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Radiation dosimetry of 68Ga-PSMA-11 (HBED-CC) and preliminary evaluation of optimal imaging timing

  • Ali Afshar-Oromieh
  • Henrik Hetzheim
  • Wolfgang Kübler
  • Clemens Kratochwil
  • Frederik L. Giesel
  • Thomas A. Hope
  • Matthias Eder
  • Michael Eisenhut
  • Klaus Kopka
  • Uwe Haberkorn
Original Article

Abstract

Purpose

The clinical introduction of 68Ga-PSMA-11 (“HBED-CC”) ligand targeting the prostate-specific membrane antigen (PSMA) has been regarded as a significant step forward in the diagnosis of prostate cancer (PCa). In this study, we provide human dosimetry and data on optimal timing of PET imaging after injection.

Methods

Four patients with recurrent PCa were referred for 68Ga-PSMA-11 PET/CT. Whole-body PET/CTlow-dose scans were conducted at 5 min, and 1, 2, 3, 4 and 5 h after injection of 152–198 MBq 68Ga-PSMA-11. Organs of moderate to high uptake were used as source organs; their total activity was determined at all measured time points. Time–activity curves were created for each source organ as well as for the remainder. The radiation exposure of a 68Ga-PSMA-11 PET was identified using the OLINDA-EXM software. In addition, tracer uptake was measured in 16 sites of metastases.

Results

The highest tracer uptake was observed in the kidneys, liver, upper large intestine, and the urinary bladder. Mean organ doses were: kidneys 0.262 ± 0.098 mGy/MBq, liver 0.031 ± 0.004 mGy/MBq, upper large intestine 0.054 ± 0.041 mGy/MBq, urinary bladder 0.13 ± 0.059 mGy/MBq. The calculated mean effective dose was 0.023 ± 0.004 mSv/MBq (=0.085 ± 0.015 rem/mCi). Most tumor lesions (n = 16) were visible at 3 h p.i., while at all other time points many were not qualitatively present (10/16 visible at 1 h p.i.).

Conclusions

The mean effective dose of a 68Ga-PSMA-11 PET is 0.023 mSv/MBq. A 3-h delay after injection was optimal timing for 68Ga-PSMA-11 PET/CT in this patient cohort.

Keywords

Prostate cancer PET/CT HBED-CC PSMA-11 Prostate-specific membrane antigen Dosimetry 

Notes

Acknowledgments

We express our gratitude to the Klaus Tschira Foundation (grant no. 00.198.2012) for funding our research. In addition, we would like to thank our staff, in particular Stephanie Biedenstein, Kirsten Kunze, Larissa Engel, and Peter Seybold for their help in performing this analysis.

Compliance with ethical standards

Funding

This study was funded by the Klaus Tschira Foundation (grant no. 00.198.2012).

Conflict of interest

Ali Afshar-Oromieh has received honoraria from Siemens Healthcare for one educational talk. All other authors declare that they have no conflict of interest.

Ethical approval

All patients published in this manuscript signed a written informed consent form for the purpose of anonymized evaluation and publication of their data. All reported investigations were conducted in accordance with the Helsinki Declaration and with our national regulations (German Medicinal Products Act, AMG §13 2b). This evaluation was approved by the ethics committee of the University of Heidelberg (S-321-2012).

Supplementary material

259_2016_3419_Fig7_ESM.gif (79 kb)
Supplementary Table 1

SUVs of the background at different times in all four patients. (GIF 78 kb)

259_2016_3419_MOESM1_ESM.tif (105 kb)
High Resolution (TIF 104 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Ali Afshar-Oromieh
    • 1
    • 2
  • Henrik Hetzheim
    • 3
  • Wolfgang Kübler
    • 4
  • Clemens Kratochwil
    • 1
  • Frederik L. Giesel
    • 1
  • Thomas A. Hope
    • 5
  • Matthias Eder
    • 6
  • Michael Eisenhut
    • 6
  • Klaus Kopka
    • 6
  • Uwe Haberkorn
    • 1
    • 2
  1. 1.Department of Nuclear MedicineHeidelberg University HospitalHeidelbergGermany
  2. 2.Clinical Cooperation Unit Nuclear MedicineGerman Cancer Research CenterHeidelbergGermany
  3. 3.Division of Medical Physics in RadiologyGerman Cancer Research CenterHeidelbergGermany
  4. 4.Division of Radiation Protection and DosimetryGerman Cancer Research CenterHeidelbergGermany
  5. 5.Department of Radiology and Biomedical ImagingUniversity of CaliforniaSan FranciscoUSA
  6. 6.Division of Radiopharmaceutical ChemistryGerman Cancer Research CenterHeidelbergGermany

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