Combined Early and Late [68Ga]PSMA-HBED-CC PET Scans Improve Lesion Detectability in Biochemical Recurrence of Prostate Cancer with Low PSA Levels

Abstract

The time period between injection and data acquisition influences the detection rate of [Ga]PSMA-HBED-CC PET/CT. In biochemical recurrence with low PSA levels, late [Ga]PSMA-HBED-CC PET/CT imaging offers frequent advantages with regard to lesion contrast.

An 18F-Labeled PSMA Ligand for PET/CT of Prostate Cancer: First-in-Humans Observational Study and Clinical Experience with 18F-JK-PSMA-7 During the First Year of Application

“…This finding corroborates our earlier observations on 18 F-DCFPyL (7,18). In contrast to our previous studies, however, we were able to observe this improved sensitivity pattern of 18 F-JK-PSMA-7 although the acquisition protocol for 68 Ga-PSMA-11 had been amended by a second PET scan 3 h after injection for patients with PSA levels below 2.0 mg/L (25)(26)(27)(28). This finding suggests that the ability of 18 F-PSMA-specific ligands to visualize small anatomic structures reflects an intrinsic quality of the 18 F label and does not result from differences in image acquisition protocols.…”

“…Following previously published protocols, 68 Ga-PSMA-11 PET scans were acquired 1 h after injection (3)(4)(5). In patients with a PSA level below 2.0 mg/L, a second scan of the pelvis and lower abdomen was performed 3 h after injection, to guarantee maximal sensitivity for the 68 Ga-PSMA-11 tracer (25)(26)(27)(28). In parallel with previous studies using 18 F-DCFPyL (6,7), 18 F-JK-PSMA-7 PET scans were acquired 2 h after tracer injection.…”

Detection Rate of Prostate Specific Membrane Antigen Tracers for Positron Emission Tomography/Computerized Tomography in Prostate Cancer Biochemical Recurrence: A Systematic Review and Network Meta-Analysis

“…20 Similarly the study of Hohberg et al included 2 patients treated with ADT only. 28 For the same reason we have also included the recent study of Albert et al 52 The statistical relevance and the relative paucity of ADT treated patients led us to include these articles in our analysis. The study of Schwenck et al was included even though it had a mixed population of staging and restaging patients as the authors treated the 2 cohorts separately.…”

18F-Labeled, PSMA-Targeted Radiotracers: Leveraging the Advantages of Radiofluorination for Prostate Cancer Molecular Imaging

“…The longer half-life of 18 F allows for delayed imaging protocols. Using [ 68 Ga]PSMA-HBED-CC, Hohberg and co-workers reported on a higher lesion detection rate for a later imaging time-point as compared to early imaging (1h vs 3h post-injection), in particular for patients with low PSA levels 43. Schmuck et al have also shown that in patients with biochemical recurrence or PSA persistence after primary therapy for PCa, tumor-to-background ratios have increased at later imaging time-points using [ 68 Ga]PSMA I&T 44.…”