Article Figures & Data
Figures
- FIGURE 1.
Maximum-intensity projections of patient 4 with normal distribution of 68Ga-PSMA-617 at 3 h after injection. Physiologic accumulation is seen in lacrimal and salivary glands, nasal mucosa, liver, spleen, bowels, and kidneys. Surplus tracer is excreted via urinary tract and urinary bladder. No pathologic tracer uptake was found.
- FIGURE 2.
Average SUVmean and SUVmax in different organs 1 and 3 h after injection. Significance of differences between 1 and 3 h (t test): #P < 0.001; *P < 0.05; ∼P > 0.05. Gl. = glandular; Glut. Musc. = gluteal musculature.
- FIGURE 3.
(A-C) 68Ga-PSMA-617 PET/CT of patient 11 at 1 h after injection. Red arrows point to a bone metastasis with SUVmax of 21.7 at 1 h and 32.6 at 3 h after injection. (A) Low dose CT. (B) Fusion of PET and CT. (C) MIP of PET/CT. MIP = maximum-intensity projection.
- FIGURE 4.
68Ga-PSMA-617-PET/CT of patient 3 at 1 h (C and D) and 3 h after injection (A and B). Red arrows point to LN (Virchow’s node), which was identified as metastasis in images at 3 h after injection only. In images at 1 h after injection, tracer accumulation was rated as artifact. In this patient, also 4 other LNs (retroperitoneal) were identified as metastases in images at 3 h after injection only. (A) Fusion of PET and CT 3 h after injection. (B) Maximum-intensity projection of PET/CT 3 h after injection. (C) Fusion of PET and CT 1 h after injection. (D) Maximum-intensity projection of PET/CT 1 h after injection.
- FIGURE 5.
Average SUVmax in 53 representative PCa lesions and their ratio to background (contrast) 1 and 3 h after injection. Five of overall 8 lesions (lesions 11, 12, 14, 17, and 18) in patient 3 and 1 of overall 2 lesions (lesion 31) patient 16 were not visible in images at 1 h after injection because of low contrast.
- FIGURE 6.
Development of SUVs and tumor contrast over time in all bone metastases (n = 7), LN metastases (n = 15), and primary tumors (n = 2) in patients 16–19. met. = metastases.
- FIGURE 7.
(Upper) Maximum-intensity projections of sequential PET/CT scan of patient 18 at different times after injection of 213 MBq of 68Ga-PSMA-617. Blue and red arrows point to 2 primary PCa lesions. (Lower) SUVmax of the 2 primary PCa lesions at the different times. p.i. = after injection.
Tables
Patient no. Age (y) 68Ga-PSMA-617 (MBq) Gleason score PSA (ng/mL) Previous treatment LN metastases Bone metastases Local relapse Soft-tissue metastases Primary tumor 1* 66 237 7 0.40 RPx + RT 0 0 0 0 0 2 55 295 8 6.40 RPx >10 0 0 0 0 3 73 286 7 10.30 RPx 8 0 0 0 0 4* 49 255 7 0.10 RPx + RT 0 0 0 0 0 5 69 262 5 1.30 RPx + RT 0 0 1 0 0 6 71 178 7 4.90 RPx 3 0 0 0 0 7* 71 68 7 1.30 RPx + RT 0 0 0 0 0 8 47 138 6 2.81 RPx 2 0 0 0 0 9* 64 238 8 0.40 RPx 0 0 0 0 0 10 60 194 7 2.90 RPx + RT + ADT 0 0 1 0 0 11 69 177 8 5.16 RPx + RT + ADT 0 1 0 0 0 12 60 151 6 24.30 Biopsy 0 0 0 0 1 13* 70 149 7 0.22 RPx 0 0 0 0 0 14 75 164 7 1.40 RPx 0 0 1 0 0 15 59 132 7 1.30 RPx + RT + ADT 1 0 0 0 0 Dosimetry 16 67 260 7 6.60 RPx + RT 2 0 0 0 0 17 75 230 9 14.91 RPx + ADT >10 0 0 0 0 18 61 213 NA 13.70 ADT 0 0 0 0 2 19 60 221 NA 2.86 RT >10 >10 0 0 0 ↵* Patients without pathologic tracer uptake in 68Ga-PSMA-617 PET/CT (n = 5).
