Comparison of [18F]DCFPyL and [68Ga]Ga-PSMA-HBED-CC for PSMA-PET Imaging in Patients with Relapsed Prostate Cancer

• Published in: Molecular imaging and biology Vol. 17; no. 4; pp. 575 - 584
• Main Authors: Dietlein, Markus, Kobe, Carsten, Kuhnert, Georg, Stockter, Simone, Fischer, Thomas, Schomäcker, Klaus, Schmidt, Matthias, Dietlein, Felix, Zlatopolskiy, Boris D., Krapf, Philipp, Richarz, Raphael, Neubauer, Stephan, Drzezga, Alexander, Neumaier, Bernd
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.08.2015; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Edetic Acid - analogs & derivatives; Edetic Acid - pharmacokinetics; Edetic Acid - therapeutic use; Humans; Imaging; Liver - metabolism; Lysine - analogs & derivatives; Lysine - pharmacokinetics; Lysine - therapeutic use; Male; Medicine; Medicine & Public Health; Middle Aged; Oligopeptides - pharmacokinetics; Oligopeptides - therapeutic use; Positron-Emission Tomography - methods; Prostatic Neoplasms - diagnostic imaging; Prostatic Neoplasms - pathology; Radiology; Radiopharmaceuticals - pharmacokinetics; Radiopharmaceuticals - therapeutic use; Recurrence; Research Article; Urea - analogs & derivatives; Urea - pharmacokinetics; Urea - therapeutic use; Prostate-specific membrane antigen (PSMA); Ga-68; Positron emission tomography (PET); Prostate cancer; F-18
• ISSN: 1536-1632; 1860-2002
• DOI: 10.1007/s11307-015-0866-0

Purpose Gallium-68 (Ga-68)-labeled tracers for imaging expression of the prostate-specific membrane antigen (PSMA) such as the [ 68 Ga]Ga-PSMA-HBED-CC have already demonstrated high potential for the detection of recurrent prostate cancer. However, compared to Ga-68, a labeling with fluorine-18 (F-18) would offer advantages with respect to availability, production amount, and image resolution. [ 18 F]DCFPyL is a promising F-18-labeled candidate for PSMA-positron emission tomography (PET) imaging that has been recently introduced. In the current study, we aimed to compare [ 68 Ga]Ga-PSMA-HBED-CC and [ 18 F]DCFPyL for clinical use in biochemically relapsed prostate cancer. Procedures In 14 selected patients with PSA relapse of prostate cancer, [ 18 F]DCFPyL PET/X-ray computed tomography (CT) was performed in addition to [ 68 Ga]Ga-PSMA-HBED-CC PET/CT. A systematic comparison was carried out between results obtained with both tracers with regard to the number of detected PSMA-positive lesions, the standardized uptake value (SUV) max and the lesion to background ratios. Results All suspicious lesions identified by [ 68 Ga]Ga-PSMA-HBED-CC were also detected with [ 18 F]DCFPyL. In three patients, additional lesions were observed using [ 18 F]DCFPyL PET/CT. The mean SUV max in the concordant [ 18 F]DCFPyL PSMA-positive lesions was significantly higher as compared to [ 68 Ga]Ga-PSMA-HBED-CC (14.5 vs. 12.2, p  = 0.028, n  = 15). The mean tumor to background ratios ( n  = 15) were significantly higher for [ 18 F]DCFPyL compared to [ 68 Ga]Ga-PSMA-HBED-CC using kidney, spleen, or parotid as reference organs ( p  = 0.006, p  = 0.002, p  = 0.008), but no significant differences were found using the liver ( p  = 0.167) or the mediastinum ( p  = 0.363) as reference organs. Conclusion [ 18 F]DCFPyL PET/CT provided a high image quality and visualized small prostate lesions with excellent sensitivity. [ 18 F]DCFPyL represents a highly promising alternative to [ 68 Ga]Ga-PSMA-HBED-CC for PSMA-PET/CT imaging in relapsed prostate cancer.