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Research ArticleTheranostics

68Ga-PSMA-11 PET Imaging of Response to Androgen Receptor Inhibition: First Human Experience

Thomas A. Hope, Charles Truillet, Eric C. Ehman, Ali Afshar-Oromieh, Rahul Aggarwal, Charles J. Ryan, Peter R. Carroll, Eric J. Small and Michael J. Evans
Journal of Nuclear Medicine January 2017, 58 (1) 81-84; DOI: https://doi.org/10.2967/jnumed.116.181800
Thomas A. Hope
1Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
2Department of Radiology, San Francisco VA Medical Center, San Francisco, California
3Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California
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Charles Truillet
1Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
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Eric C. Ehman
4Department of Radiology, Mayo Clinic, Rochester, Minnesota
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Ali Afshar-Oromieh
5Department of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany
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Rahul Aggarwal
3Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California
6Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, California; and
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Charles J. Ryan
3Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California
6Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, California; and
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Peter R. Carroll
3Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California
7Department of Urology, University of California, San Francisco, San Francisco, California
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Eric J. Small
3Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California
6Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, California; and
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Michael J. Evans
1Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
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  • FIGURE 1.
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    FIGURE 1.

    68Ga-PSMA-11 PET demonstrates increased PSMA expression in prostate cancer xenografts with inhibition of AR. (A) Ratio of SUVmean at day 7 to day 0 increased an average of 72% with orchiectomy and 105% with ARN-509 compared with vehicle. (B) Visual assessment of 68Ga-PSMA-11 PET demonstrates clear increase in uptake in xenografts in response to ARN-509 (middle row) and orchiectomy (bottom row), compared with controls treated with vehicle (top row). *P = 0.007. **P = 0.013. ID = injected dose; ROI = region of interest; RX = treatment.

  • FIGURE 2.
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    FIGURE 2.

    (A and B) Coronal maximum-intensity projections of patient with castration-sensitive metastatic prostate cancer imaged using 68Ga-PSMA-11 before ADT (A) and after ADT (B) demonstrate marked increase in uptake in lesions. (C) Each visualized lesion demonstrated increased uptake, averaging more than 7 times the initial uptake. (D and E) Numerous lesions (13 of 22) were visualized only on posttreatment imaging, as exemplified by the upper thoracic osseous metastasis seen on these axial PET images. (F and G) Other lesions increased in size and had increased uptake on posttreatment imaging, as exemplified by the lesion seen on these axial PET images.

  • FIGURE 3.
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    FIGURE 3.

    Examples of lesions seen only on post-ADT PSMA PET. (A) Pretreatment PET image demonstrates single lesion (circled) in right acetabulum. (B) Additional non–PSMA-avid right acetabular lesion (arrow) is seen just lateral to larger lesion on MR image of same location. (C) On post-ADT PET image, numerous additional lesions are seen, including adjacent acetabular lesion (arrow). (D) This lesion (arrow) is again demonstrated on enhanced T1-weighted MR image.

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Journal of Nuclear Medicine: 58 (1)
Journal of Nuclear Medicine
Vol. 58, Issue 1
January 1, 2017
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68Ga-PSMA-11 PET Imaging of Response to Androgen Receptor Inhibition: First Human Experience
Thomas A. Hope, Charles Truillet, Eric C. Ehman, Ali Afshar-Oromieh, Rahul Aggarwal, Charles J. Ryan, Peter R. Carroll, Eric J. Small, Michael J. Evans
Journal of Nuclear Medicine Jan 2017, 58 (1) 81-84; DOI: 10.2967/jnumed.116.181800

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68Ga-PSMA-11 PET Imaging of Response to Androgen Receptor Inhibition: First Human Experience
Thomas A. Hope, Charles Truillet, Eric C. Ehman, Ali Afshar-Oromieh, Rahul Aggarwal, Charles J. Ryan, Peter R. Carroll, Eric J. Small, Michael J. Evans
Journal of Nuclear Medicine Jan 2017, 58 (1) 81-84; DOI: 10.2967/jnumed.116.181800
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Keywords

  • Oncology: GU
  • PET
  • androgen receptor
  • PSMA PET
  • prostate cancer
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