Renal Cortical⁶⁸Ga-PSMA-11 PET and^99mTc-DMSA Images

Abstract

Ga-prostate-specific membrane antigen (PSMA) ligands are novel PET radiotracers for prostate cancer. These radiotracers also localize in the normal renal cortex to a high degree and can demonstrate parenchymal defects. We recently started a prospective research study to compare 68 Ga-PSMA-11 PET/CT with 99m Tc-dimercaptosuccinic acid (DMSA) scan in adults with pyelonephritis. Here, we present a side-by-side comparison of renal cortical PSMA PET/CT and DMSA images of an adult patient with chronic recurring pyelonephritis. Methods: Our prospective study was approved by the Ethical Committees. DMSA images (multiple planar and SPECT) were obtained 3 h after intravenous injection of 111 MBq (3 mCi) of 99m Tc-DMSA. On a separate day, we obtained PET/CT images of the kidneys 60 min after intravenous injection of 74 MBq (2 mCi) of 68 Ga-PSMA-11 after the patient provided written informed consent. Results: The patient was a 46-y-old woman with history of chronic recurring pyelonephritis. Both DMSA scan and PSMA PET/CT demonstrated slight cortical thinning with mildly reduced uptake in the upper pole of the right kidney, with no significant cortical defects. There was an excellent distribution of activity in the renal cortex and better image resolution with PSMA PET than with DMSA scan. Non-attenuation-corrected PSMA PET images also showed the same findings, with reasonable image quality. Conclusion: In our first case, 68 Ga-PSMA-11 PET imaging provided promising results in an adult patient with pyelonephritis. The results of our prospective study on a larger number of adult patients will provide a more accurate comparison of 68 Ga-PSMA-11 PET to 99m Tc-DMSA scanning in pyelonephritis.

Dose-reduced [18F]PSMA-1007 PET is feasible for functional imaging of the renal cortex

“…The use of PSMA PET has been suggested for functional imaging of the renal cortex [ 4 , 5 ]. [ 68 Ga]Ga-PSMA-11 PET has been compared to technetium-99m labeled dimercaptosuccinic acid (DMSA) scan in two adult patients with pyelonephritis [ 6 , 7 ]. A recent study has shown correlation between renal uptake of [ 68 Ga]Ga-PSMA-11 and renal function as measured with glomerular filtration rate (GFR) [ 8 ].…”

Altered Biodistribution on 99mTc-Dimercaptosuccinic Acid Renal Scan

“…In addition, excreted radiotracer activity is noted within the urinary bladder. Typically, 99m Tc-DMSA binds to the renal cortex via metalloproteins in the proximal tubules and is used to evaluate for parenchymal abnormalities such as pyelonephritis and scarring 1–3 . Differential renal function can also be estimated using 99m Tc-DMSA 4 .…”

Letter to the Editor: 68Ga-PSMA-11 for renal cortical PET imaging

“…In a prospective study, we compared 68 Ga-PSMA-11 PET to 99m Tc-dimercaptosuccinic acid (DMSA) scan in adult patients with pyelonephritis. Our study was interrupted by Covid-19 pandemic but we were able to obtain renal PSMA PET and DMSA images in 2 adult patients with pyelonephritis [ 5 , 6 ]. In our cases, renal PSMA PET provided superior image resolution over DMSA scan and demonstrated the scar formation from pyelonephritis.…”

“…Non-attenuation corrected PSMA PET also provided high resolution images of the kidneys. Estimated effective doses of 111 MBq (3 mCi) of 99m Tc-DMSA and 37 MBq (1 mCi) of 68 Ga-PSMA-11 seems comparable [ 5 , 6 ]. We also assessed the correlation between 68 Ga-PSMA-11 renal PET parameters and renal function tests in patients with prostate cancers [ 7 ].…”