Lesion Detection Efficacy of F-18-rhPSMA-7.3 Positron Emission Tomography in Men with Biochemical Recurrence of Prostate Cancer: Initial clinical data from 285 consecutive Patients

T Langbein; M Krönke; A Wurzer; H Wörther; C Franz; T Maurer; T Horn; WA Weber; HJ Wester; M Eiber

doi:10.1055/s-0040-1708123

Nuklearmedizin - NuclearMedicine, Inhaltsverzeichnis

Nuklearmedizin 2020; 59(02): 90
DOI: 10.1055/s-0040-1708123

Leuchttürme

Leuchtturm-Sitzung 1: Innovative Bildgebung

Lesion Detection Efficacy of F-18-rhPSMA-7.3 Positron Emission Tomography in Men with Biochemical Recurrence of Prostate Cancer: Initial clinical data from 285 consecutive Patients

Authors

T Langbein

¹Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Nuklearmedizin, München
M Krönke

¹Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Nuklearmedizin, München
A Wurzer

²Klinikum rechts der Isar, Technische Universität München, Lehrstuhl für Pharmazeutische Radiochemie, München
H Wörther

¹Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Nuklearmedizin, München
C Franz

¹Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Nuklearmedizin, München
T Maurer

³Universitätsklinikum Hamburg-Eppendorf, Martini-Klinik, Hamburg
T Horn

⁴Klinikum rechts der Isar, Technische Universität München, Urologische Klinik und Poliklinik, München
WA Weber

¹Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Nuklearmedizin, München
HJ Wester

²Klinikum rechts der Isar, Technische Universität München, Lehrstuhl für Pharmazeutische Radiochemie, München
M Eiber

¹Klinikum rechts der Isar, Technische Universität München, Klinik und Poliklinik für Nuklearmedizin, München

Abstract

Volltext

Ziel/Aim F-18-labeled PSMA-ligands are currently under clinical evaluation for biochemical recurrence (BCR) of prostate cancer. Radiohybidref PSMA (rhPSMA) ligands are a new class of PSMA-targeting agents. rhPSMA-7 consists of four isomers (rhPSMA-7.1-rhPSMA-7.4) from which F-18-rhPSMA-7.3 was selected as lead compound for PET-imaging based on preclinical findings. We report first efficacy data for F-18-rhPSMA-7.3 in patients with hormone-sensitive BCR after radical prostatectomy (RPE).

Methodik/Methods 285 patients (median [range] PSA, 1.24 [0.01–129.5] ng/mL) underwent F-18-rhPSMA-7.3 PET. Median (range) injected activity and uptake time were 332 (204–454) MBq, and 74 (44–85) min, respectively. Images were re-read by an experienced nuclear medicine physician. Lesion detection rates were stratified by PSA, and the potential association between histological differentiation or treatment history explored.

Ergebnisse/Results In total, 225/285 (79 %) patients showed pathological findings; F-18-rhPSMA-7.3 detection rates were 45 % (9/20), 65 % (33/51), 56 % (20/36), 83 % (34/41) and 97 % (93/96) at PSA < 0.2 ng/mL, 0.2–<0.5 ng/mL, 0.5–<1 ng/mL, 1–<2 ng/mL and ≥2 ng/mL, respectively. F-18-rhPSMA-7.3 PET revealed local recurrence, pelvic lymph node metastases, bone metastases, retroperitoneal lymph nodes metastases, supradiaphragmatic lymph nodes and other distant sites in 44 % (126), 32 % (90), 23 % (65), 17 % (49), 8 % (23) and 8 % (22) of patients, respectively. Notably, bone lesions were identified in 10 % of patients (7/71) with PSA <0.5 ng/mL. Detection efficacy was not significantly influenced by ADT in the 6 months pre-scan (84 % with ADT vs. 76 % without, p = 0.183), nor by primary Gleason Score (67 % for scores ≤ 7 vs. 80 % ≥8, p = 0.109). Prior EBRT was related to scan positivity (85 % with vs. 70 % without, p = 0.018).

Schlussfolgerungen/Conclusions F-18-rhPSMA-7.3 PET offers high detection efficacy in BCR after RPE especially at low PSA values and shows comparable efficacy to values reported for Ga-68-PSMA-11.