PuSH - Publikationsserver des Helmholtz Zentrums München: Matched-pair comparison of Ga<sup>68</sup>-PSMA-11 and F<sup>18</sup>-rhPSMA-7 PET/CT in patients with primary and biochemical recurrence of prostate cancer: Frequency of non-tumor-related uptake and tumor positivity.

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Kroenke, M.* ; Mirzoyan, L.* ; Horn, T.* ; Peeken, J.C. ; Wurzer, A.* ; Wester, H.* ; Makowski, M.* ; Weber, W.A.* ; Eiber, M.* ; Rauscher, I.*

Matched-pair comparison of Ga⁶⁸-PSMA-11 and F¹⁸-rhPSMA-7 PET/CT in patients with primary and biochemical recurrence of prostate cancer: Frequency of non-tumor-related uptake and tumor positivity.

J. Nucl. Med. 62, 1082-1088 (2021)

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Open Access Green möglich sobald Postprint bei der ZB eingereicht worden ist.

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Radiohybrid prostate-specific membrane antigen (rhPSMA) ligands are a new class of prostate cancer theranostic agents. F-18-rhPSMA-7 offers the advantages of F-18 labeling and low urinary excretion compared with 68Ga-PSMA-11. Here, we compare the frequency of non-tumor-related uptake and tumor positivity with Ga-68-PSMA-11 and F-18-rhPSMA-7 in patients with primary or recurrent prostate cancer. Methods: This retrospective matched-pair comparison matched 160 F-18-rhPSMA-7 with 160 Ga-68-PSMA-11 PET/CT studies for primary staging (n = 33) and biochemical recurrence (n = 127) according to clinical characteristics. Two nuclear medicine physicians reviewed all scans, first identifying all PET-positive lesions and then differentiating lesions suggestive of prostate cancer from those that were benign, on the basis of known pitfalls and ancillary information from CT. For each region, the SUVmax of the lesion with the highest PSMA ligand uptake was noted. Tumor positivity rates were determined, and SUVmax was compared separately for each tracer. Results: F-18-rhPSMA-7 and Ga-68-PSMA-11 PET revealed 566 and 289 PSMA ligand-positive lesions, respectively. Of these, 379 and 100 lesions, equaling 67.0% and 34.6%, respectively, of all PSMA-positive lesions, were considered benign. The distribution of their etiology was similar (42%, 24%, and 25% with 18F-rhPSMA-7 vs. 32%, 24%, and 38% with Ga-68-PSMA-1 1 for ganglia, bone, and unspecific lymph nodes, respectively). All primary tumors were positive with both agents (n = 33 each), whereas slightly more metastatic lesions were observed with Ga-68-PSMA-11 in both disease stages (113 for F-18-rhPSMA-7 and 124 for Ga-68-PSMA-11). The SUVmax of F-18-rhPSMA-7 and Ga-68-PSMA-1 1 did not differ (P > 0.05) in local recurrence or primary prostate cancer; however, the tumor-to-bladder ratio was significantly higher with 18F-rhPSMA-7 (4.9 +/- 5.3 vs. 2.2 +/- 3.7, P = 0.02, for local recurrence; 9.8 +/- 9.7 vs. 2.3 +/- 2.6, P < 0.001, for primary prostate cancer). Conclusion: The tumor positivity rate was consistently high for Ga-68-PSMA-1 1 and F-18-rhPSMA-7. Both tracers revealed a considerable number of areas of uptake that were reliably identified as benign by trained physicians making use of corresponding morphologic imaging and known PSMA pitfalls. These were more frequent with F-18-rhPSMA-7. However, the matched-pair comparison could have introduced a source of bias. Adequate reader training can allow physicians to differentiate benign uptake from disease and be able to benefit from the logistical and clinical advantages of F-18-rhPSMA-7.

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PuSH - Publikationsserver des Helmholtz Zentrums München

Matched-pair comparison of Ga68-PSMA-11 and F18-rhPSMA-7 PET/CT in patients with primary and biochemical recurrence of prostate cancer: Frequency of non-tumor-related uptake and tumor positivity.

Matched-pair comparison of Ga⁶⁸-PSMA-11 and F¹⁸-rhPSMA-7 PET/CT in patients with primary and biochemical recurrence of prostate cancer: Frequency of non-tumor-related uptake and tumor positivity.