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Open Access 01-12-2020 | Prostate Cancer | Original research

Kinetic modeling of ⁶⁸Ga-PSMA-11 and validation of simplified methods for quantification in primary prostate cancer patients

Authors: Anna Ringheim, Guilherme de Carvalho Campos Neto, Udunna Anazodo, Lumeng Cui, Marcelo Livorsi da Cunha, Taise Vitor, Karine Minaif Martins, Ana Cláudia Camargo Miranda, Marycel Figols de Barboza, Leonardo Lima Fuscaldi, Gustavo Caserta Lemos, José Roberto Colombo Junior, Ronaldo Hueb Baroni

Published in: EJNMMI Research | Issue 1/2020

Abstract

Background

The positron emission tomography (PET) ligand ⁶⁸Ga-Glu-urea-Lys(Ahx)-HBED-CC (⁶⁸Ga-PSMA-11) targets the prostate-specific membrane antigen (PSMA), upregulated in prostate cancer cells. Although ⁶⁸Ga-PSMA-11 PET is widely used in research and clinical practice, full kinetic modeling has not yet been reported nor have simplified methods for quantification been validated. The aims of our study were to quantify ⁶⁸Ga-PSMA-11 uptake in primary prostate cancer patients using compartmental modeling with arterial blood sampling and to validate the use of standardized uptake values (SUV) and image-derived blood for quantification.

Results

Fifteen patients with histologically proven primary prostate cancer underwent a 60-min dynamic ⁶⁸Ga-PSMA-11 PET scan of the pelvis with axial T1 Dixon, T2, and diffusion-weighted magnetic resonance (MR) images acquired simultaneously. Time-activity curves were derived from volumes of interest in lesions, normal prostate, and muscle, and mean SUV calculated. In total, 18 positive lesions were identified on both PET and MR. Arterial blood activity was measured by automatic arterial blood sampling and manual blood samples were collected for plasma-to-blood ratio correction and for metabolite analysis. The analysis showed that ⁶⁸Ga-PSMA-11 was stable in vivo. Based on the Akaike information criterion, ⁶⁸Ga-PSMA-11 kinetics were best described by an irreversible two-tissue compartment model. The rate constants K₁ and k₃ and the net influx rate constants K_i were all significantly higher in lesions compared to normal tissue (p < 0.05). K_i derived using image-derived blood from an MR-guided method showed excellent agreement with K_i derived using arterial blood sampling (intraclass correlation coefficient = 0.99). SUV correlated significantly with K_i with the strongest correlation of scan time-window 30–45 min (rho 0.95, p < 0.001). Both K_i and SUV correlated significantly with serum prostate specific antigen (PSA) level and PSA density.

Conclusions

⁶⁸Ga-PSMA-11 kinetics can be described by an irreversible two-tissue compartment model. An MR-guided method for image-derived blood provides a non-invasive alternative to blood sampling for kinetic modeling studies. SUV showed strong correlation with K_i and can be used in routine clinical settings to quantify ⁶⁸Ga-PSMA-11 uptake.

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Title: Kinetic modeling of 68Ga-PSMA-11 and validation of simplified methods for quantification in primary prostate cancer patients
Authors: Anna Ringheim
Guilherme de Carvalho Campos Neto
Udunna Anazodo
Lumeng Cui
Marcelo Livorsi da Cunha
Taise Vitor
Karine Minaif Martins
Ana Cláudia Camargo Miranda
Marycel Figols de Barboza
Leonardo Lima Fuscaldi
Gustavo Caserta Lemos
José Roberto Colombo Junior
Ronaldo Hueb Baroni
Publication date: 01-12-2020
Publisher: Springer Berlin Heidelberg
Keywords: Prostate Cancer
Prostate Cancer
Positron Emission Tomography
Published in: EJNMMI Research / Issue 1/2020
Electronic ISSN: 2191-219X
DOI: https://doi.org/10.1186/s13550-020-0594-6

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Kinetic modeling of ⁶⁸Ga-PSMA-11 and validation of simplified methods for quantification in primary prostate cancer patients

Abstract

Background

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Results

Conclusions

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