PT  - JOURNAL ARTICLE
AU  - Costa, Pedro Fragoso
AU  - Püllen, Lukas
AU  - Kesch, Claudia
AU  - Krafft, Ulrich
AU  - Tschirdewahn, Stephan
AU  - Moraitis, Alexandros
AU  - Radtke, Jan Philipp
AU  - Ting, Saskia
AU  - Nader, Michael
AU  - Wosniack, Jasmin
AU  - Kersting, David
AU  - Lückerath, Katharina
AU  - Herrmann, Ken
AU  - Fendler, Wolfgang Peter
AU  - Hadaschik, Boris Alexander
AU  - Darr, Christopher
TI  - <sup>18</sup>F-PSMA Cerenkov Luminescence and Flexible Autoradiography Imaging in a Prostate Cancer Mouse Model and First Results of a Radical Prostatectomy Feasibility Study in Men
AID  - 10.2967/jnumed.122.264670
DP  - 2023 Apr 01
TA  - Journal of Nuclear Medicine
PG  - 598--604
VI  - 64
IP  - 4
4099  - http://jnm.snmjournals.org/content/64/4/598.short
4100  - http://jnm.snmjournals.org/content/64/4/598.full
SO  - J Nucl Med2023 Apr 01; 64
AB  - Intraoperative identification of positive resection margins (PRMs) in high-risk prostate cancer (PC) needs improvement. Cerenkov luminescence imaging (CLI) with 68Ga-PSMA-11 is promising, although limited by low residual activity and artificial signals. Here, we aimed to assess the value of CLI and flexible autoradiography (FAR) with 18F-PSMA-1007. Methods: Mice bearing subcutaneous PSMA-avid RM1-PGLS tumors were administered 18F-PSMA-1007, and PET/CT was performed. After the animals had been killed, organs were excised and measured signals in CLI and FAR CLI were correlated with tracer activity concentrations (ACs) obtained from PET/CT. For clinical assessment, 7 high-risk PC patients underwent radical prostatectomy immediately after preoperative 18F-PSMA PET/CT. Contrast-to-noise ratios (CNRs) were calculated for both imaging modalities in intact specimens and after incision above the index lesion. Results: In the heterotopic in vivo mouse model (n = 5), CLI did not detect any lesion. FAR CLI detected a distinct signal in all mice, with a lowest AC of 7.25 kBq/mL (CNR, 5.48). After incision above the index lesion of the prostate specimen, no increased signal was observed at the cancer area in CLI. In contrast, using FAR CLI, a signal was detectable in 6 of 7 patients. The AC in the missed index lesion was 1.85 kBq/mL, resulting in a detection limit of at least 2.06 kBq/mL. Histopathology demonstrated 2 PRMs, neither of which was predicted by CLI or FAR CLI. Conclusion: 18F-PSMA FAR CLI was superior to CLI in tracer-related signal detectability. PC was could be visualized in radical prostatectomy down to 2.06 kBq/mL. However, the detection of PRMs was limited. Direct anatomic correlation of FAR CLI is challenging because of the scintillator overlay.