Application of Cu-64 NODAGA-PSMA PET in Prostate Cancer
The high diagnostic potential of 64Cu-PSMA PET–CT imaging was clinically investigated in prostate cancer patients with recurrent disease and in the primary staging of selected patients with advanced local disease. The aim of our study is to assess the uptake behavior in the clinical setting of 64Copper Prostate-Specific Membrane Antigen (64Cu PSMA) Positron Emission Tomography/Computed Tomography (PET/CT) in prostate cancer.
A retrospective study was performed in 23 patients with intermediate, high risk and progressive disease at primary staging of prostate cancer. All patients underwent 64Cu-PSMA PET. Overall, 250 MBq (4 MBq per kg bodyweight, range 230–290 MBq) of 64Cu-NODAGA PSMA was intravenously applied. PET images were performed 30 min (pelvis and abdomen) and 1–2 h post-injection (skull base to mid-thigh). Maximum standardized uptake values (SUVmax) were measured in the organs with high physiological uptake such as liver and kidney, and, additionally, background activity was measured in the gluteal area and in suspected tumor lesions using a HERMES workstation.
PSMA uptake was detected in prostate bed in nine patients, in six patients in distant metastases (bone, lung and liver) and in nine patients in lymph nodes. Of 23 patients, 5 (20.8%) did not show any focal pathological uptake in the whole body. The number of sites (prostate bed, lymph nodes, distant metastases) with positive PSMA uptake was significantly associated with PSA values before imaging (P = 0.0032). The 64Cu PSMA uptake increased significantly from 30 min to 1–3 h post-injection (Wilcoxon signed rank test, P = 0.002).
64Cu NODAGA-PSMA PET is a promising imaging tool in the detection of residual disease in patients with recurrent or primary progressive prostate cancer. Furthermore, the increased tracer uptake over time indicates in vivo stability of the diagnostic radiopharmaceutical.
KeywordsCopper PSMA Oncology Prostate cancer PSMA positron emission tomography/computed tomography (PSMA–PET–CT) Prostate-specific membrane antigen (PSMA) Standardized uptake values (SUV)
We thank the participants of the study.
No funding or sponsorship was received for this study or publication of this article.
All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.
Sabina Sevcenco, Hans Christoph Klingler, Klaus Eredics, Alexander Friedl, Jenifer Schneeweiss, Peter Knoll, Thomas Kunit, Lukas Lusuardi and Siroos Mirzaei have nothing to disclose.
Compliance with Ethics Guidelines
All patients were examined with a standalone PET scanner (EXACT, Siemens, Erlangen, Germany) in compliance with the 1964 Declaration of Helsinki, and the responsible regulatory bodies in Austria. Formal consent was obtained from all patients prior to examination.
The manuscript has no associated data or the data will not be deposited.
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