Comparison of [68Ga]Ga-PSMA-11 PET/CT with [18F]NaF PET/CT in the evaluation of bone metastases in metastatic prostate cancer patients prior to radionuclide therapy

Abstract

In comparison to Ga-PSMA-11 PET/CT,F-NaF PET/CT detects a higher number of pathologic bone lesions in advanced stage PC patients scheduled for radionuclide therapy. Our data suggest that Ga-PSMA-11 PET should be combined withF-NaF PET in PC patients with skeletal metastases for restaging prior to initiation or modification of therapy.

Prospective Comparison of PET Imaging with PSMA-Targeted 18F-DCFPyL Versus Na18F for Bone Lesion Detection in Patients with Metastatic Prostate Cancer

“…In that study, the use of 18 F-DCFBC, an agent with high blood-pool activity and lower tumor-to-background ratios than most other PSMAtargeted agents being investigated, may have led to limited lesion detectability relative to Na 18 F (3). Interestingly, another study that compared a 68 Ga-labeled PSMA-targeted PET radiotracer to Na 18 F also found a lower rate of lesion detection with the PSMA-targeted compound (25). For the patients in that study, radionuclide therapy with either 177 Lu-PSMA-617 or 223 Ra was being planned, and many of the patients had been pretreated with systemic therapy before the PET scans (25).…”

“…Interestingly, another study that compared a 68 Ga-labeled PSMA-targeted PET radiotracer to Na 18 F also found a lower rate of lesion detection with the PSMA-targeted compound (25). For the patients in that study, radionuclide therapy with either 177 Lu-PSMA-617 or 223 Ra was being planned, and many of the patients had been pretreated with systemic therapy before the PET scans (25). This may have led to a proportion of the lesions in those patients being effectively treated or healed, limiting the detection efficiency of a tumor-specific radiotracer such as a PSMA-targeted agent.…”

The 68Ga/177Lu-theragnostic concept in PSMA-targeting of metastatic castration–resistant prostate cancer: impact of post-therapeutic whole-body scintigraphy in the follow-up

“…68 Ga-PSMA-11 PET/CT revealed a higher probability for a positive PET-finding in patients with low PSA values (≤ 0.5 ng/ml) than any other imaging modality including 18 F-choline PET/CT [3], which can substantially influence the clinical management. In fact, 68 Ga-PSMA-11 provides more accurate assessment than conventional imaging [4] and can also be superior to 18 F-sodium fluoride PET/CT for the evaluation of bone metastases in response to 223 Ra-chloride therapy [5].…”

A comparison of prostate cancer bone metastases on 18F-Sodium Fluoride and Prostate Specific Membrane Antigen (18F-PSMA) PET/CT: Discordant uptake in the same lesion

“…Different pairs of PSMA PET and bone scan agents have shown differing detection performance of metastatic bone disease in the past [11–13]. Similar detection differences with other PET agents used in metastatic prostate cancer have been reported [29–31].…”