(64)Cu-PSMA-617 PET/CT Imaging of Prostate Adenocarcinoma: First In-Human Studies

The prostate-specific membrane antigen (PSMA) is a cell surface protein, which is overexpressed in nearly all cases of prostate cancer (PCa). PET imaging with (68)Ga-PSMA-HBED-CC has recently found widespread application in the diagnosis of recurrent PCa. In this study, the diagnostic potential of (64)Cu-labeled PSMA ligand (PSMA-617) PET in patients with PCa has been investigated.

The study was conducted simultaneously at two nuclear medicine centers, Austria (Vienna, Center 1) and Germany (Bad Berka, Center 2). The patients (n = 29) included in this study were referred for PET (Center 1, 21 patients) or PET/CT (Center 2, 8 patients) imaging with either a high suspicion of recurrent disease or for possible surgical or PSMA radioligand therapy planning. PET images of the whole body were performed at 1 hour p.i. and additional images of the pelvis at 2 hours p.i.

In 23 of 29 patients, at least one focus of pathological tracer uptake suspicious for primary disease in the prostate lobe or recurrent disease was detected. Among healthy organs, the salivary glands, kidneys, and liver showed the highest radiotracer uptake. Lesions suspicious for PCa were detected with excellent contrast as early as 1 hour p.i. with high detection rates even at low prostate-specific antigen (PSA) levels.

The preliminary results of this study demonstrate the high potential of (64)Cu-PSMA ligand PET/CT imaging in patients with recurrent disease and in the primary staging of selected patients with progressive local disease. The acquired PET images showed an excellent resolution of the detected lesions with very high lesion-to- background contrast. Furthermore, the long half-life of (64)Cu allows distribution of the tracer to clinical PET centers that lack radiochemistry facilities for the preparation of (68)Ga-PSMA ligand (satellite concept).

Cancer biotherapy & radiopharmaceuticals. 2016 [Epub ahead of print]

Bernhard Grubmüller, Richard P Baum, Enza Capasso, Aviral Singh, Yasaman Ahmadi, Peter Knoll, Andreas Floth, Sergio Righi, Shahin Zandieh, Carlo Meleddu, Shahrokh F Shariat, Hans Christoph Klingler, Siroos Mirzaei

1 Department of Urology, Vienna General Hospital, Medical University of Vienna , Vienna, Austria ., 2 THERANOSTICS Center for Molecular Radiotherapy and Molecular Imaging (PET/CT), ENETS Center of Excellence , Zentralklinik Bad Berka, Bad Berka, Germany ., 3 Regional Oncological Hospital , U.O.C. Nuclear Medicine, Cagliari, Italy ., 4 Institute of Nuclear Medicine with PET Center , Wilhelminenspital Vienna, Vienna, Austria ., 5 Department of Urology, Wilhelminenspital Vienna , Vienna, Austria ., 6 Dirigente Fisico Sanitario , S.C. Fisica Sanitaria, E.O. Ospedali Galliera, Genova, Italy ., 7 Institute of Radiology and Nuclear Medicine, Hanusch Hospital, Teaching Hospital of the Medical University of Vienna , Vienna, Austria .