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European Journal of Nuclear Medicine and Molecular Imaging

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01-05-2017 | Original Article

Early dynamic imaging in ⁶⁸Ga- PSMA-11 PET/CT allows discrimination of urinary bladder activity and prostate cancer lesions

Authors: Christian Uprimny, Alexander Stephan Kroiss, Clemens Decristoforo, Josef Fritz, Boris Warwitz, Lorenza Scarpa, Llanos Geraldo Roig, Dorota Kendler, Elisabeth von Guggenberg, Jasmin Bektic, Wolfgang Horninger, Irene Johanna Virgolini

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 5/2017

Abstract

Purpose

PET/CT with ⁶⁸Ga-labelled prostate-specific membrane antigen (PSMA)-ligands has been proven to establish a promising imaging modality in the work-up of prostate cancer (PC) patients with biochemical relapse. Despite a high overall detection rate, the visualisation of local recurrence may be hampered by high physiologic tracer accumulation in the urinary bladder on whole body imaging, usually starting 60 min after injection. This study sought to verify whether early dynamic ⁶⁸Ga-PSMA-11 (HBED-CC)PET/CT can differentiate pathologic PC-related tracer uptake from physiologic tracer accumulation in the urinary bladder.

Methods

Eighty consecutive PC patients referred to ⁶⁸Ga -PSMA-11 PET/CT were included in this retrospective analysis (biochemical relapse: n = 64; primary staging: n = 8; evaluation of therapy response/restaging: n = 8). In addition to whole-body PET/CT acquisition 60 min post injection early dynamic imaging of the pelvis in the first 8 min after tracer injection was performed. SUV_max of pathologic lesions was calculated and time–activity curves were generated and compared to those of urinary bladder and areas of physiologic tracer uptake.

Results

A total of 55 lesions consistent with malignancy on 60 min whole body imaging exhibited also pathologic ⁶⁸Ga-PSMA-11 uptake during early dynamic imaging (prostatic bed/prostate gland: n = 27; lymph nodes: n = 12; bone: n = 16). All pathologic lesions showed tracer uptake within the first 3 min, whereas urinary bladder activity was absent within the first 3 min of dynamic imaging in all patients. Suv_max was significantly higher in PC lesions in the first 6 min compared to urinary bladder accumulation (p < 0.001). In the subgroup of PC patients with biochemical relapse the detection rate of local recurrence could be increased from 20.3 to 29.7%.

Conclusions

Early dynamic imaging in ⁶⁸Ga-PSMA-11 PET/CT reliably enables the differentiation of pathologic tracer uptake in PC lesions from physiologic bladder accumulation. Performance of early dynamic imaging in addition to whole body imaging 60 min after tracer injection might improve the detection rate of local recurrence in PC patients with biochemical relapse referred for ⁶⁸Ga-PSMA-11 PET/CT.

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Title: Early dynamic imaging in 68Ga- PSMA-11 PET/CT allows discrimination of urinary bladder activity and prostate cancer lesions
Authors: Christian Uprimny
Alexander Stephan Kroiss
Clemens Decristoforo
Josef Fritz
Boris Warwitz
Lorenza Scarpa
Llanos Geraldo Roig
Dorota Kendler
Elisabeth von Guggenberg
Jasmin Bektic
Wolfgang Horninger
Irene Johanna Virgolini
Publication date: 01-05-2017
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 5/2017
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-016-3578-z

At a glance: The STEP trials

Springer Medicine

Early dynamic imaging in ⁶⁸Ga- PSMA-11 PET/CT allows discrimination of urinary bladder activity and prostate cancer lesions

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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