RPx = radical prostatectomy; RT = radiation therapy; ADT = androgen-deprivation therapy; NA = not available.
68Ga-PSMA-617 PET/CT at 1 h after injection 68Ga-PSMA-617 PET/CT at 3 h after injection Different types of PCa SUV Range Median SUV Range Median LN metastases (n = 39) SUVmean 7.1 ± 4.3 1.4–22.0 6.4 SUVmean 9.9 ± 2.4 2.5–34.1 7.7 Bone metastases (n = 8) SUVmean 9.4 ± 7.5 3.3–25.6 5.9 SUVmean 16.9 ± 12.5 4.5–44.9 12.5 Local relapses (n = 3) SUVmean 6.5 ± 0.9 5.9–7.5 6.2 SUVmean 7.7 ± 0.6 7.2–8.3 7.7 Primary tumors (n = 3) SUVmean 7.1 ± 0.4 6.8–7.3 7.1 SUVmean 11.7 ± 1.1 10.9–12.5 11.7 LN metastases (n = 39) SUVmax 12.3 ± 10.3 1.4–50.4 9.3 SUVmax 20.4 ± 22.5 2.5–84.4 12.3 Bone metastases (n = 8) SUVmax 17.8 ± 12.0 4.7–43.0 13.9 SUVmax 43.3 ± 24.8 12.1–92.6 38.6 Local relapses (n = 3) SUVmax 11.1 ± 2.1 9.6–13.5 10.1 SUVmax 16.3 ± 0.9 15.4–17.1 16.4 Primary tumors (n = 3) SUVmax 8.6 ± 3.4 4.8–11.4 9.5 SUVmax 12.7 ± 7.5 4.1–18.2 15.8 Data are SUVmean or SUVmax ± SD.
Residence time (Bq × h/Bq) for patient Source organ 16 17 18 19 Liver 0.110 0.068 0.102 0.090 Spleen 0.014 0.006 0.003 0.013 Kidneys 0.153 0.053 0.196 0.125 Urinary bladder 0.076 0.095 0.045 0.059 Small intestine 0.011 0.002 0.018 0.004 Colon 0.042 0.033 0.052 0.004 Remainder 1.190 1.320 1.190 1.290 Absorbed organ dose (mGy/MBq) for patient Target organ 16 17 18 19 Adrenals 0.015 0.014 0.015 0.015 Brain 0.010 0.011 0.010 0.011 Breasts 0.010 0.011 0.010 0.010 Gallbladder 0.015 0.014 0.016 0.015 Lower colon 0.013 0.014 0.013 0.013 Small intestine 0.019 0.015 0.024 0.015 Stomach 0.013 0.013 0.013 0.013 Upper colon 0.053 0.045 0.064 0.017 Heart 0.012 0.012 0.012 0.012 Kidneys 0.239 0.085 0.305 0.196 Liver 0.033 0.022 0.032 0.028 Lungs 0.011 0.012 0.011 0.012 Muscle 0.011 0.012 0.011 0.012 Pancreas 0.014 0.014 0.015 0.015 Red marrow 0.010 0.010 0.010 0.010 Osteogenic cells 0.015 0.017 0.015 0.016 Skin 0.009 0.010 0.009 0.010 Spleen 0.040 0.020 0.015 0.039 Testes 0.011 0.012 0.011 0.012 Thymus 0.011 0.012 0.011 0.012 Thyroid 0.011 0.012 0.011 0.011 Urinary bladder 0.098 0.121 0.062 0.080 Total body 0.013 0.013 0.013 0.013 Effective dose (mSv/MBq) 0.023 0.018 0.022 0.020
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