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PSMA Gallium

Michael McCarthy, Tiffany Langton, Divesh Kumar, Andrew Campbell
PURPOSE: Gallium(68)-labelled prostate-specific membrane antigen (PSMA) radiopharmaceuticals can be used to detect prostate cancer (PCa) cells due the their over expression of PSMA. The (68)Ga HBED-PSMA (PSMA-HBED) ligand has been most widely used and can be considered the current gold standard agent. Further PSMA ligands based on the DOTAGA and DOTA conjugates have more recently been developed. These agents (PSMA-I&T and PSMA-617) have potential theranostic capabilities as they can be conjugated with therapeutic radioisotopes...
May 4, 2017: European Journal of Nuclear Medicine and Molecular Imaging
Claudia Kesch, Clemens Kratochwil, Walter Mier, Klaus Kopka, Frederik L Giesel
The introduction of prostate specific membrane antigen (PSMA)-positron emission tomography (PET) using (68)Ga revolutionized prostate cancer imaging. Outperforming standard imaging, it allows complete staging of the local tumor and possible lymph nodes, visceral or bone metastases with high accuracy in only one examination (1,2). Sensitivities of 66% and specificities of 99% were observed for primary lymph node staging. Moreover, it has become an excellent staging tool for recurrent prostate cancer even at early stage and low PSA levels...
April 13, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Louise M McEwan, David Wong, John Yaxley
Gallium-68 prostate specific membrane antigen ligand (Ga-68 PSMA) positron emission tomography/computed tomography (PET/CT) scanning is emerging as a useful imaging modality for the staging of suspected and known recurrent or metastatic prostate cancer and in staging of newly diagnosed higher grade prostate cancer. However, we have observed at our institution that in some cases of the more aggressive ductal variant, Ga-68 PSMA uptake has sometimes been poor compared with prominent 18-flourodeoxyglucose (F-18 FDG) avidity seen in F-18 FDG PET/CT, which would suggest that FDG PET/CT scans are important in staging of ductal pattern prostate cancer...
March 28, 2017: Journal of Medical Imaging and Radiation Oncology
Michael S Hofman, Amir Iravani
The role of gallium-68 ((68)Ga) prostate-specific membrane antigen (PSMA) PET imaging is evolving and finding its place in the imaging armamentarium for prostate cancer (PCa). Despite the progress of conventional imaging strategies, significant limitations remain, including identification of small-volume disease and assessment of bone. Clinical studies have demonstrated that (68)Ga-PSMA is a promising tracer for detection of PCa metastases, even in patients with low prostate-specific antigen. To provide an accurate interpretation of (68)Ga-PSMA PET/computed tomography, nuclear medicine specialists and radiologists should be familiar with physiologic (68)Ga-PSMA uptake, common variants, patterns of locoregional and distant spread of PCa, and inherent pitfalls...
April 2017: PET Clinics
Asim Afaq, Deepak Batura, Jamshed Bomanji
Prostate-specific membrane antigen positron emission tomography (PSMA PET) is a relatively new method of imaging prostate cancer that increases diagnostic accuracy in detecting and guiding management in various stages of the disease pathway. Gallium-68-labelled PSMA PET has increased the sensitivity of detection of disease recurrence at low PSA levels, thus allowing an optimal window for salvage treatment. Apart from its use in disease recurrence, PSMA PET has the potential for increasing sensitivity and specificity for primary tumour localisation and in detecting lymph node disease, leading to a more accurate initial staging of the condition...
February 14, 2017: International Urology and Nephrology
Giampiero Giovacchini, Elisabetta Giovannini, Mattia Riondato, Andrea Ciarmiello
Neuroendocrine differentiation of prostate cancer (PCa) is a relatively frequent event, generally understudied, that carries important prognostic information. It is most frequently observed during the advanced stages of disease, when PCa has lost its sensitivity to androgen deprivation therapy or to chemotherapy, moderate to diffuse bone metastatic spread dominates the imaging scenario and it is responsible for painful clinical symptomatology. However, evidences indicate that neuroendocrine differentiation is a progressive phenomenon that starts at the very early part of the pathogenesis of cancer transformation contributing to it...
December 29, 2016: Current Radiopharmaceuticals
Handoo Rhee, John Blazak, Chui Ming Tham, Keng Lim Ng, Benjamin Shepherd, Malcolm Lawson, John Preston, Ian Vela, Paul Thomas, Simon Wood
BACKGROUND: In this study, we prospectively evaluate the diagnostic potential of a gallium-68 (68Ga) prostate-specific membrane antigen (PSMA)-binding ligand and positron emission tomography (PET) in detecting metastatic lesions in patients with renal tumour. The secondary aim was to determine whether the findings would result in the alteration of patient management. RESULTS: Ten patients with renal lesion and potential metastatic disease on conventional imaging were recruited...
December 2016: EJNMMI Research
Alexander Solle, Carsten Wanke, Lilli Geworski
Ga-68-labeled radiotracers, particularly used for the detection of neuroendocrine tumors by means of Ga-68-DOTA-TATE or -DOTA-TOC or for the diagnosis of prostate cancer by means of Ga-68-labeled antigens (Ga 68-PSMA), become increasingly important. In addition to the high sensitivity and specificity of these radiopharmaceuticals, the short-lived radionuclide Ga-68 offers almost ideal nuclear characteristics for use in PET. Ga-68 is obtained from a germanium-gallium-generator system, so that the availability of Ga-68-labeled radiotracers is independent of an on-site-cyclotron regardless of the short half-life of Ga-68 of about 68minutes...
