[¹⁸F]PSMA-1007 PET/CT in 166 Patients with BCR after radical prostatectomy

Introduction: Prostate-specific membrane antigen (PSMA) targeted PET-imaging has gained significant interest in staging and restaging of prostate cancer during the last years. Most published studies investigate the diagnostic potential of Ga-labeled PSMA-agents. [¹⁸F]PSMA-1007 is a novel PSMA-ligand with excellent preclinical characteristics and the lack of urinary excretion. The aim of this study was to investigate the diagnostic efficacy of [¹⁸F]PSMA-1007 in biochemical recurrence.

Methods: 166 patients from two center with BCR after radical prostatectomy were evaluated in a retrospective analysis. Patients who have already received second line androgen deprivation therapy and/or chemotherapy were excluded. The median PSA-level was 1.21 ng/ml (range: 0.21-107.7 ng/mL). All patients underwent a PSMA-PET/CT after injection of 4 MBq [¹⁸F]PSMA-1007 per kg BW at 60-120 min post injection. The detection rates were correlated with PSA-level.

Results: 149 patients (89.8.1%) patients showed pathological findings in [¹⁸F]PSMA-1007 PET/CT. The detection rates were 72.7% (24/33), 84.4% (27/32), 97.5% (39/40) and 96.7% (59/61) at PSA-levels of 0.2 to<0.5 ng/ml, 0.5 to<1 ng/ml, 1 to<2 ng/ml and ≥2ng/ml, respectively (Figure-1). [¹⁸F]PSMA-1007 PET/CT revealed local recurrence in 23.7% (40) patients. Lymph node metastases were present in the pelvis in 43.2% (73), in the retroperitoneum in 24.9% (42) and supradiaphragmatic location in 12.4% (21) patients. Bone and visceral metastases were detected in 50.3% (85) and 5.3% (9) patients.

Conclusions: [¹⁸F]PSMA-1007PET/CT offers superb detection rates in BCR after radical prostatectomy with a trend towards higher efficacy compared to data published in literature for Ga-labelled PSMA-radioligands.

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