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18F-PSMA-1007 multiparametric, dynamic PET/CT in biochemical relapse and progression of prostate cancer

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Abstract

Objectives

Aim of the present analysis is to investigate the biodistribution and pharmacokinetics of the recently clinically introduced radioligand 18F-PSMA-1007 in patients with biochemical recurrence or progression of prostate cancer (PC) by means of multiparametric (dynamic and whole-body) PET/CT.

Methods

Twenty-five (25) patients with PC biochemical relapse or progression (median age = 66.0 years) were enrolled in the analysis. The median PSA value was 1.2 ng/mL (range = 0.1–237.3 ng/mL) and the median Gleason score was 7 (range = 6–10). All patients underwent dynamic PET/CT (dPET/CT) scanning (60 min) of the pelvis and lower abdomen as well as whole-body PET/CT with 18F-PSMA-1007. PET/CT assessment was based on qualitative evaluation, SUV calculation, and quantitative analysis based on a two-tissue compartment model and fractal analysis.

Results

15/25 patients were PET-positive. Plasma PSA values in the 18F-PSMA-1007 positive group were higher (median = 3.6 ng/mL; range = 0.2–237.3 ng/mL) than in the 18F-PSMA-1007 negative group (median value = 0.7 ng/mL; range = 0.1–3.0 ng/mL). Semi-quantitative analysis in the PC lesions demonstrated a mean SUVaverage = 25.1 (median = 15.4; range = 3.5–119.2) and a mean SUVmax = 41.5 (median = 25.7; range = 3.8–213.2). Time–activity curves derived from dPET/CT revealed an increasing tracer accumulation during the 60 min of dynamic PET acquisition into the PC lesions, higher than in the urinary bladder and the colon. Significant correlations were observed between 18F-PSMA-1007 uptake (SUV), influx, and fractal dimension (FD).

Conclusions

18F-PSMA-1007 PET/CT could detect PC lesions in 60% of the patients of a mixed population, including also patients with very low PSA values. Higher PSA values were associated with a higher detection rate. Dynamic PET analysis revealed an increasing tracer uptake during the dynamic PET acquisition as well as high binding and internalization of the radiofluorinated PSMA ligand in the PC lesions.

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Authors and Affiliations

  1. Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, D-69210, Heidelberg, Germany

    Christos Sachpekidis, D. S. Strauss, L. Pan, U. Haberkorn & A. Dimitrakopoulou-Strauss

  2. Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

    Christos Sachpekidis & A. Afshar-Oromieh

  3. Division of Nuclear Medicine, University of Heidelberg, Heidelberg, Germany

    A. Afshar-Oromieh & U. Haberkorn

  4. Division of Radiopharmaceutical Chemistry, German Cancer Research Center (DKFZ), Heidelberg, Germany

    K. Kopka

  5. German Cancer Consortium (DKTK), Heidelberg, Germany

    K. Kopka

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  1. Christos Sachpekidis
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  2. A. Afshar-Oromieh
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Correspondence to Christos Sachpekidis.

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Conflict of interest

The clinical development of 18F-PSMA-1007 is partly funded by a grant of the Federal Ministry of Education and Research (BMBF), project ProstaPET (2U2WTZKOREA-021; no. 01DR17031A).

Uwe Haberkorn and Klaus Kopka are inventors within a patent application for PSMA-1007. Other potential declarations of interest relevant to this article do not exist.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Sachpekidis, C., Afshar-Oromieh, A., Kopka, K. et al. 18F-PSMA-1007 multiparametric, dynamic PET/CT in biochemical relapse and progression of prostate cancer. Eur J Nucl Med Mol Imaging 47, 592–602 (2020). https://doi.org/10.1007/s00259-019-04569-0

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