Research ArticleClinical Investigation

PET Imaging and Protein Expression of Prostate-Specific Membrane Antigen in Glioblastoma: A Multicenter Inventory Study

Sanne A.M. van Lith, Ilanah J. Pruis, Nelleke Tolboom, Tom J. Snijders, Dylan Henssen, Mark ter Laan, Maarten te Dorsthorst, William P.J. Leenders, Martin Gotthardt, James Nagarajah, Pierre A. Robe, Philip De Witt Hamer, Harry Hendrikse, Daniela E. Oprea-Lager, Maqsood Yaqub, Ronald Boellaard, Pieter Wesseling, Rutger K. Balvers, Frederik A. Verburg, Anita A. Harteveld, Marion Smits, Martin van den Bent, Sophie E.M. Veldhuijzen van Zanten and Elsmarieke van de Giessen
Journal of Nuclear Medicine August 2023, jnumed.123.265738; DOI: https://doi.org/10.2967/jnumed.123.265738

Article Figures & Data

Figures

  • Figure
  • FIGURE 1.
    FIGURE 1.

    Selected examples of PET (A, D, G, and J), MRI (B, E, H, and K), hybrid PET/MRI (C), and fused PET/MRI (F, I, and L) of patients injected with [68Ga]Ga-PSMA-11 (patient 1 from Erasmus MC [A–C], SUVmax, 20.0, and patient 10 from UMCU [G–I], SUVmax, 1.3), [18F]DCFpyl (patient 8 from Amsterdam UMC [D–F], SUVmax, 13.1), and [18F]PSMA-1007 (patient 14 from Radboudumc [J–L], SUVmax, 12.4). Note heterogeneity of tracer uptake within tumors.

  • FIGURE 2.
    FIGURE 2.

    (A) Time–activity curves showing tumor uptake of [18F]DCFpyl (orange) and [68Ga]Ga-PSMA (blue) in MBq/mL from 0 to 240 min after injection for patients 1–8 (each marker icon represents one patient). Representative images of early (B, blue contour) and late (C, red contour) perfusion in first 2 min after injection of [18F]DCFpyl in patient 6.

  • FIGURE 3.
    FIGURE 3.

    Representative images of PSMA immunohistochemistry in formalin-fixed and paraffin-embedded biopsy samples. (A) Positive, dispersed individual cells of unknown origin in periphery of tumor and positive vasculature in tumor cell–dense region. (B) Positive vasculature in tumor cell–dense region. (C) Positive, dispersed individual cells and granular staining in neuropil. (D) Positive individual cells and strong granular staining in neuropil. To exemplify method used for scoring IHC findings, following scores would have been given for these snapshot figures for microvasculature, individual cells, and granular staining in neuropil (sum score), respectively: 2, 3, and 1 (sum, 6) (A); 4, 0, and 0 (sum, 4) (B); 0, 3, and 3 (sum, 6) (C); and 0, 4, and 4 (sum, 8) (D). (E) Correlation between total IHC score and tracer uptake. (F) Correlation between normalized RNA expression of FOLH1 (PSMA-encoding gene) and tracer uptake. Tracer uptake is expressed in SUVmax and measured on PET in 1-cm spheric volumes of interest in region on scan where biopsies were performed. IHC = immunohistochemistry; FOLH1 = folate hydrolase 1; FPM = fragments per million.

Tables

  • TABLE 1.

    Tumor Uptake of Various PSMA-Targeting Tracers

    No.RadioligandTime after injection (min)SUVmaxSUVmeanTBRmax/max
    1[68Ga]Ga-PSMA-1190 (WB)15.34.432.6
    16520.04.566.7
    24017.04.038.6
    2[68Ga]Ga-PSMA-1190 (WB)3.61.7359.0
    1655.92.9295.0
    2405.82.835.9
    3[68Ga]Ga-PSMA-1190 (WB)7.42.5185.3
    1659.82.698.4
    24010.02.826.3
    4[68Ga]Ga-PSMA-1190 (WB)6.53.110.3
    1659.03.517.3
    2409.03.67.5
    5[68Ga]Ga-PSMA-1190 (WB)7.31.966.6
    1657.72.329.5
    2409.02.664.6
    6[18F]DCFPyl804.52.121.9
    NA (WB)NANANA
    1406.82.925.7
    7[18F]DCFPyl805.32.123.5
    95 (WB)4.52.313.6
    1407.42.724.4
    8[18F]DCFPyl8010.34.634.8
    95 (WB)12.65.329.9
    14013.16.036.5
    9[68Ga]Ga-PSMA-11602.21.072.3
    10[68Ga]Ga-PSMA-11601.30.610.3
    11[18F]PSMA-10071203.41.66.1
    12[18F]PSMA-10071208.13.410.1
    13[18F]PSMA-100712014.66.839.6
    14[18F]PSMA-100712012.44.77.8

    • TBRmax/max = SUVmax tumor divided by SUVmax background; WB = whole body; NA = not available.

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