Comparison of [(18)F]DCFPyL and [ (68)Ga]Ga-PSMA-HBED-CC for PSMA-PET Imaging in Patients with Relapsed Prostate Cancer.

Abstract

PURPOSE:

Gallium-68 (Ga-68)-labeled tracers for imaging expression of the prostate-specific membrane antigen (PSMA) such as the [(68)Ga]Ga-PSMA-HBED-CC have already demonstrated high potential for the detection of recurrent prostate cancer. However, compared to Ga-68, a labeling with fluorine-18 (F-18) would offer advantages with respect to availability, production amount, and image resolution. [(18)F]DCFPyL is a promising F-18-labeled candidate for PSMA-positron emission tomography (PET) imaging that has been recently introduced. In the current study, we aimed to compare [(68)Ga]Ga-PSMA-HBED-CC and [(18)F]DCFPyL for clinical use in biochemically relapsed prostate cancer.

PROCEDURES:

In 14 selected patients with PSA relapse of prostate cancer, [(18)F]DCFPyL PET/X-ray computed tomography (CT) was performed in addition to [(68)Ga]Ga-PSMA-HBED-CC PET/CT. A systematic comparison was carried out between results obtained with both tracers with regard to the number of detected PSMA-positive lesions, the standardized uptake value (SUV)max and the lesion to background ratios.

RESULTS:

All suspicious lesions identified by [(68)Ga]Ga-PSMA-HBED-CC were also detected with [(18)F]DCFPyL. In three patients, additional lesions were observed using [(18)F]DCFPyL PET/CT. The mean SUVmax in the concordant [(18)F]DCFPyL PSMA-positive lesions was significantly higher as compared to [(68)Ga]Ga-PSMA-HBED-CC (14.5 vs. 12.2, p = 0.028, n = 15). The mean tumor to background ratios (n = 15) were significantly higher for [(18)F]DCFPyL compared to [(68)Ga]Ga-PSMA-HBED-CC using kidney, spleen, or parotid as reference organs (p = 0.006, p = 0.002, p = 0.008), but no significant differences were found using the liver (p = 0.167) or the mediastinum (p = 0.363) as reference organs.

CONCLUSION:

[(18)F]DCFPyL PET/CT provided a high image quality and visualized small prostate lesions with excellent sensitivity. [(18)F]DCFPyL represents a highly promising alternative to [(68)Ga]Ga-PSMA-HBED-CC for PSMA-PET/CT imaging in relapsed prostate cancer.

• Authors: Markus Dietlein, Carsten Kobe, Georg Kuhnert, Simone Stockter, Thomas Fischer, Klaus Schomäcker, Matthias Schmidt, Felix Dietlein, Boris D Zlatopolskiy, Philipp Krapf, Raphael Richarz, Stephan Neubauer, Alexander Drzezga, Bernd Neumaier
• Journal: Molecular imaging and biology (Mol Imaging Biol) Vol. 17 Issue 4 Pg. 575-84 (Aug 2015) ISSN: 1860-2002 [Electronic] United States
• PMID: 26013479 (Publication Type: Comparative Study, Journal Article)

Chemical References

• 2-(3-(1-carboxy-5-((6-fluoropyridine-3-carbonyl)amino)pentyl)ureido)pentanedioic acid
• Gallium Isotopes
• Gallium Radioisotopes
• Oligopeptides
• Radiopharmaceuticals
• gallium 68 PSMA-11
• Urea
• Edetic Acid
• Lysine

Topics

• Aged
• Aged, 80 and over
• Edetic Acid (analogs & derivatives, pharmacokinetics, therapeutic use)
• Gallium Isotopes
• Gallium Radioisotopes
• Humans
• Liver (metabolism)
• Lysine (analogs & derivatives, pharmacokinetics, therapeutic use)
• Male
• Middle Aged
• Oligopeptides (pharmacokinetics, therapeutic use)
• Positron-Emission Tomography (methods)
• Prostatic Neoplasms (diagnostic imaging, pathology)
• Radiopharmaceuticals (pharmacokinetics, therapeutic use)
• Recurrence
• Urea (analogs & derivatives, pharmacokinetics, therapeutic use)