Universität zu Köln

Heilinger, Jan ORCID: 0009-0004-0026-824X, Roth, Katrin Sabine ORCID: 0000-0002-3786-2777, Weis, Henning ORCID: 0000-0001-8638-3281, Fink, Antonis, Weindler, Jasmin ORCID: 0009-0001-8810-0617, Dietlein, Felix ORCID: 0000-0002-6651-7155, Krapf, Philipp ORCID: 0000-0003-1671-2443, Schomäcker, Klaus ORCID: 0000-0003-2636-0058, Neumaier, Bernd ORCID: 0000-0001-5425-3116, Dietlein, Markus ORCID: 0000-0003-0992-6099, Drzezga, Alexander ORCID: 0000-0001-6018-716X and Kobe, Carsten ORCID: 0000-0002-2909-0826 (2025). Do you know your PSMA-tracer? Variability in the biodistribution of different PSMA ligands and its potential impact on defining PSMA-positivity prior to PSMA-targeted therapy. EJNMMI Research, 15 (1). pp. 1-8. Springer Nature. ISSN 2191-219X

PDF s13550-024-01190-7.pdf Bereitstellung unter der CC-Lizenz: Creative Commons Attribution. Download (1MB)

Abstract

[Article number 4] Background: In clinical practice, several radiopharmaceuticals are used for PSMA-PET imaging, each with distinct biodistribution patterns. This may impact treatment decisions and outcomes, as eligibility for PSMA-directed radioligand therapy is usually assessed by comparing tumoral uptake to normal liver uptake as a reference. In this study, we aimed to compare tracer uptake intraindividually in various reference regions including liver, parotid gland and spleen as well as the respective tumor-to-background ratios (TBR) of different 18 F-labeled PSMA ligands to today’s standard radiopharmaceutical 68 Ga-PSMA-11 in a series of patients with biochemical recurrence of prostate cancer who underwent a dual PSMA-PET examination as part of an individualized diagnostic approach. Results: Differences in background activity among different PSMA-PET tracers lead to variations in tumor-to-background ratios (TBR). In [ 18 F]F-DCFPyL-PET, TBR with the liver as the reference organ (TBR liver ) was comparable to [ 68 Ga]Ga-PSMA-11-PET, while [ 18 F]F-PSMA-1007-PET and [ 18 F]F-JK-PSMA-7-PET showed significantly lower values. Using the parotid gland as the reference (TBR parotidgland ), [ 18 F]F-DCFPyL-PET exhibited significantly higher values, whereas [ 18 F]F-PSMA-1007-PET and [ 18 F]F-JK-PSMA-7-PET were comparable. For the spleen (TBR spleen ), [ 18 F]F-JK-PSMA-7-PET was comparable, but [ 18 F]F-DCFPyL-PET and [ 18 F]F-PSMA-1007-PET showed significantly higher and lower values, respectively. An additional Bland-Altman analyses revealed low bias for [ 18 F]F-DCFPyL-PET in TBR parotidgland , whereas significant differences in TBR liver and TBR spleen for the other tracers resulted in higher bias. Conclusion: Different PSMA-PET tracers exhibit distinct biodistribution patterns, leading to variations in tumor-to-background ratios (TBR) in reference organs such as the liver, parotid gland, and spleen. Patient selection for PSMA-directed radioligand therapy is currently based on a semiquantitative approach using the liver as a reference region in [ 68 Ga]Ga-PSMA-11-PET. Thus, the use of alternative [ 18 F]-labeled tracers may result in under- or overestimation of a patient’s suitability for therapy. This highlights the importance of a comprehensive understanding of the differences in tracer-specific uptake behavior for accurate decisions regarding PSMA-expression levels. However, as the patient cohort in this study is at earlier disease stages, the generalizability of these findings to later-stage patients remains unclear and requires further investigation.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Heilinger, Jan UNSPECIFIED https://orcid.org/0009-0004-0026-824X UNSPECIFIED Roth, Katrin Sabine UNSPECIFIED https://orcid.org/0000-0002-3786-2777 UNSPECIFIED Weis, Henning UNSPECIFIED https://orcid.org/0000-0001-8638-3281 UNSPECIFIED Fink, Antonis UNSPECIFIED UNSPECIFIED UNSPECIFIED Weindler, Jasmin UNSPECIFIED https://orcid.org/0009-0001-8810-0617 UNSPECIFIED Dietlein, Felix UNSPECIFIED https://orcid.org/0000-0002-6651-7155 UNSPECIFIED Krapf, Philipp UNSPECIFIED https://orcid.org/0000-0003-1671-2443 UNSPECIFIED Schomäcker, Klaus UNSPECIFIED https://orcid.org/0000-0003-2636-0058 UNSPECIFIED Neumaier, Bernd UNSPECIFIED https://orcid.org/0000-0001-5425-3116 UNSPECIFIED Dietlein, Markus UNSPECIFIED https://orcid.org/0000-0003-0992-6099 UNSPECIFIED Drzezga, Alexander UNSPECIFIED https://orcid.org/0000-0001-6018-716X UNSPECIFIED Kobe, Carsten UNSPECIFIED https://orcid.org/0000-0002-2909-0826 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-793184
Identification Number:	10.1186/s13550-024-01190-7
Journal or Publication Title:	EJNMMI Research
Volume:	15
Number:	1
Page Range:	pp. 1-8
Date:	10 January 2025
Publisher:	Springer Nature
ISSN:	2191-219X
Language:	English
Faculty:	External institution Faculty of Medicine
Divisions:	Außeruniversitäre Forschungseinrichtungen > Forschungszentrum Jülich Faculty of Medicine > Nuklearmedizin > Klinik und Poliklinik für Nuklearmedizin
Subjects:	Medical sciences Medicine
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/79318