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European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-01-2017 | Original Article

Comparison of ⁶⁸Ga-labelled PSMA-11 and ¹¹C-choline in the detection of prostate cancer metastases by PET/CT

Authors: Johannes Schwenck, Hansjoerg Rempp, Gerald Reischl, Stephan Kruck, Arnulf Stenzl, Konstantin Nikolaou, Christina Pfannenberg, Christian la Fougère

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 1/2017

Abstract

Purpose

Prostate-specific membrane antigen (PSMA) is expressed ubiquitously on the membrane of most prostate tumors and its metastasis. While PET/CT using ¹¹C-choline was considered as the gold standard in the staging of prostate cancer, PET with radiolabelled PSMA ligands was introduced into the clinic in recent years. Our aim was to compare the PSMA ligand ⁶⁸Ga-PSMA-11 with ¹¹C-choline in patients with primary and recurrent prostate cancer.

Methods

123 patients underwent a whole-body PET/CT examination using ⁶⁸Ga-PSMA-11 and ¹¹C-choline. Suspicious lesions were evaluated visually and semiquantitatively (SUVavg). Out of these, 103 suffered from a confirmed biochemical relapse after prostatectomy and/or radiotherapy (mean PSA level of 4.5 ng/ml), while 20 patients underwent primary staging.

Results

In 67 patients with biochemical relapse, we detected 458 lymph nodes suspicious for metastasis. PET using ⁶⁸Ga-PSMA-11 showed a significantly higher uptake and detection rate than ¹¹C-choline PET. Also ⁶⁸Ga-PSMA-11 PET identified significantly more patients with suspicious lymph nodes as well as affected lymph nodes regions especially at low PSA levels. Bone lesions suspicious for prostate cancer metastasis were revealed in 36 patients’ biochemical relapse. Significantly more bone lesions were detected by ⁶⁸Ga-PSMA-11, but only 3 patients had only PSMA-positive bone lesions. Nevertheless, we detected also 29 suspicious lymph nodes and 8 bone lesions, which were only positive as per ¹¹C-choline PET. These findings led to crucial differences in the TNM classification and the identification of oligometastatic patients. In the patients who underwent initial staging, all primary tumors showed uptake of both tracers. Although significantly more suspicious lymph nodes and bone lesions were identified, only 2 patients presented with bone lesions only detected by ⁶⁸Ga-PSMA-11 PET.

Conclusion

Thus, PET using ⁶⁸Ga-PSMA-11 showed a higher detection rate than ¹¹C-choline PET for lymph nodes as well as bone lesions. However, we found lymph nodes and bone lesions which were not concordant applying both tracers.

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Title: Comparison of 68Ga-labelled PSMA-11 and 11C-choline in the detection of prostate cancer metastases by PET/CT
Authors: Johannes Schwenck
Hansjoerg Rempp
Gerald Reischl
Stephan Kruck
Arnulf Stenzl
Konstantin Nikolaou
Christina Pfannenberg
Christian la Fougère
Publication date: 01-01-2017
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 1/2017
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-016-3490-6

At a glance: The STEP trials

Springer Medicine

Comparison of ⁶⁸Ga-labelled PSMA-11 and ¹¹C-choline in the detection of prostate cancer metastases by PET/CT

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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