An exploratory study of unexplained concentration of 18F-PSMA-1007 in the bladder for prostate cancer PET/CT imaging

Dang, Jun; Yao, Yutang; Li, Yingchun; Tan, Xiaofei; Ye, Zhenyan; Zhao, Yi; Qing, Shiwei; Kou, Ying; Jiang, Xiao; Lu, Hao; Chen, Shirong; Zhao, Meng; Cheng, Zhuzhong

doi:10.3389/fmed.2023.1238333

Cited by 2 publications

(1 citation statement)

References 26 publications

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“…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]. Several efforts have been made to reduce renal uptake, either to improve the tumor-to-kidney ratio and, thus, a sensitivity for renal or kidney-adjacent tumors by evaluating new radiopharmaceuticals [39] or for dosimetric purposes by administering additional drugs in preparation [40].…”

Section: Results and Comparison To The Literaturementioning

confidence: 91%

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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Section: Results and Comparison To The Literaturementioning

confidence: 91%

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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The impact of preliminary patient hydration on physiological [18F]PSMA-1007 uptake in the urinary bladder on PET/CT

Antonevskaya,

Khalimon,

Mukhortova

et al. 2024

Issled. prakt. med. (Print)

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Оne of the most commonly used fluorine‑18 labeled prostate-specific membrane antigen (PSMA) ligands in positron emission tomography combined with computed tomography (PET/CT) is [18F]PSMA‑1007. In comparison to other clinically available PSMA radioligands characterized by renal clearance, [18F]PSMA‑1007 exhibits predominantly hepatobiliary excretion. It allows a better assessment of the pelvic area in patients with prostate cancer (PCa). Nevertheless, in our clinical practice, we routinely observed a notably high [ 18F]PSMA‑1007 uptake in the urinary bladder. The underlying reasons for this phenomenon remain inadequately explored.Purpose of the study. The purpose of this study was to assess the impact of preliminary hydration of patients on [18F]PSMA‑1007 uptake in the urinary bladder.Materials and methods. Prospective, multicenter, randomized controlled study included 180 patients with PCa who underwent [18F]PSMA‑1007 PET/CT. Scans were performed using three different PET/CT-systems: GE Discovery IQ Gen 2 (USA), Siemens Biograph 64 mCT and Biograph 64 TruePoint (Germany). All patients were divided into two groups: the group with hydration (n = 95, 53 %), which included the subgroups of patients with oral (n = 76, 80 %) and intravenous (n = 19, 20 %) routes of hydration, and the control group with no hydration (n = 85, 47 %). [18F]PSMA‑1007 uptake in the urinary bladder was quantified using SUVmean (Mean Standardized Uptake value), measured within a spherical VOI with a fixed volume of 2.5 cm3 delineating the bladder boundaries. Additionally, the TBRmean (Mean Target-to-Background Ratio), reflecting the ratio between urinary bladder and right gluteal muscles SUVmean.Results. SUVmean and TBRmean in urinary bladder were significantly lower (p < 0,001) in the group with hydration compared to the control group, with the following values: 1.3 [0.8; 2.0] versus 4.5 [2.7; 8.5] for SUVmean and 4.0 [2.3; 6.3] versus 13.0 [7.7; 24.0] for TBRmean. There was no significant differences in SUVmean and TBRmean between the subgroups with oral and intravenous routes of hydration (p = 0.95 for SUVmean, p = 0.49 for TBRmean). Additionally, comparatively lower interquartile range (IQR) values for both SUVmean and TBRmean in the group with hydration were noted: 1.2 versus 5.8 for SUVmean, 4.0 versus 16.3 for TBRmean.Conclusion. Preliminary hydration of patients in uptake period significantly reduces both the level and variability of [18F]PSMA‑1007 uptake in the urinary bladder.

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An exploratory study of unexplained concentration of 18F-PSMA-1007 in the bladder for prostate cancer PET/CT imaging

Cited by 2 publications

References 26 publications

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

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

The impact of preliminary patient hydration on physiological [18F]PSMA-1007 uptake in the urinary bladder on PET/CT

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