Afshar-Oromieh Ali, Hetzheim Henrik, Kübler Wolfgang, Kratochwil Clemens, Giesel Frederik L, Hope Thomas A, Eder Matthias, Eisenhut Michael, Kopka Klaus, Haberkorn Uwe
Department of Nuclear Medicine, Heidelberg University Hospital, INF 400, 69120, Heidelberg, Germany.
Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center, INF 280, 69120, Heidelberg, Germany.
Eur J Nucl Med Mol Imaging. 2016 Aug;43(9):1611-20. doi: 10.1007/s00259-016-3419-0. Epub 2016 Jun 3.
The clinical introduction of (68)Ga-PSMA-11 ("HBED-CC") ligand targeting the prostate-specific membrane antigen (PSMA) has been regarded as a significant step forward in the diagnosis of prostate cancer (PCa). In this study, we provide human dosimetry and data on optimal timing of PET imaging after injection.
Four patients with recurrent PCa were referred for (68)Ga-PSMA-11 PET/CT. Whole-body PET/CTlow-dose scans were conducted at 5 min, and 1, 2, 3, 4 and 5 h after injection of 152-198 MBq (68)Ga-PSMA-11. Organs of moderate to high uptake were used as source organs; their total activity was determined at all measured time points. Time-activity curves were created for each source organ as well as for the remainder. The radiation exposure of a (68)Ga-PSMA-11 PET was identified using the OLINDA-EXM software. In addition, tracer uptake was measured in 16 sites of metastases.
The highest tracer uptake was observed in the kidneys, liver, upper large intestine, and the urinary bladder. Mean organ doses were: kidneys 0.262 ± 0.098 mGy/MBq, liver 0.031 ± 0.004 mGy/MBq, upper large intestine 0.054 ± 0.041 mGy/MBq, urinary bladder 0.13 ± 0.059 mGy/MBq. The calculated mean effective dose was 0.023 ± 0.004 mSv/MBq (=0.085 ± 0.015 rem/mCi). Most tumor lesions (n = 16) were visible at 3 h p.i., while at all other time points many were not qualitatively present (10/16 visible at 1 h p.i.).
The mean effective dose of a (68)Ga-PSMA-11 PET is 0.023 mSv/MBq. A 3-h delay after injection was optimal timing for (68)Ga-PSMA-11 PET/CT in this patient cohort.
靶向前列腺特异性膜抗原(PSMA)的(68)Ga-PSMA-11(“HBED-CC”)配体的临床应用被视为前列腺癌(PCa)诊断中的一项重大进展。在本研究中,我们提供了人体剂量测定以及注射后PET成像最佳时间的数据。
4例复发性PCa患者接受了(68)Ga-PSMA-11 PET/CT检查。在注射152-198 MBq(68)Ga-PSMA-11后的5分钟、1、2、3、4和5小时进行全身PET/CT低剂量扫描。摄取量中等至高的器官用作源器官;在所有测量时间点测定其总活度。为每个源器官以及其余部分绘制时间-活度曲线。使用OLINDA-EXM软件确定(68)Ga-PSMA-11 PET的辐射暴露。此外,在16个转移部位测量示踪剂摄取情况。
在肾脏、肝脏、上大肠和膀胱中观察到最高的示踪剂摄取。平均器官剂量为:肾脏0.262±0.098 mGy/MBq,肝脏0.031±0.004 mGy/MBq,上大肠0.054±0.041 mGy/MBq,膀胱0.13±0.059 mGy/MBq。计算出的平均有效剂量为0.023±0.004 mSv/MBq(=0.085±0.015 rem/mCi)。大多数肿瘤病变(n = 16)在注射后3小时可见,而在所有其他时间点,许多病变在质量上并不存在(注射后1小时10/16可见)。
(68)Ga-PSMA-11 PET的平均有效剂量为0.023 mSv/MBq。在该患者队列中,注射后3小时的延迟是(68)Ga-PSMA-11 PET/CT的最佳时间。