Research ArticleTheranostics

Intraindividual Comparison of 18F-PSMA-1007 with Renally Excreted PSMA Ligands for PSMA PET Imaging in Patients with Relapsed Prostate Cancer

Felix Dietlein, Carsten Kobe, Melanie Hohberg, Boris D. Zlatopolskiy, Philipp Krapf, Heike Endepols, Philipp Täger, Jochen Hammes, Axel Heidenreich, Thorsten Persigehl, Bernd Neumaier, Alexander Drzezga and Markus Dietlein
Journal of Nuclear Medicine May 2020, 61 (5) 729-734; DOI: https://doi.org/10.2967/jnumed.119.234898

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    18F-JK-PSMA-7 PET/low-dose CT (A and C) and 18F-PSMA-1007 PET/low-dose CT (B and D) images in patient 21, with biochemical recurrence. Histologically confirmed PSMA-positive lesion in right seminal vesicle is shown in Supplemental Figure 1. Osteomedullary spots with 18F-PSMA-1007 in left os ilium (red arrows in B and D), in right os ilium (blue arrow in B), and in left femur (orange arrow in B) did not have any correlate on MRI scan (E and F). Salvage prostatectomy produced excellent PSA response. DWIBS = diffusion weighted whole body imaging with background body signal suppression; mDIXON FS = multiple-echo Dixon fat suppression.

  • FIGURE 2.
    FIGURE 2.

    18F-DCFPyL PET/low-dose CT (A and C) and 18F-PSMA-1007 PET/low-dose CT (B and D) images in patient 13, with biochemical recurrence. PSMA-positive intraprostatic lesions in left and right lobes of prostate are visible with both 18F-DCFPyL and 18F-PSMA-1007 (green arrows). Osteomedullary spots in thoracic spine (T3, red arrows) did not have any correlate on MRI scan (E and F). Hemangioma in C3 was PSMA-negative (blue arrow). T1w = T1-weighted.

  • FIGURE 3.
    FIGURE 3.

    18F-JK-PSMA-7 PET/low-dose CT (A, C, and E) and 18F-PSMA-1007 PET/low-dose CT (B, D, and F) images in patient 27, with biochemical recurrence. Maximum-intensity projections with 18F-JK-PSMA-7 and 18F-PSMA-1007 show 2 PSMA-positive right iliac lymph nodes and PSMA-positive relapse below bladder. Additionally, 18F-PSMA-1007 PET scan in B shows further relapse at junction between bladder and urethra. Osteomedullary spots in cervical spine (C3, dashed red arrows in B and D) and thoracic spine (T5, solid red arrows in B and F) did not have any correlate on MRI scan (G and H).

Tables

  • TABLE 1

    Contingency Table of PSMA-RADS Results for Lesions Confirmed as True-Positive for Locoregional Relapse

    PET-2
    PET-1PSMA-RADSRADS 1/2RADS 3RADS 4/5
    Reader 1RADS 1/2003
    RADS 3069
    RADS 4/5009
    Reader 2RADS 1/2015
    RADS 3042
    RADS 4/50015

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