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| Hauptseite > Publikationsdatenbank > PSA-Stratified Performance of $^{18}$F- and $^{68}$Ga-PSMA PET in Patients with Biochemical Recurrence of Prostate Cancer > print |
| Hauptseite > Publikationsdatenbank > PSA-Stratified Performance of $^{18}$F- and $^{68}$Ga-PSMA PET in Patients with Biochemical Recurrence of Prostate Cancer > print |
| 001 | 836360 | ||
| 005 | 20210129230950.0 | ||
| 024 | 7 | _ | |a 10.2967/jnumed.116.185538 |2 doi |
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| 100 | 1 | _ | |a Dietlein, Felix |0 P:(DE-HGF)0 |b 0 |e Corresponding author |
| 245 | _ | _ | |a PSA-Stratified Performance of $^{18}$F- and $^{68}$Ga-PSMA PET in Patients with Biochemical Recurrence of Prostate Cancer |
| 260 | _ | _ | |a New York, NY |c 2017 |b Soc. |
| 336 | 7 | _ | |a article |2 DRIVER |
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| 520 | _ | _ | |a Several studies outlined the sensitivity of 68Ga-labeled PET tracers against the prostate-specific membrane antigen (PSMA) for localization of relapsed prostate cancer in patients with renewed increase in the prostate-specific antigen (PSA), commonly referred to as biochemical recurrence. Labeling of PSMA tracers with 18F offers numerous advantages, including improved image resolution, longer half-life, and increased production yields. The aim of this study was to assess the PSA-stratified performance of the 18F-labeled PSMA tracer 18F-DCFPyL and the 68Ga-labeled reference 68Ga-PSMA-HBED-CC. Methods: We examined 191 consecutive patients with biochemical recurrence according to standard acquisition protocols using 18F-DCFPyL (n = 62, 269.8 MBq, PET scan at 120 min after injection) or 68Ga-PSMA-HBED-CC (n = 129, 158.9 MBq, 60 min after injection). We determined PSA-stratified sensitivity rates for both tracers and corrected our calculations for Gleason scores using iterative matched-pair analyses. As an orthogonal validation, we directly compared tracer distribution patterns in a separate cohort of 25 patients, sequentially examined with both tracers. Results: After prostatectomy (n = 106), the sensitivity of both tracers was significantly associated with absolute PSA levels (P = 4.3 × 10−3). Sensitivity increased abruptly, when PSA values exceeded 0.5 μg/L (P = 2.4 × 10−5). For a PSA less than 3.5 μg/L, most relapses were diagnosed at a still limited stage (P = 3.4 × 10−6). For a PSA of 0.5–3.5 μg/L, PSA-stratified sensitivity was 88% (15/17) for 18F-DCFPyL and 66% (23/35) for 68Ga-PSMA-HBED-CC. This significant difference was preserved in the Gleason-matched-pair analysis. Outside of this range, sensitivity was comparably low (PSA < 0.5 μg/L) or high (PSA > 3.5 μg/L). After radiotherapy (n = 85), tracer sensitivity was largely PSA-independent. In the 25 patients examined with both tracers, distribution patterns of 18F-DCFPyL and 68Ga-PSMA-HBED-CC were strongly comparable (P = 2.71 × 10−8). However, in 36% of the PSMA-positive patients we detected additional lesions on the 18F-DCFPyL scan (P = 3.7 × 10−2). Conclusion: Our data suggest that 18F-DCFPyL is noninferior to 68Ga-PSMA-HBED-CC, while offering the advantages of 18F labeling. Our results indicate that imaging with 18F-DCFPyL may even exhibit improved sensitivity in localizing relapsed tumors after prostatectomy for moderately increased PSA levels. Although the standard acquisition protocols, used for 18F-DCFPyL and 68Ga-PSMA-HBED-CC in this study, stipulate different activity doses and tracer uptake times after injection, our findings provide a promising rationale for validation of 18F-DCFPyL in future prospective trials. |
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| 700 | 1 | _ | |a Kobe, Carsten |0 P:(DE-HGF)0 |b 1 |
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| 700 | 1 | _ | |a Drzezga, Alexander |0 P:(DE-HGF)0 |b 9 |
| 700 | 1 | _ | |a Dietlein, Markus |0 P:(DE-HGF)0 |b 10 |
| 700 | 1 | _ | |a Schmidt, M. |0 P:(DE-HGF)0 |b 11 |
| 773 | _ | _ | |a 10.2967/jnumed.116.185538 |g Vol. 58, no. 6, p. 947 - 952 |0 PERI:(DE-600)2040222-3 |n 6 |p 947 - 952 |t Journal of nuclear medicine |v 58 |y 2017 |x 2159-662X |
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