSMA-BCH for Prostate Cancer PET Imaging

Liu

et al. 2019

J Nucl Med

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“…68 Ga-PSMA-617 ( 68 Ga-PSMA) was produced as described previously (16). Each patient received an intravenous injection of 68 Ga-PSMA-617 (median dose: 206.09 MBq; range: 121.73-361.12 MBq), followed by PET and CT scans at 60±10 min using a Gemini TF scanner (Philips Medical Systems, The Netherlands).…”

Section: Ga-psma Pet/ctmentioning

confidence: 99%

⁶⁸Ga-PSMA PET/CT Combined with PET/Ultrasound-Guided Prostate Biopsy Can Diagnose Clinically Significant Prostate Cancer in Men with Previous Negative Biopsy Results

Liu

Zhang

et al. 2020

J Nucl Med

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parameters to predict the outcome of repeat prostate biopsy. Results: The median age of patients was 65 years (range 53-81), and the median PSA level was 18.0 ng/ml (range 5.48-49.77 ng/ml). Prostate cancer was detected in 15/31 patients (48.4%) and 12/31 patients (38.7%) had clinically significant disease. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 68 Ga-PSMA PET/CT in the diagnosis of clinically significant prostate cancer were 100.0%, 68.4%, 66.7%, 100.0% and 80.6%, respectively. The detection rate of prostate cancer increased with the increase of miPSMA-ES score. The detection rate of clinically significant prostate cancer in miPSMA-ES 0-1, 2 and 3 groups were 0%, 54.5% and 85.7% respectively. Semi-quantitative analysis of 68 Ga-PSMA PET/CT images showed that predictive models based on maximum standardized uptake value (SUVmax), tumor-to-background normal prostate SUV (SUVT/BGp) and tumor-to-background normal liver SUV (SUVratio) could effectively predict clinically significant prostate cancer; area under the curves were 0.930, 0.877, and 0.956, respectively. Conclusion: This study preliminarily confirmed that 68 Ga-PSMA PET/CT imaging combined with PET-ultrasound fusion image-guided prostate biopsy can effectively detect clinically significant prostate cancer. Prebiopsy 68 Ga-PSMA PET/CT has predictive value for clinically significant cancer in the studied patient population.

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68Ga-PSMA-617 PET/CT: a promising new technique for predicting risk stratification and metastatic risk of prostate cancer patients

Abstract: Semi-quantitative analysis indexes of Ga-PSMA-617 PET/CT imaging can be used as "imaging biomarkers" to predict risk stratification and metastatic risk of prostate cancer.

Cited by 55 publications

References 32 publications

Day-to-day variability of [68Ga]Ga-PSMA-11 accumulation in primary prostate cancer: effects on tracer uptake and visual interpretation

Day-to-day variability of [68Ga]Ga-PSMA-11 accumulation in primary prostate cancer: effects on tracer uptake and visual interpretation

Preclinical Evaluation and Pilot Clinical Study of Al¹⁸F-PSMA-BCH for Prostate Cancer PET Imaging

⁶⁸Ga-PSMA PET/CT Combined with PET/Ultrasound-Guided Prostate Biopsy Can Diagnose Clinically Significant Prostate Cancer in Men with Previous Negative Biopsy Results

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68Ga-PSMA-617 PET/CT: a promising new technique for predicting risk stratification and metastatic risk of prostate cancer patients

Abstract: Semi-quantitative analysis indexes of Ga-PSMA-617 PET/CT imaging can be used as "imaging biomarkers" to predict risk stratification and metastatic risk of prostate cancer.

Cited by 55 publications

References 32 publications

Day-to-day variability of [68Ga]Ga-PSMA-11 accumulation in primary prostate cancer: effects on tracer uptake and visual interpretation

Day-to-day variability of [68Ga]Ga-PSMA-11 accumulation in primary prostate cancer: effects on tracer uptake and visual interpretation

Preclinical Evaluation and Pilot Clinical Study of Al18F-PSMA-BCH for Prostate Cancer PET Imaging

68Ga-PSMA PET/CT Combined with PET/Ultrasound-Guided Prostate Biopsy Can Diagnose Clinically Significant Prostate Cancer in Men with Previous Negative Biopsy Results

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Product

Resources

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Preclinical Evaluation and Pilot Clinical Study of Al¹⁸F-PSMA-BCH for Prostate Cancer PET Imaging

⁶⁸Ga-PSMA PET/CT Combined with PET/Ultrasound-Guided Prostate Biopsy Can Diagnose Clinically Significant Prostate Cancer in Men with Previous Negative Biopsy Results