Intrapatient Comparison of 111In-PSMA I&T SPECT/CT and Hybrid 68Ga-HBED-CC PSMA PET in Patients With Early Recurrent Prostate Cancer

Purpose The aim of this study was to evaluate the detection efficiency of 111In-PSMA-I&T SPECT/CT in comparison to hybrid 68Ga-PSMA HBED-CC PET in patients with early recurrent prostate cancer. Methods Twenty-two patients (mean age, 68.2 ± 6.8 years; range, 52–76 years) with rising prostate-specific antigen (PSA; median, 1.03 ng/mL; range, 0.2–7.2ng/mL) and known positive lesions in hybrid 68Ga-PSMA HBED-CC PET scheduled for salvage surgery were included. Whole-body scintigraphy and SPECT/CT were performed 4 hours after application of 147.0 ± 24.8 MBq (range, 90–183 MBq) 111In-PSMA I&T. Images were evaluated for suspected lesions, and conspicuity of all lesions was rated using a 4-point-scale (0 = not seen, 1 = retrospectively seen in knowledge of 68Ga-PSMA HBED-CC PET, 2 = low signal, 3 = high signal). Tumor-to-background ratios were determined for SPECT and PET and compared. Tumor-to-background ratio of SPECT was correlated with lesion size as well as patients’ Gleason score and PSA level. Results 111In-PSMA I&T SPECT/CT detected 14 of 29 PET-positive lesions (48.3%) with no additional lesions identified with 111In-PSMA I&T SPECT/CT. There was a significant weak to moderate correlation of PSA level with tumor-to-background ratio of 111In-PSMA I&T SPECT/CT (correlation coefficient r = 0.6406; 95% confidence interval, 0.1667–0.8741; P = 0.0136). There was no significant difference (P > 0.05), but a weak trend toward a higher detectability in 111In-PSMA I&T SPECT/CT regarding lesion size and initial PSA level. Conclusions In a preselected collective of recurrent prostate cancer patients with low PSA values, 111In-PSMA I&T SPECT/CT showed lower detection rates than hybrid 68Ga-HBED-CC PSMA PET. However, 111In-PSMA I&T SPECT/CT showed a patient based detection rate of 59%, making it a potentially valuable imaging tool where PET is not available apart from its proven value as a PSMA-targeted probe for radioguided surgery.

[1]  T. Maurer,et al.  [111In]PSMA-I&T: expanding the spectrum of PSMA-I&T applications towards SPECT and radioguided surgery , 2015, EJNMMI Research.

[2]  Nassir Navab,et al.  Prostate-specific membrane antigen-radioguided surgery for metastatic lymph nodes in prostate cancer. , 2015, European urology.

[3]  Michael Lassmann,et al.  68Ga- and 177Lu-Labeled PSMA I&T: Optimization of a PSMA-Targeted Theranostic Concept and First Proof-of-Concept Human Studies , 2015, The Journal of Nuclear Medicine.

[4]  A. Buck,et al.  Biodistribution and Radiation Dosimetry for a Probe Targeting Prostate-Specific Membrane Antigen for Imaging and Therapy , 2015, The Journal of Nuclear Medicine.

[5]  M. Schwaiger,et al.  PET imaging with of prostate-specific membrane antigen (PSMA) for staging of primary prostate cancer with 68Ga-HBED-PSMA. , 2015 .

[6]  F. Montorsi,et al.  Contemporary role of salvage lymphadenectomy in patients with recurrence following radical prostatectomy. , 2015, European urology.

[7]  M. Schwaiger,et al.  Evaluation of Hybrid 68Ga-PSMA Ligand PET/CT in 248 Patients with Biochemical Recurrence After Radical Prostatectomy , 2015, The Journal of Nuclear Medicine.

[8]  F. Montorsi,et al.  Long-term outcomes of salvage lymph node dissection for clinically recurrent prostate cancer: results of a single-institution series with a minimum follow-up of 5 years. , 2015, European urology.

[9]  Ambros J Beer,et al.  Positron emission tomography/magnetic resonance imaging with 68Gallium‐labeled ligand of prostate‐specific membrane antigen: Promising novel option in prostate cancer imaging? , 2014, International journal of urology : official journal of the Japanese Urological Association.

[10]  M. Schwaiger,et al.  Synthesis and preclinical evaluation of DOTAGA-conjugated PSMA ligands for functional imaging and endoradiotherapy of prostate cancer , 2014, EJNMMI Research.

[11]  S. Vallabhajosula,et al.  99mTc-Labeled Small-Molecule Inhibitors of Prostate-Specific Membrane Antigen: Pharmacokinetics and Biodistribution Studies in Healthy Subjects and Patients with Metastatic Prostate Cancer , 2014, The Journal of Nuclear Medicine.

[12]  A. Mojtahedi,et al.  The value of (68)Ga-DOTATATE PET/CT in diagnosis and management of neuroendocrine tumors compared to current FDA approved imaging modalities: a review of literature. , 2014, American journal of nuclear medicine and molecular imaging.

