Abstract
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Introduction: 68Ga-P137 is a novel oxalyldiaminopropionic acid-urea (ODAP-Urea) PSMA ligand. The aim of the present study is to compare the distribution, diagnostic and staging performance of 68Ga-P137 and 68Ga-PSMA-11 in the patients with suspected prostate cancer (PCa).
Methods: The prospective study was approved by the institutional ethical committee (reference number, KY20212118-F-1). Twelve patients with suspected PCa were prospectively recruited. All the patients underwent 68Ga-PSMA-11 PET/CT scanning and comparative 68Ga- P137 PET/CT within 10 days. All patients were monitored for adverse events. The quantitative uptake of radiotracers was obtained in intraprostatic lesions, metastatic and normal organ. Pathological results from prostate biopsy and prostatectomy were used as references.
Results: The mean age was 72.83±7.17 and the median PSA level was 17.28 (range, 4.49-100). All PCa patients (10/12, 83.33%) were correctly diagnosed by both tracers. The SUVmax of intraprostatic PCa lesions was 9.59 (±7.30) in 68Ga-P137 PET and 7.6 (±3.28) in 68Ga-PSMA PET. In these intraprostatic lesion, 68Ga-P137 showed relatively lower tumor-to-background ratio (1.67±0.44 vs 2.59±1.23, P<0.050) than 68Ga-PSMA-11, using blood pool as background. The number and sites of primary PCa lesions, lymph node metastases and bone metastases were identical. 68Ga-P137 showed significantly lower urinary excretion than 68Ga-PSMA-11 in bladder (11.43±7.28 vs 30.43±17.86, P=0.006) and in kidney (14.66±2.39 vs 32.69±10.65, P<0.001).
Conclusions: In this prospective head-to-head comparison with 68Ga-PSMA-11, the uptake of 68Ga-P137 in intraprostatic lesions were relatively high, with relatively low TBR. There were no significant differences in diagnostic performance, ES-PSMA score and detection of metastases between two tracers. Although higher uptake can be observed in blood pool and muscles after 1-hour injection, the less urinary excretion and bladder background can not only facilitate the detection of PCa lesions near bladder but also alleviate the potential radiation injury for kidney.
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