Abstract
Recently, prostate-specific membrane antigen (PSMA) targeted PET-imaging has emerged as new method of staging and restaging of prostate cancer. Most published studies have investigated the diagnostic potential of 68Ga-labeled PSMA-agents which are excreted renally. [18F]PSMA-1007 is a novel PSMA-ligand with excellent preclinical characteristics which is only minimally excreted by the urinary tract, a potential advantage for pelvic imaging. The aim of this study was to investigate the diagnostic efficacy of [18F]PSMA-1007 in biochemical recurrence (BCR) after radical prostatectomy (RP). Methods: 251 patients from three academic centers with BCR after radical prostatectomy were evaluated in a retrospective analysis. Patients who had received second line androgen deprivation therapy and/or chemotherapy were excluded, however prior first line ADT exposure was allowed. The median PSA-level was 1.2 ng/ml (range: 0.2-228 ng/mL). All patients underwent a PSMA-PET/CT after injection of 301±46 MBq [18F]PSMA-1007 at 92±26 min post injection. The detection rate of presumed recurrence sites was correlated with PSA-level and original primary Gleason score. A comparison to a subset of patients treated previously with androgen deprivation therapy (ADT) was undertaken. Results: 204 of 251 patients (81.3%) patients had evidence of recurrence on [18F]PSMA-1007 PET/CT. The detection rates were 94.1% (79/84), 90.1% (50/55), 74.5% (35/47) and 61.5% (40/65) for PSA-levels of ≥2, 1-<2, 0.5-<1 and 0.2-<0.5ng/mL, respectively. [18F]PSMA-1007 PET/CT revealed local recurrence in 43.7% (62) of patients. Lymph node metastases were present in the pelvis in 40.6% (102), in the retroperitoneum in 19.5% (49) and in supradiaphragmatic locations in 12.0% (30) of patients. Bone and visceral metastases were detected in 40.2% (101) and 3.6% (9) patients. In higher Gleason score tumors (≤7vs.≥8) detection efficacy trended higher (76.3% vs. 86.7%) but was not statistically significant (P = 0.32). However, detection efficacy was higher in patients who had previously been on ADT (91.7% vs. 78.0%) within 6 months prior to imaging (P = 0.0179). Conclusion: [18F]PSMA-1007 PET/CT offers high detection rates in BCR after radical prostatectomy which is comparable to or better than that published for 68Ga-labelled PSMA-ligands.
- Genitourinary
- Molecular Imaging
- Oncology: GU
- PET/CT
- Radiation Therapy Planning
- Radionuclide Therapy
- 18F-PSMA-1007
- Biochemical recurrence
- PSMA
- Prostate Cancer
Footnotes
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- Copyright © 2018 by the Society of Nuclear Medicine and Molecular Imaging, Inc.