Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, No. 270, Dong'an Road, Xuhui District, Shanghai, 200032, China.
Department of Oncology, Shanghai Medical College, Fudan University, No. 130, Dong'an Road, Xuhui District, Shanghai, 200032, China.
Ann Nucl Med. 2023 Jan;37(1):60-69. doi: 10.1007/s12149-022-01804-x. Epub 2022 Nov 8.
Molecular imaging of prostate-specific membrane antigen (PSMA) inhibitors has become a favorite for prostate cancer (PCa). This study aimed to estimate the dosimetry and the preliminary clinical application of the [Tc]Tc-HYNIC-PSMA-XL-2, which is a novel imaging tracer invented by our team that can specifically targets PSMA for PCa and its metastases.
The single-photon emission computed tomography (SPECT) whole-body (WB) planar images were collected on 6 patients at 0.5, 1.0, 2.0, 4.0 and 8.0 h after Tc-PSMA-XL-2 injection, respectively. The SPECT/computed tomography (CT) scan was carried out immediately following the WB planar image scan performed after 2.0 h. The volumes of interest (VOIs) of the bladder, heart wall, intestines, kidneys, liver, lungs, and spleen were segmented in the SPECT/CT images. VOIs of the salivary glands and the whole body were drawn in SPECT planar images. The dosimetry toolkit was used to process the data and project the SPECT/CT images onto planar images. The dosimetry analysis was performed using the IDAC-Dose dosimetry software. Furthermore, other PCa patients were enrolled to study the preliminary clinical application of [Tc]Tc-HYNIC-PSMA-XL-2.
The clearance of [Tc]Tc-HYNIC-PSMA-XL-2 is primarily by the hepatobiliary and intestinal system, due to its lipophilic characteristic. The effective half-life of [99mTc]Tc-HYNIC-PSMA-XL-2 is about 3.90 h. High absorbed doses were observed in the salivary glands (1.93E-02 ± 3.88E-03 mSv/MBq), kidneys (1.63E-02 ± 7.32E-03 mSv/MBq) and spleen (1.21E-02 ± 2.64E-03 mSv/MBq). The total body effective dose was 4.84E-03 ± 9.30E-05 mSv/MBq. The preliminary clinical case indicated that [Tc]Tc-HYNIC-PSMA-XL-2 SPECT/CT could detect the primary prostate lesion, lymph node and bone metastases comprehensively.
[Tc]Tc-HYNIC-PSMA-XL-2 is a safe SPECT/CT tracer, which can detect prostate malignant lesions without interference from the bladder. In addition, the malignant lesions of the lymph node and bone of PCa patients also can be detected efficiently.
前列腺特异性膜抗原（PSMA）抑制剂的分子成像已成为前列腺癌（PCa）的首选方法。本研究旨在评估我们团队发明的新型成像示踪剂 [Tc]Tc-HYNIC-PSMA-XL-2 的剂量学和初步临床应用，该示踪剂可特异性靶向 PSMA 用于 PCa 及其转移。
在 Tc-PSMA-XL-2 注射后 0.5、1.0、2.0、4.0 和 8.0 h 分别采集 6 名患者的单光子发射计算机断层扫描（SPECT）全身（WB）平面图像。在 2.0 h 后进行 WB 平面图像扫描后立即进行 SPECT/CT 扫描。在 SPECT/CT 图像中分割膀胱、心肌壁、肠、肾、肝、肺和脾的感兴趣区（VOI）。在 SPECT 平面图像中绘制唾液腺和全身的 VOI。使用剂量学工具包处理数据并将 SPECT/CT 图像投影到平面图像上。使用 IDAC-Dose 剂量学软件进行剂量学分析。此外，还招募了其他 PCa 患者来研究 [Tc]Tc-HYNIC-PSMA-XL-2 的初步临床应用。
由于其亲脂性特征，[Tc]Tc-HYNIC-PSMA-XL-2 的清除主要通过肝胆和肠道系统。[99mTc]Tc-HYNIC-PSMA-XL-2 的有效半衰期约为 3.90 h。在唾液腺（1.93E-02 ± 3.88E-03 mSv/MBq）、肾脏（1.63E-02 ± 7.32E-03 mSv/MBq）和脾脏（1.21E-02 ± 2.64E-03 mSv/MBq）中观察到高吸收剂量。全身有效剂量为 4.84E-03 ± 9.30E-05 mSv/MBq。初步临床病例表明，[Tc]Tc-HYNIC-PSMA-XL-2 SPECT/CT 可以全面检测前列腺原发病变、淋巴结和骨转移。
[Tc]Tc-HYNIC-PSMA-XL-2 是一种安全的 SPECT/CT 示踪剂，可在不干扰膀胱的情况下检测前列腺恶性病变。此外，还可以有效地检测 PCa 患者的淋巴结和骨恶性病变。
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