Intra-individual comparison of 18F-PSMA-1007 and 18F-DCFPyL PET/CT in the prospective evaluation of patients with newly diagnosed prostate carcinoma: A pilot study

Introduction: The introduction of 18F-labelled prostate-specific membrane antigen (PSMA) targeted positron emission tomography/computed-tomography (PET/CT) tracers, firstly 18F-DCFPyL and more recently 18F-PSMA-1007, have demonstrated promising results for the diagnostic workup of prostate cancer (PCa). This clinical study presents an intra-individual comparison to evaluate tracer-specific characteristics of 18F-DCFPyL versus 18F-PSMA-1007. Methods: Twelve prostate cancer patients, drug naive or prior to surgery, received similar activities of about 250 MBq 18F-DCFPyL and 18F-PSMA-1007 48 h apart and were imaged 2 h p.i. in the same PET/CT-scanner using the same reconstruction-algorithm. Normal organ biodistribution and tumor uptakes were quantified using SUVmaxResults: PSMA-positive lesions were detected in twelve out of twelve PCa patients. Both tracers, 18F-DCFPyL and 18F-PSMA-1007, detected the identical lesions. No statistical significance could be observed when comparing the SUVmax of 18F-DCFPyL and 18F-PSMA-1007 for local tumor, lymph node metastases and bone metastases. With regard to normal organs, 18F-DCFPyL presented statistically significant higher uptake in kidneys, urinary bladder and lacrimal gland. Vice versa, significantly higher uptake of 18F-PSMA-1007 in muscle, submandibular and sublingual gland, spleen, pancreas, liver and gallbladder was observed. Conclusion: Excellent imaging quality was achieved with both 18F-DCFPyL and 18F-PSMA-1007 resulting in identical clinical findings for the evaluated routine situations. Non-urinary excretion of 18F-PSMA-1007 might present some advantage with regard to delineation of local recurrence or pelvic lymph-node metastasis in selective patients; the lower hepatic background might favor 18F-DCFPyL in very late stages when rare cases of liver metastases can occur.

Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 2017 Dec 21 [Epub ahead of print]

Frederik Giesel, Leon Will, Ismaheel Lawal, Thabo Lengana, Clemens Kratochwil, Mariza Vorster, Oliver Neels, Florette Reyneke, Uwe Haberkon, Klaus Kopka, Mike Sathekge

Heidelberg University Hospital, Germany., University of Pretoria, South Africa., German Cancer Research Center (dkfz), Germany.