Comparison of [18F]PSMA-1007 with [68Ga]Ga-PSMA-11 PET/CT in Restaging of Prostate Cancer Patients with PSA Relapse

Manuela A Hoffmann; Finn Edler von Eyben; Nicolas Fischer; Florian Rosar; Jonas Müller-Hübenthal; Hans-Georg Buchholz; Helmut J Wieler; Mathias Schreckenberger

doi:10.3390/cancers14061479

Comparison of [¹⁸F]PSMA-1007 with [⁶⁸Ga]Ga-PSMA-11 PET/CT in Restaging of Prostate Cancer Patients with PSA Relapse

Cancers (Basel). 2022 Mar 14;14(6):1479. doi: 10.3390/cancers14061479.

Authors

Manuela A Hoffmann^{1

2}, Finn Edler von Eyben³, Nicolas Fischer⁴, Florian Rosar⁵, Jonas Müller-Hübenthal⁶, Hans-Georg Buchholz², Helmut J Wieler⁷, Mathias Schreckenberger²

Affiliations

¹ Department of Occupational Health & Safety, Federal Ministry of Defense, 53123 Bonn, Germany.
² Clinic of Nuclear Medicine, Johannes Gutenberg University, 55101 Mainz, Germany.
³ Center for Tobacco Control Research, DK-5230 Odense, Denmark.
⁴ Department of Urology, University of Cologne, 50937 Cologne, Germany.
⁵ Department of Nuclear Medicine, Saarland University Medical Center, 66421 Homburg, Germany.
⁶ Practice of Radiology and Nuclear Medicine, Praxis im KölnTriangle, 50679 Cologne, Germany.
⁷ Medical Center, University of Dusseldorf, 40225 Dusseldorf, Germany.

Abstract

This study aimed to compare the diagnostic performance of [18F]PSMA-1007 positron emission tomography/computed tomography (PET/CT) (18F-PSMA) and [68Ga]Ga-PSMA-11 PET/CT (68Ga-PSMA) by identifying prostate-specific antigen (PSA) threshold levels for optimal detecting recurrent prostate cancer (PC) and to compare both methods. Retrospectively, the study included 264 patients. The performances of 18F-PSMA and 68Ga-PSMA in relation to the pre-scan PSA were assessed by receiver operating characteristic (ROC) curve. 18F-PSMA showed PC-lesions in 87.5% (112/128 patients), while 68Ga-PSMA identified them in 88.9% (121/136). For 18F-PSMA biochemical recurrent (BCR) patients treated with radical prostatectomy (78/128, patient group: F-RP), a PSA of 1.08 ng/mL was found to be the optimal cut-off level for predicting positive and negative scans (AUC = 0.821; 95%, CI: 0.710−0.932), while for prostatectomized 68Ga-PSMA BCR-patients (89/136, patient group: Ga-RP), the cut-off was 1.84 ng/mL (AUC = 0.588; 95%, CI: 0.410−0.766). In patients with PSA < 1.08 ng/mL (F-RP) 76.3% and <1.84 ng/mL (Ga-RP) 78.6% scans were positive, whereas patients with PSA ≥ 1.08 ng/mL (F-RP) or 1.84 ng/mL (Ga-RP) had positive scan results in 100% and 91.5% (p < 0.001/p = 0.085). The identified PSA thresholds for PSMA-mappable PC lesions in BCR-patients (RP) showed a better separation for 18F-PSMA with regard to the distinguishing of positive and negative PC-lesions compared to 68Ga-PSMA. However, the two PSMA PET/CT tracers gave similar overall findings.

Keywords: PSA threshold level; [18F]PSMA-1007 PET/CT; [68Ga]Ga-PSMA-11 PET/CT; biochemical recurrence; optimal PSA cut-off level; prostate cancer; prostate-specific antigen.