18F-PSMA-1007 and 18F-fluorocholine PET/CT in prostate cancer progression diagnostics. First comparative experience

Background. Prostate cancer progression remains as a major problem among patients after their radical treatment. During last years a broad spectrum radiopharmaceuticals had developed to reveal the cause of biochemical recurrence.

Objective: the comparison of 18F-fluorocholine and 18F-prostate-specific membrane antigen-1007 (18F-PSMA-1007) diagnostic abilities for the prostate cancer progression detection.

Materials and methods. In this study had been included 18F-fluorocholine and 18F-PSMA-1007 PET/CT (positron emission tomography combined with computed tomography) scans of 9 patients after radical treatment with increased prostate-specific antigen (PSA) level (range 0.10–9.06 ng/ml).

Results. 18F-PSMA-1007-PET/CT detected lesions in 7 (77.8 %) out of 9 patients, after radical prostatectomy and brachytherapy, in comparison with negative 18F-fluorocholine-PET/CT results in all cases.

Conclusion. In this pilot study, 18F-PSMA-1007-PET/CT has showed high potential in pathological changes detection among patients with increased PSA level (minimum 0.10 ng/ml) and demonstrated the advantages in comparison with 18F-fluorocholine-PET/CT, especially in terms of revealing local recurrence and metastatic lymph nodes, as well as, in bone lesions early detection.

1. Malignant tumors in Russia in 2017 (morbidity and mortality). Eds.: А.D. Kaprin, V.V. Starinskiy, G.V. Petrova. Moscow: MNIOI im. P.A. Gertsena – filial FGBU “NMIRTS radiologii” Minzdrava Rossii, 2018. 250 p. (In Russ.).

2. Afshar-Oromieh A., Haberkorn U., Eder M. et al. [68Ga]Gallium labelled PSMA ligand as superior PET tracer for the diagnosis of prostate cancer: comparison with 18F-FECH. Eur J Nucl Med Mol Imaging 2012;39(6):1085–6. DOI: 10.1007/s00259-012-2069-0.

3. Morigi J.J., Stricker P.D., van Leeuwen P.J. et al. Prospective comparison of 18Ffluoromethylcholine versus 68Ga-PSMA PET/ CT in prostate cancer patients who have rising PSA after curative treatment and are being considered for targeted therapy. J Nucl Med 2015;56(8):1185–90. DOI: 10.2967/jnumed.115.160382.

4. Giesel F.L., Hadaschik B., Cardinale J. et al. F18 labelled PSMA1007: biodistribution, radiation dosimetry and histopathological validation of tumor lesions in prostate cancer patients. Eur J Nucl Med Mol Imaging 2017;44:678–88.

5. von Eyben F.E., Kairemo K. Meta-analysis of (11)C-choline and (18)F-choline PET/CT for management of patients with prostate cancer. Nucl Med Commun 2014;35(3):221–30. DOI: 10.1097/MNM.0000000000000040.

6. von Eyben F.E., Picchio M., von Eyben R. et al. 68Ga-labeled prostate-specific membrane antigen ligand positron emission tomography/ computed tomography for prostate cancer: a systematic review and meta-analysis. Eur Urol Focus 2018;4(5):686–93. DOI: 10.1016/j.euf.2016.11.002

7. Pfister D., Bolla M., Briganti A. et al. Early salvage radiotherapy following radical prostatectomy. Eur Urol 2014;65(6):1034– 43. DOI: 10.1016/j.eururo.2013.08.013.

8. Giesel F.L., Knorr K., Will L. et al. Detection efficacy of 18F-PSMA-1007 PET/CT in 251 patients with biochemical recurrence of prostate cancer after radical prostatectomy. J Nucl Med 2019;60(3):362– 8. DOI: 10.2967/jnumed.118.212233.

9. Budäus L., Leyh-Bannurah S.R., Salomon G. et al. Initial experience of (68)Ga-PSMA PET/CT imaging in high-risk prostate cancer patients prior to radical prostatectomy. Eur Urol 2016;69(3):393–6. DOI: 10.1016/j.eururo.2015.06.010.

10. Giesel F.L., Will L., Kesch C. et al. Biochemical recurrence of prostate cancer: initial results with 18F-PSMA-1007 PET/ CT. J Nucl Med 2018;59(4):632–5. DOI: 10.2967/jnumed.117.196329.

11. Dietlein F., Kobe C., Neubauer S. et al. PSA-stratified performance of 18F and 68GaPSMA PET in patients with biochemical recurrence of prostate cancer. J Nucl Med 2017;58(6):947–52. DOI: 10.2967/jnumed.116.185538.

12. Kemerink G.J., Visser M.G., Franssen R. et al. Effect of the positron range of 18F, 68Ga and 124I on PET/CT in lung equivalent materials. Eur J Nucl Med Mol Imaging 2011;38(5):940–8. DOI: 10.1007/s00259-011-1732-1.