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PET imaging with a [68Ga]gallium-labelled PSMA ligand for the diagnosis of prostate cancer: biodistribution in humans and first evaluation of tumour lesions

  • A. Afshar-Oromieh
  • A. Malcher
  • M. Eder
  • M. Eisenhut
  • H. G. Linhart
  • B. A. Hadaschik
  • T. Holland-Letz
  • F. L. Giesel
  • C. Kratochwil
  • S. Haufe
  • U. Haberkorn
  • C. M. Zechmann
Original Article

Abstract

Purpose

Prostate-specific membrane antigen (PSMA) is a cell surface protein with high expression in prostate carcinoma (PC) cells. Recently, procedures have been developed to label PSMA ligands with 68Ga, 99mTc and 123/124/131I. Our initial experience with Glu-NH-CO-NH-Lys-(Ahx)-[68Ga(HBED-CC)](68Ga-PSMA) suggests that this novel tracer can detect PC relapses and metastases with high contrast. The aim of this study was to investigate its biodistribution in normal tissues and tumour lesions.

Methods

A total of 37 patients with PC and rising prostate-specific antigen (PSA) levels were subjected to 68Ga-PSMA positron emission tomography (PET)/CT. Quantitative assessment of tracer uptake was performed 1 and 3 h post-injection (p.i.) by analysis of mean and maximum standardized uptake values (SUVmean/max) of several organs and 65 tumour lesions. Subsequently, tumour to background ratios were calculated.

Results

The PET/CT images showed intense tracer uptake in both kidneys and salivary glands. Moderate uptake was seen in lacrimal glands, liver, spleen and in small and large bowel. Quantitative assessment revealed excellent contrast between tumour lesions and most normal tissues. Of 37 patients, 31 (83.8 %) showed at least one lesion suspicious for cancer at a detection rate of 60 % at PSA <2.2 ng/ml and 100 % at PSA >2.2 ng/ml. Median tumour to background ratios were 18.8 (2.4–158.3) in early images and 28.3 (2.9–224.0) in late images.

Conclusion

The biodistribution of the novel 68Ga-PSMA tracer and its ability to detect PC lesions was analysed in 37 patients. Within healthy organs, kidneys and salivary glands demonstrated the highest radiotracer uptake. Lesions suspicious for PC presented with excellent contrast as early as 1 h p.i. with high detection rates even at low PSA levels.

Keywords

Prostate cancer PET/CT Positron emission tomography PSMA Prostate-specific membrane antigen 

Notes

Acknowledgments

We thank our staff for their help in performing this study.

Conflicts of interest

None.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • A. Afshar-Oromieh
    • 1
  • A. Malcher
    • 1
  • M. Eder
    • 2
  • M. Eisenhut
    • 2
  • H. G. Linhart
    • 3
  • B. A. Hadaschik
    • 4
  • T. Holland-Letz
    • 5
  • F. L. Giesel
    • 1
  • C. Kratochwil
    • 1
  • S. Haufe
    • 1
  • U. Haberkorn
    • 1
    • 6
  • C. M. Zechmann
    • 1
  1. 1.Department of Nuclear MedicineUniversity Hospital of HeidelbergHeidelbergGermany
  2. 2.Department of Radiopharmaceutical ChemistryGerman Cancer Research CenterHeidelbergGermany
  3. 3.National Center for Tumor Diseases (NCT)/DKFZHeidelbergGermany
  4. 4.Department of UrologyUniversity Hospital of HeidelbergHeidelbergGermany
  5. 5.Department of BiostatisticsGerman Cancer Research CenterHeidelbergGermany
  6. 6.Clinical Cooperation Unit Nuclear MedicineGerman Cancer Research CentreHeidelbergGermany

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