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[89Zr]Zr-PSMA-617 PET/CT in biochemical recurrence of prostate cancer: first clinical experience from a pilot study including biodistribution and dose estimates

Rosar F, Schaefer-Schuler A, Bartholomä M, Maus S, Petto S, Burgard C, Privé BM, Franssen GM, Derks YH, Nagarajah J, Khreish F, Ezziddin S (2022)

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Publication Type: Journal article

Publication year: 2022

Journal

Book Volume: 49

Pages Range: 4736-4747

Journal Issue: 13

DOI: 10.1007/s00259-022-05925-3

Abstract

Purpose: Prostate-specific membrane antigen (PSMA)-targeted PET/CT has become increasingly important in the management of prostate cancer, especially in localization of biochemical recurrence (BCR). PSMA-targeted PET/CT imaging with long-lived radionuclides as ⁸⁹Zr (T1/2 = 78.4 h) may improve diagnostics by allowing data acquisition on later time points. In this study, we present our first clinical experience including preliminary biodistribution and dosimetry data of [⁸⁹Zr]Zr-PSMA-617 PET/CT in patients with BCR of prostate cancer. Methods: Seven patients with BCR of prostate cancer who revealed no (n = 4) or undetermined (n = 3) findings on [⁶⁸Ga]Ga-PSMA-11 PET/CT imaging were referred to [⁸⁹Zr]Zr-PSMA-617 PET/CT. PET/CT imaging was performed 1 h, 24 h, 48 h, and 72 h post injection (p.i.) of 111 ± 11 MBq [⁸⁹Zr]Zr-PSMA-617 (mean ± standard deviation). Normal organ distribution and dosimetry were determined. Lesions visually considered as suggestive of prostate cancer were quantitatively analyzed. Results: Intense physiological uptake was observed in the salivary and lacrimal glands, liver, spleen, kidneys, intestine and urinary tract. The parotid gland received the highest absorbed dose (0.601 ± 0.185 mGy/MBq), followed by the kidneys (0.517 ± 0.125 mGy/MBq). The estimated overall effective dose for the administration of 111 MBq was 10.1 mSv (0.0913 ± 0.0118 mSv/MBq). In 6 patients, and in particular in 3 of 4 patients with negative [⁶⁸Ga]Ga-PSMA-11 PET/CT, at least one prostate cancer lesion was detected in [⁸⁹Zr]Zr-PSMA-617 PET/CT imaging at later time points. The majority of tumor lesions were first visible at 24 h p.i. with continuously increasing tumor-to-background ratio over time. All tumor lesions were detectable at 48 h and 72 h p.i. Conclusion: [⁸⁹Zr]Zr-PSMA-617 PET/CT imaging is a promising new diagnostic tool with acceptable radiation exposure for patients with prostate cancer especially when [⁶⁸Ga]Ga-PSMA-11 PET/CT imaging fails detecting recurrent disease. The long half-life of ⁸⁹Zr enables late time point imaging (up to 72 h in our study) with increased tracer uptake in tumor lesions and higher tumor-to-background ratios allowing identification of lesions non-visible on [⁶⁸Ga]Ga-PSMA-11 PET/CT imaging.

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How to cite

APA:

Rosar, F., Schaefer-Schuler, A., Bartholomä, M., Maus, S., Petto, S., Burgard, C.,... Ezziddin, S. (2022). [89Zr]Zr-PSMA-617 PET/CT in biochemical recurrence of prostate cancer: first clinical experience from a pilot study including biodistribution and dose estimates. European Journal of Nuclear Medicine and Molecular Imaging, 49(13), 4736-4747. https://doi.org/10.1007/s00259-022-05925-3

MLA:

Rosar, Florian, et al. "[89Zr]Zr-PSMA-617 PET/CT in biochemical recurrence of prostate cancer: first clinical experience from a pilot study including biodistribution and dose estimates." European Journal of Nuclear Medicine and Molecular Imaging 49.13 (2022): 4736-4747.

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