| Title: |
PSA-Stratified Performance of $^{18}$F- and $^{68}$Ga-PSMA PET in Patients with Biochemical Recurrence of Prostate Cancer |
| Authors: |
Dietlein, Felix; Kobe, Carsten; Dietlein, Markus; Schmidt, M.; Neubauer, Stephan; Stockter, Simone; Fischer, Thomas; Schomäcker, Klaus; Heidenreich, Axel; Zlatopolskiy, Boris D.; Neumaier, Bernd; Drzezga, Alexander |
| Source: |
Journal of nuclear medicine 58(6), 947 - 952 (2017). doi:10.2967/jnumed.116.185538 |
| Publisher Information: |
Soc. |
| Publication Year: |
2017 |
| Collection: |
Forschungszentrum Jülich: JuSER (Juelich Shared Electronic Resources) |
| Subject Terms: |
info:eu-repo/classification/ddc/610 |
| Subject Geographic: |
DE |
| Description: |
Several studies outlined the sensitivity of 68Ga-labeled PET tracers against the prostate-specific membrane antigen (PSMA) for localization of relapsed prostate cancer in patients with renewed increase in the prostate-specific antigen (PSA), commonly referred to as biochemical recurrence. Labeling of PSMA tracers with 18F offers numerous advantages, including improved image resolution, longer half-life, and increased production yields. The aim of this study was to assess the PSA-stratified performance of the 18F-labeled PSMA tracer 18F-DCFPyL and the 68Ga-labeled reference 68Ga-PSMA-HBED-CC. Methods: We examined 191 consecutive patients with biochemical recurrence according to standard acquisition protocols using 18F-DCFPyL (n = 62, 269.8 MBq, PET scan at 120 min after injection) or 68Ga-PSMA-HBED-CC (n = 129, 158.9 MBq, 60 min after injection). We determined PSA-stratified sensitivity rates for both tracers and corrected our calculations for Gleason scores using iterative matched-pair analyses. As an orthogonal validation, we directly compared tracer distribution patterns in a separate cohort of 25 patients, sequentially examined with both tracers. Results: After prostatectomy (n = 106), the sensitivity of both tracers was significantly associated with absolute PSA levels (P = 4.3 × 10−3). Sensitivity increased abruptly, when PSA values exceeded 0.5 μg/L (P = 2.4 × 10−5). For a PSA less than 3.5 μg/L, most relapses were diagnosed at a still limited stage (P = 3.4 × 10−6). For a PSA of 0.5–3.5 μg/L, PSA-stratified sensitivity was 88% (15/17) for 18F-DCFPyL and 66% (23/35) for 68Ga-PSMA-HBED-CC. This significant difference was preserved in the Gleason-matched-pair analysis. Outside of this range, sensitivity was comparably low (PSA < 0.5 μg/L) or high (PSA > 3.5 μg/L). After radiotherapy (n = 85), tracer sensitivity was largely PSA-independent. In the 25 patients examined with both tracers, distribution patterns of 18F-DCFPyL and 68Ga-PSMA-HBED-CC were strongly comparable (P = 2.71 × 10−8). However, in 36% ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| ISSN: |
0022-3123; 1535-5667; 0097-9058; 0161-5505; 2159-662X |
| Relation: |
info:eu-repo/semantics/altIdentifier/wos/WOS:000402572500021; info:eu-repo/semantics/altIdentifier/issn/0022-3123; info:eu-repo/semantics/altIdentifier/issn/1535-5667; info:eu-repo/semantics/altIdentifier/issn/0097-9058; info:eu-repo/semantics/altIdentifier/pmid/pmid:27908968; info:eu-repo/semantics/altIdentifier/issn/0161-5505; info:eu-repo/semantics/altIdentifier/issn/2159-662X |
| Availability: |
https://juser.fz-juelich.de/record/836360; https://juser.fz-juelich.de/search?p=id:%22FZJ-2017-05481%22 |
| Rights: |
info:eu-repo/semantics/closedAccess |
| Accession Number: |
edsbas.6367715B |
| Database: |
BASE |