Keeping up with the prostate-specific membrane antigens (PSMAs): an introduction to a new class of positron emission tomography (PET) imaging agents

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Abstract

Prostate-specific membrane antigen (PSMA) targeted positron emission tomography (PET) is an emerging prostate cancer imaging method, which has been reported to have a higher sensitivity and specificity than the currently approved PET imaging agents. Multiple PSMA ligands are being investigated around the world and applications range from primary tumor characterization, to local staging, biochemical recurrence, metastasis, and image-guided interventions. The most investigated PET tracers are labelled with 68-Gallium or 18-Fluoride and are discussed in this review. Additionally, ^99mTc labeled PSMA agents for single photon emission computed tomography (SPECT) imaging are elucidated as an alternative method of PSMA image acquisition.

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Most cited references 45

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German Multicenter Study Investigating 177Lu-PSMA-617 Radioligand Therapy in Advanced Prostate Cancer Patients.

Kambiz Rahbar, Hojjat Ahmadzadehfar, Clemens Kratochwil … (2017)

(177)Lu-labeled PSMA-617 is a promising new therapeutic agent for radioligand therapy (RLT) of patients with metastatic castration-resistant prostate cancer (mCRPC). Initiated by the German Society of Nuclear Medicine, a retrospective multicenter data analysis was started in 2015 to evaluate efficacy and safety of (177)Lu-PSMA-617 in a large cohort of patients.

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F-18 labelled PSMA-1007: biodistribution, radiation dosimetry and histopathological validation of tumor lesions in prostate cancer patients

Frederik L. Giesel, B Hadaschik, Christopher J Cardinale … (2016)

Purpose The prostate-specific membrane antigen (PSMA) targeted positron-emitting-tomography (PET) tracer 68Ga-PSMA-11 shows great promise in the detection of prostate cancer. However, 68Ga has several shortcomings as a radiolabel including short half-life and non-ideal energies, and this has motivated consideration of 18F-labelled analogs. 18F-PSMA-1007 was selected among several 18F-PSMA-ligand candidate compounds because it demonstrated high labelling yields, outstanding tumor uptake and fast, non-urinary background clearance. Here, we describe the properties of 18F-PSMA-1007 in human volunteers and patients. Methods Radiation dosimetry of 18F-PSMA-1007 was determined in three healthy volunteers who underwent whole-body PET-scans and concomitant blood and urine sampling. Following this, ten patients with high-risk prostate cancer underwent 18F-PSMA-1007 PET/CT (1 h and 3 h p.i.) and normal organ biodistribution and tumor uptakes were examined. Eight patients underwent prostatectomy with extended pelvic lymphadenectomy. Uptake in intra-prostatic lesions and lymph node metastases were correlated with final histopathology, including PSMA immunostaining. Results With an effective dose of approximately 4.4–5.5 mSv per 200–250 MBq examination, 18F-PSMA-1007 behaves similar to other PSMA-PET agents as well as to other 18F-labelled PET-tracers. In comparison to other PSMA-targeting PET-tracers, 18F-PSMA-1007 has reduced urinary clearance enabling excellent assessment of the prostate. Similar to 18F-DCFPyL and with slightly slower clearance kinetics than PSMA-11, favorable tumor-to-background ratios are observed 2–3 h after injection. In eight patients, diagnostic findings were successfully validated by histopathology. 18F-PSMA-1007 PET/CT detected 18 of 19 lymph node metastases in the pelvis, including nodes as small as 1 mm in diameter. Conclusion 18F-PSMA-1007 performs at least comparably to 68Ga-PSMA-11, but its longer half-life combined with its superior energy characteristics and non-urinary excretion overcomes some practical limitations of 68Ga-labelled PSMA-targeted tracers. Electronic supplementary material The online version of this article (doi:10.1007/s00259-016-3573-4) contains supplementary material, which is available to authorized users.

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Initial Evaluation of [(18)F]DCFPyL for Prostate-Specific Membrane Antigen (PSMA)-Targeted PET Imaging of Prostate Cancer.

Zsolt Szabó, Esther Mena, Steven Rowe … (2015)

Prostate-specific membrane antigen (PSMA) is a recognized target for imaging prostate cancer. Here we present initial safety, biodistribution, and radiation dosimetry results with [(18)F]DCFPyL, a second-generation fluorine-18-labeled small-molecule PSMA inhibitor, in patients with prostate cancer.

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Author and article information

Journal

Journal ID (nlm-ta): Transl Androl Urol

Journal ID (iso-abbrev): Transl Androl Urol

Journal ID (publisher-id): TAU

Title: Translational Andrology and Urology

Publisher: AME Publishing Company

ISSN (Electronic): 2223-4691

Publication date (Print and electronic): October 2018

Publication date (Print): October 2018

Volume: 7

Issue: 5

Pages: 831-843

Affiliations

[1 ]Molecular Imaging Program, National Cancer Institute, National Institutes of Health , Bethesda, MD, USA;

[2 ]Department of Nuclear Medicine, Medical University Warsaw , Warsaw, Poland;

[3 ]Clinical Research Directorate/Clinical Monitoring Research Program, Frederick National Laboratory for Cancer Research sponsored by the National Cancer Institute , Frederick, MD, USA;

[4 ]Department of Urology, Heidelberg University Hospital, INF 400, 69120 Heidelberg, Germany

[5 ]Department of Nuclear Medicine, Heidelberg University Hospital, INF 400, 69120 Heidelberg, Germany

Author notes

Contributions: (I) Conception and design: M Czarniecki, B Turkbey; (II) Administrative support: None; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: M Czarniecki, E Mena, M Cacko, L Lindenberg; (V) Data analysis and interpretation: M Czarniecki, E Mena, M Cacko, L Lindenberg; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

Correspondence to: Baris Turkbey, MD. Molecular Imaging Program, National Cancer Institute, 10 Center Dr, MSC 1182, Bldg 10, Room B3B85, Bethesda, MD 20892-1088, USA. Email: turkbeyi@ 123456mail.nig.gov .

Article

Publisher ID: tau-07-05-831

DOI: 10.21037/tau.2018.08.03

PMC ID: 6212618

PubMed ID: 30456186

SO-VID: 7d9dbe56-d374-4d7b-a5fd-5a7d156a0b82

History

Date received : 15 June 2018

Date accepted : 31 July 2018

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