复发前列腺癌患者中[(18)F]DCFPyL与[(68)Ga]Ga-PSMA-HBED-CC用于PSMA-PET成像的比较
Comparison of [(18)F]DCFPyL and [ (68)Ga]Ga-PSMA-HBED-CC for PSMA-PET Imaging in Patients with Relapsed Prostate Cancer.
作者信息
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
机构信息
Department of Nuclear Medicine, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany,
出版信息
Mol Imaging Biol. 2015 Aug;17(4):575-84. 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 SUVmax 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.
目的
镓-68（Ga-68）标记的示踪剂用于成像前列腺特异性膜抗原（PSMA）的表达，如[（68）Ga]Ga-PSMA-HBED-CC，已显示出检测复发性前列腺癌的巨大潜力。然而，与Ga-68相比，用氟-18（F-18）标记在可用性、产量和图像分辨率方面具有优势。[（18）F]DCFPyL是一种有前景的F-18标记的候选物，用于PSMA正电子发射断层扫描（PET）成像，最近已被引入。在本研究中，我们旨在比较[（68）Ga]Ga-PSMA-HBED-CC和[（18）F]DCFPyL在生化复发前列腺癌临床应用中的效果。
程序
在14例选定的前列腺癌PSA复发患者中，除了进行[（68）Ga]Ga-PSMA-HBED-CC PET/CT外，还进行了[（18）F]DCFPyL PET/X射线计算机断层扫描（CT）。对两种示踪剂获得的结果在检测到的PSMA阳性病变数量、标准化摄取值（SUV）最大值和病变与背景比值方面进行了系统比较。
结果
[（68）Ga]Ga-PSMA-HBED-CC识别出的所有可疑病变也能用[（18）F]DCFPyL检测到。在3例患者中，使用[（1）F]DCFPyL PET/CT观察到了额外的病变。与[（68）Ga]Ga-PSMA-HBED-CC相比，[（18）F]DCFPyL PSMA阳性病变中的平均SUV最大值显著更高（14.5对12.2，p = 0.028，n = 15）。以肾脏、脾脏或腮腺作为参考器官时，[（18）F]DCFPyL的平均肿瘤与背景比值（n = 15）显著高于[（68）Ga]Ga-PSMA-HBED-CC（p = 0.006，p = 0.002，p = 0.008），但以肝脏（p = 0.167）或纵隔（p = 0.363）作为参考器官时未发现显著差异。
结论
[（18）F]DCFPyL PET/CT提供了高质量的图像，并以优异的灵敏度显示了小的前列腺病变。对于复发前列腺癌的PSMA-PET/CT成像，[（18）F]DCFPyL是[（68）Ga]Ga-PSMA-HBED-CC极具前景的替代物。
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