[13]  T. Holland-Letz,et al.  Comparison of PET imaging with a 68Ga-labelled PSMA ligand and 18F-choline-based PET/CT for the diagnosis of recurrent prostate cancer , 2013, European Journal of Nuclear Medicine and Molecular Imaging.

[14]  W. Eckelman,et al.  99mTc-Labeled Small-Molecule Inhibitors of Prostate-Specific Membrane Antigen for Molecular Imaging of Prostate Cancer , 2013, The Journal of Nuclear Medicine.

[15]  L. Bachmann,et al.  The role of 11C-choline and 18F-fluorocholine positron emission tomography (PET) and PET/CT in prostate cancer: a systematic review and meta-analysis. , 2013, European urology.

[16]  P. Muzzio,et al.  Utility of choline positron emission tomography/computed tomography for lymph node involvement identification in intermediate- to high-risk prostate cancer: a systematic literature review and meta-analysis. , 2013, European urology.

[17]  S. Fürst,et al.  PET/MR in prostate cancer: technical aspects and potential diagnostic value , 2013, European Journal of Nuclear Medicine and Molecular Imaging.

[18]  U. Haberkorn,et al.  PSMA as a target for radiolabelled small molecules , 2013, European Journal of Nuclear Medicine and Molecular Imaging.

[19]  U. Haberkorn,et al.  A dimerized urea-based inhibitor of the prostate-specific membrane antigen for 68Ga-PET imaging of prostate cancer , 2012, EJNMMI Research.

[20]  R. Hicks,et al.  High management impact of Ga‐68 DOTATATE (GaTate) PET/CT for imaging neuroendocrine and other somatostatin expressing tumours , 2012, Journal of medical imaging and radiation oncology.

[21]  B. Glaser,et al.  68Ga-DOTA-NOC PET/CT Imaging of Neuroendocrine Tumors: Comparison with 111In-DTPA-Octreotide (OctreoScan®) , 2011, Molecular Imaging and Biology.

[22]  M. Khalil,et al.  Molecular SPECT Imaging: An Overview , 2011, International journal of molecular imaging.

[23]  I. Kayani,et al.  The Role of 68Ga-DOTATATE PET in Patients with Neuroendocrine Tumors and Negative or Equivocal Findings on 111In-DTPA-Octreotide Scintigraphy , 2010, Journal of Nuclear Medicine.

[24]  D. Rubello,et al.  What can gallium-68 PET add to receptor and molecular imaging? , 2007, European Journal of Nuclear Medicine and Molecular Imaging.

[25]  Patrick W McLaughlin,et al.  Indium-111-capromab pendetide radioimmunoscintigraphy and prognosis for durable biochemical response to salvage radiation therapy in men after failed prostatectomy. , 2003, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[26]  M. Terris,et al.  Time trends in biochemical recurrence after radical prostatectomy: results of the SEARCH database. , 2003, Urology.

[27]  Steven Piantadosi,et al.  Biochemical (prostate specific antigen) recurrence probability following radical prostatectomy for clinically localized prostate cancer. , 2003, The Journal of urology.

[28]  Alan W Partin,et al.  Clinical utility of indium 111‐capromab pendetide immunoscintigraphy in the detection of early, recurrent prostate carcinoma after radical prostatectomy , 2002, Cancer.

[29]  J. Reubi,et al.  Affinity profiles for human somatostatin receptor subtypes SST1–SST5 of somatostatin radiotracers selected for scintigraphic and radiotherapeutic use , 2000, European Journal of Nuclear Medicine.

[30]  G H Hinkle,et al.  Multicenter radioimmunoscintigraphic evaluation of patients with prostate carcinoma using indium‐111 capromab pendetide , 1998, Cancer.

[31]  M. Schwaiger,et al.  Evaluation of hybrid Ga-PSMA-ligand PET/CT in 248 patients with biochemical recurrence after radical prostatectomy , 2015 .

[32]  A. Jemal,et al.  Cancer statistics, 2014 , 2014, CA: a cancer journal for clinicians.

[33]  T. Holland-Letz,et al.  Reply to Reske et al.: PET imaging with a [68Ga]gallium-labelled PSMA ligand for the diagnosis of prostate cancer: biodistribution in humans and first evaluation of tumour lesions , 2013, European Journal of Nuclear Medicine and Molecular Imaging.

[34]  W. Eckelman,et al.  99mTc-Labeled Small-Molecule Inhibitors of Prostate-Specific Membrane Antigen for Molecular Imaging of Prostate Cancer , 2013, The Journal of Nuclear Medicine.

[35]  M. Schwaiger,et al.  The detection rate of [11C]Choline-PET/CT depends on the serum PSA-value in patients with biochemical recurrence of prostate cancer , 2007, European Journal of Nuclear Medicine and Molecular Imaging.

[36]  N. Dubrawsky.  Cancer statistics , 2022 .