18 F-rhPSMA-7 PET for the Detection of Biochemical Recurrence of Prostate Cancer After Curative-Intent Radiation Therapy: A Bicentric Retrospective Study

The Journal of Nuclear Medicine

article

Harun Ilhan¹  Markus Kroenke²  Alexander Wurzer³  Marcus Unterrainer¹  Matthias Heck⁴  Claus Belka⁵  Karina Knorr²  Thomas Langbein²  Isabel Rauscher²  Nina-Sophie Schmidt-Hegemann⁵  Kilian Schiller⁶  Peter Bartenstein¹  Hans-Jürgen Wester³  Matthias Eiber² 

[1] Department of Nuclear Medicine, University Hospital;Department of Nuclear Medicine, School of Medicine, Technical University of Munich;Chair of Pharmaceutical Radiochemistry, Technical University of Munich;Department of Urology, Technical University of Munich;Department of Radiation Oncology, University Hospital;Department of Radiation Oncology, School of Medicine, Technical University of Munich

关键词: prostate-specific membrane antigen;    PSMA;    PET imaging;    biochemical recurrence;    BCR;    radiation therapy;   

DOI  :  10.2967/jnumed.121.262861

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

This bicentric, retrospective analysis investigated the efficacy of PET/CT with a novel theranostic prostate-specific membrane antigen (PSMA)--targeting ligand, 18F-rhPSMA-7, in patients with biochemical recurrence (BCR) of prostate cancer after curative-intent primary radiotherapy. Methods: Datasets from patients with BCR of prostate cancer after external-beam radiation therapy or brachytherapy who underwent 18F-rhPSMA-7 PET/CT at either Technical University Munich or Ludwig-Maximilians-University Munich were retrospectively reviewed by experienced nuclear medicine physicians and radiologists at both centers. The median injected activity was 299 MBq (range, 204–420 MBq), and the median uptake time was 77 min (range, 46–120 min). All lesions suggestive of recurrent prostate cancer were noted. Detection rates were correlated with patients’ prostate-specific antigen (PSA) level, primary Gleason score, and prior use of androgen-deprivation therapy (ADT). Results: Ninety-seven patients were included (65 at Technical University Munich and 32 at Ludwig-Maximilians-University Munich). The median prescan PSA was 4.19 ng/mL (range, 0.1–159 ng/mL). The primary Gleason score was ≤6 in 19 patients, 7 in 25, ≥8 in 33, and unknown in 20. Thirty patients received ADT in the 6 mo preceding PET/CT. 18F-rhPSMA-7 identified lesions in 91 of 97 (94%) patients. Detection rates stratified by PSA were 88% (22/25), 97% (30/31), 90% (19/21), and 100% (20/20) for a PSA of <2, 2–<5, 5–<10, and ≥10 ng/mL, respectively. Detection rates in the subgroup of patients not meeting the Phoenix criteria for BCR were 80% (4/5), 90% (9/10), 100% (4/4), and 83% (5/6) for a PSA of <0.5, 0.5–<1, 1–<1.5, and 1.5–2 ng/mL, respectively. There were no significant differences in detection rates between patients with and without prior ADT (100% vs. 91%, P = 0.173) or patients with a Gleason score of ≤7 and a Gleason score of ≥8 (98% vs. 91%, P = 0.316).18F-rhPSMA-7 revealed local recurrence in 80% (78/97); pelvic lymph node metastases in 38% (37/97); retroperitoneal and supradiaphragmatic lymph node metastases in 9% (9/97) and 4% (4/97), respectively; bone metastases in 27% (26/97); and visceral metastases in 3% (3/97). In the subgroup of patients with a PSA of <2 ng/mL above nadir, local recurrence occurred in 76% (19/25) and pelvic lymph node metastases in 36% (9/25). Conclusion: 18F-rhPSMA-7 PET/CT demonstrates high detection rates in prostate cancer patients with BCR after primary radiation therapy, even at low PSA values. Its diagnostic efficacy is comparable to published data for other PSMA ligands.

【 授权许可】

CC BY