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Total-body PET/CT with half-dose [68 Ga]Ga-PSMA-11 for biochemical recurrent prostate cancer: comparable diagnostic value to short axial field-of-view PET/CT with full-dose [68 Ga]Ga-PSMA-11

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The objective of this study was to evaluate the diagnostic performance and image quality of total-body positron emission tomography/computed tomography (PET/CT) imaging using a half-dose of [68 Ga]Ga-prostate specific membrane antigen ([68 Ga]Ga-PSMA) radiotracer, compared to conventional short axial field-of-view PET/CT imaging using a full dose of [68 Ga]Ga-PSMA.

Methods

This retrospective study enrolled 52 patients with biochemical recurrent (BCR) prostate cancer after radical prostatectomy who underwent total-body PET/CT with a half-dose (0.9–1.1 MBq/kg) of [68 Ga]Ga-PSMA. These patients were matched by baseline characteristics to another 52 BCR patients after prostatectomy who underwent conventional PET/CT with a full dose (1.8–2.2 MBq/kg) of [68 Ga]Ga-PSMA. The half-dose group was further divided into 5-min (G5) and 2-min (G2) acquisition subgroups. Image quality was assessed through subjective analysis using a 5-point scale and objective measurements of standard uptake value maximum (SUVmax), standard uptake value mean (SUVmean), background variation (BV) of the liver, blood pool, and parotid glands. Additionally, SUVmax and tumor-to-background ratio (TBR) were calculated for lesions.

Results

No significant difference in subjective image quality was found between the G2 and full-dose groups (p > 0.05). PET/CT image quality was significantly higher for the G5 versus G2 (p < 0.001) and full-dose groups (p < 0.001). TBR did not differ between the G2 and full-dose groups (4.23 ± 5.21 vs 4.22 ± 3.97, p = 0.99). Liver BV was significantly lower for G2 versus full-dose groups (0.16 ± 0.03 vs 0.20 ± 0.05, p < 0.001).

Conclusions

Total-body PET/CT with a half-dose [68 Ga]Ga-PSMA yields image quality superior or comparable to that of conventional PET/CT. The utilization of total-body [68 Ga]Ga-PSMA PET/CT meets the diagnostic demands of BCR patients, particularly those who exhibit reduced tolerance to prolonged horizontal positioning and scan durations, while simultaneously reducing radiation exposure for the subjects.

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Data Availability

The data could be obtained from the corresponding author upon request.

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Funding

This study was supported by the National Natural Science Foundation of China (No. 92259103, 82171972); National Key R&D Program of China (No. 2021YFA0910004); Clinical Research Project of Health Industry of Shanghai Municipal Health Commission (20214Y0438); and Nurture Projects for the Youth Medical Talents-Medical Imaging Practitioners Program (SHWRS(2021)_099).

Author information

Author notes

  1. Yuheng Liu, Lianghua Li, and Yanyu Qin contributed equally to this work.

Authors and Affiliations

  1. Department of Nuclear Medicine, the First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiangxi Road, Guangzhou, 510120, Guangdong Province, China

    Yuheng Liu, Yanyu Qin & Xinlu Wang

  2. Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China

    Lianghua Li, Zijun Chen, Haitao Zhao & Ruohua Chen

Authors
  1. Yuheng Liu
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  2. Lianghua Li
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  5. Haitao Zhao
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  6. Xinlu Wang
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Corresponding authors

Correspondence to Xinlu Wang or Ruohua Chen.

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The study involving human participants was in line with principles of ethics committee in Renji Hospital and the declaration of Helsinki in 1964. Animal-based research was not included in this study.

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Liu, Y., Li, L., Qin, Y. et al. Total-body PET/CT with half-dose [68 Ga]Ga-PSMA-11 for biochemical recurrent prostate cancer: comparable diagnostic value to short axial field-of-view PET/CT with full-dose [68 Ga]Ga-PSMA-11. Eur J Nucl Med Mol Imaging 51, 581–589 (2024). https://doi.org/10.1007/s00259-023-06466-z

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