Department of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany.
Cooperation Unit Nuclear Medicine, German Cancer Research Center, Heidelberg, Germany.
J Nucl Med. 2018 Jul;59(7):1076-1080. doi: 10.2967/jnumed.117.204669. Epub 2017 Dec 21.
The introduction of F-labeled prostate-specific membrane antigen (PSMA)-targeted PET/CT tracers, first F-DCFPyL (2-(3-{1-carboxy-5-[(6-F-fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid) and more recently F-PSMA-1007 (((31014)-1-(4-((()-4-carboxy-2-(()-4-carboxy-2-(6-F-fluoronicotinamido)butanamido)butanamido)methyl)phenyl)-3-(naphthalen-2-ylmethyl)-1,4,12-trioxo-2,5,11,13-tetraazahexadecane-10,14,16-tricarboxylic acid)), have demonstrated promising results for the diagnostic workup of prostate cancer. This clinical study presents an intraindividual comparison to evaluate tracer-specific characteristics of F-DCFPyL versus F-PSMA-1007. Twelve prostate cancer patients, drug-naïve or before surgery, received similar activities of about 250 MBq of F-DCFPyL and F-PSMA-1007 48 h apart and were imaged 2 h after injection on the same PET/CT scanner using the same reconstruction algorithm. Normal-organ biodistribution and tumor uptake were quantified using SUV PSMA-positive lesions were detected in 12 of 12 prostate cancer patients. Both tracers, F-DCFPyL and F-PSMA-1007, detected the same lesions. No statistical significance could be observed when comparing the SUV of F-DCFPyL and F-PSMA-1007 for local tumor, lymph node metastases, and bone metastases. With regard to normal organs, F-DCFPyL had statistically significant higher uptake in kidneys, urinary bladder, and lacrimal gland. Vice versa, significantly higher uptake of F-PSMA-1007 in muscle, submandibular and sublingual gland, spleen, pancreas, liver, and gallbladder was observed. Excellent imaging quality was achieved with both F-DCFPyL and F-PSMA-1007, resulting in identical clinical findings for the evaluated routine situations. Nonurinary excretion of F-PSMA-1007 might present some advantage with regard to delineation of local recurrence or pelvic lymph node metastasis in selected patients; the lower hepatic background might favor F-DCFPyL in late stages, when rare cases of liver metastases can occur.
F-标记的前列腺特异性膜抗原（PSMA）靶向 PET/CT 示踪剂的引入，首先是 F-DCFPyL（2-（3-{1-羧基-5-[(6-F-吡啶-3-羰基)-氨基]-戊基}-脲基）戊二酸），最近是 F-PSMA-1007（(((31014)-1-(4-((()-4-羧基-2-((()-4-羧基-2-(6-F-氟烟酰胺基)氨基)丁酰胺基)氨基)甲基)苯基)-3-(萘-2-基甲基)-1,4,12-三氧代-2,5,11,13-四氮十六烷-10,14,16-三羧酸）），已证明对前列腺癌的诊断具有有前景的结果。这项临床研究进行了个体内比较，以评估 F-DCFPyL 与 F-PSMA-1007 的示踪剂特异性特征。12 名前列腺癌患者，无论是否接受过药物治疗或手术前，均接受了类似的 250MBq 左右的 F-DCFPyL 和 F-PSMA-1007 活动，相隔 48 小时，并在注射后 2 小时在同一 PET/CT 扫描仪上使用相同的重建算法进行成像。使用 SUV 定量测定正常器官的生物分布和肿瘤摄取，在 12 名前列腺癌患者中均检测到 PSMA 阳性病变。两种示踪剂，F-DCFPyL 和 F-PSMA-1007，均检测到相同的病变。比较 F-DCFPyL 和 F-PSMA-1007 的局部肿瘤、淋巴结转移和骨转移的 SUV 时，没有观察到统计学意义。关于正常器官，F-DCFPyL 在肾脏、膀胱和泪腺中的摄取量有统计学意义更高。相反，F-PSMA-1007 在肌肉、颌下腺和舌下腺、脾脏、胰腺、肝脏和胆囊中的摄取量显著更高。F-DCFPyL 和 F-PSMA-1007 均获得了出色的成像质量，对于评估的常规情况，结果相同。与 F-PSMA-1007 相比，非尿排泄可能在某些患者中具有局部复发或骨盆淋巴结转移的优势；当罕见发生肝转移时，较低的肝脏背景可能有利于 F-DCFPyL。
