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European Journal of Nuclear Medicine and Molecular Imaging

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Open Access 22-09-2022 | Short Communication

Combined [68 Ga]Ga-PSMA-11 and low-dose 2-[18F]FDG PET/CT using a long-axial field of view scanner for patients referred for [177Lu]-PSMA-radioligand therapy

Authors: Ian Alberts, Robin Schepers, Konstantinos Zeimpekis, Hasan Sari, Axel Rominger, Ali Afshar-Oromieh

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 3/2023

Abstract

Purpose

Performing 2-[¹⁸F]FDG PET/CT in addition to a PSMA-ligand PET/CT can assist in the detection of lesions with low PSMA expression and may help in prognostication and identification of patients who likely benefit from PSMA-radioligand therapy (PSMA-RLT). However, the cost and time needed for a separate PET/CT examination might hinder its routine implementation. In this communication, we present our initial experiences with additional low-dose 2-[¹⁸F]FDG PET/CT as part of a dual-tracer and same-day imaging protocol which exploits the higher sensitivity exhibited by long-axial field-of-view (LAFOV) and total-body PET/CT systems and demonstrates its feasibility.

Methods

Fourteen patients referred for evaluation for PSMA-RLT received [⁶⁸ Ga]Ga-PSMA-11 PET/CT at 1 h p.i. with a standard activity of 150 MBq and an additional low-dose 2-[¹⁸F]FDG PET/CT with 40 MBq 1 h thereafter using a long-axial field-of-view PET/CT system in a single sitting and as per institutional protocol. Scans were scrutinized by two experienced nuclear medicine physicians for mismatch findings.

Results

The combined protocol identified additional lesions with low or absent PSMA-expression but high FDG-avidity in 1/14 (7%) patients. The protocol was easily implemented and well tolerated by all patients.

Conclusion

Additional low-dose 2-[¹⁸F]FDG-PET/CT is feasible as part of a same-day imaging protocol and can help reveal lesions of low PSMA avidity as part of therapy assessment for [¹⁷⁷Lu]-PSMA radioligand therapy and demonstrates higher sensitivity compared to [⁶⁸ Ga]Ga-PSMA-11 PET/CT alone in some patients.

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Title: Combined [68 Ga]Ga-PSMA-11 and low-dose 2-[18F]FDG PET/CT using a long-axial field of view scanner for patients referred for [177Lu]-PSMA-radioligand therapy
Authors: Ian Alberts
Robin Schepers
Konstantinos Zeimpekis
Hasan Sari
Axel Rominger
Ali Afshar-Oromieh
Publication date: 22-09-2022
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 3/2023
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-022-05961-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Combined [68 Ga]Ga-PSMA-11 and low-dose 2-[18F]FDG PET/CT using a long-axial field of view scanner for patients referred for [177Lu]-PSMA-radioligand therapy

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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