March 2017: Zeitschrift Für Medizinische Physik
V Schreiter, C Reimann, D Geisel, N F Schreiter
The new tracer Gallium-68 prostate-specific membrane antigen (Ga-68 PSMA) yields new promising options for the PET/CT diagnosis of prostate cancer (PCa) and its metastases. To overcome limitations of hybrid imaging, known from the use of choline derivatives, seems to be possible with the use of Ga-68 PSMA for PCa. The benefits of hybrid imaging with Ga-68 PSMA for PCa compared to choline derivatives shall be discussed in this article based on an overview of the current literature. Key Points: • Ga-68 PSMA PET/CT can achieve higher detection rates of PCa lesions than PET/CT performed with choline derivatives• The new tracer Ga-68 PSMA has the advantage of high specificity, independence of PSA-level and low nonspecific tracer uptake in surrounding tissue• The new tracer Ga-68 PSMA seems very suitable for MR-PET diagnostic Citation Format: • Schreiter V, Reimann C, Geisel D et al...
November 2016: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
Krishan Kant Agarwal, Madhavi Tripathi, Rajeev Kumar, Chandrasekhar Bal
We describe the imaging features of a metastatic superscan on gallium-68 Glu-NH-CO-NH-Lys-(Ahx)-[Ga-68(HBED-CC)], abbreviated as gallium-68-prostate-specific membrane antigen ((68)Ga-PSMA) positron emission tomography/computed tomography (PET/CT) imaging. (68)Ga-PSMA is novel radiotracer undergoing evaluation for PET/CT imaging of prostate carcinoma. This patient had a superscan of metastases on conventional bone scintigraphy and was referred for (68)Ga-PSMA PET/CT to evaluate the feasibility of (177)Lu-PSMA therapy...
April 2016: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
Matthias Eiber, Gregor Weirich, Konstantin Holzapfel, Michael Souvatzoglou, Bernhard Haller, Isabel Rauscher, Ambros J Beer, Hans-Jürgen Wester, Juergen Gschwend, Markus Schwaiger, Tobias Maurer
BACKGROUND: Ligands of the prostate-specific membrane antigen (PSMA) show promising results in positron emission tomography (PET) imaging of prostate cancer (PCa). OBJECTIVE: To compare the diagnostic performance of simultaneous gallium 68 ((68)Ga)-PSMA HBED-CC PET/magnetic resonance imaging (MRI) for localization of primary PCa with multiparametric magnetic resonance imaging (mpMRI) and PET alone. DESIGN, SETTING, AND PARTICIPANTS: We performed (68)Ga-PSMA HBED-CC PET/MRI in 66 men with biopsy-proven PCa...
November 2016: European Urology
Bhavan Prasad Rai, Richard Paul Baum, Amit Patel, Robert Hughes, Roberto Alonzi, Tim Lane, Jim Adshead, Nikhil Vasdev
The role of positron emission tomography (PET) with (68)Gallium (Ga)-labeled prostate-specific membrane antigen (PSMA) imaging for prostate cancer is gaining prominence. Current imaging strategies, despite having progressed significantly, have limitations, in particular their ability to diagnose metastatic lymph node involvement. Preliminary results of PET with (68)Ga-labeled PSMA have shown encouraging results, particularly in the recurrent prostate cancer setting. Furthermore, the ability of PET with (68)Ga-labeled PSMA of playing a dual diagnostic and therapeutic setting (theranostics) is currently being investigated as well...
September 2016: Urology
Tobias Maurer, Jürgen E Gschwend, Isabel Rauscher, Michael Souvatzoglou, Bernhard Haller, Gregor Weirich, Hans-Jürgen Wester, Matthias Heck, Hubert Kübler, Ambros J Beer, Markus Schwaiger, Matthias Eiber
PURPOSE: Current standard imaging techniques are insufficient to reliably detect lymph node metastases in prostate cancer. Recently ligands of PSMA (prostate specific membrane antigen) were introduced in PET (positron emission tomography) of prostate cancer. Thus the aims of this retrospective analysis were to 1) investigate the diagnostic efficacy of (68)Ga-PSMA-PET imaging for lymph node staging in patients with prostate cancer scheduled for radical prostatectomy and 2) compare it to morphological imaging (computerized tomography and magnetic resonance tomography) with histopathological evaluation as the standard of reference...
May 2016: Journal of Urology
W Phillip Law, Frank Fiumara, William Fong, Kenneth A Miles
Gallium-68 (Ga-68) labelled prostate-specific membrane antigen (PSMA) imaging by positron emission tomography (PET) has emerged as a promising tool for staging of prostate cancer and restaging of disease in recurrence or biochemical failure after definitive treatment of prostate cancer. Ga-68 PSMA PET produces high target-to-background images of prostate cancer and its metastases which are reflective of the significant overexpression of PSMA in these cells and greatly facilitates tumour detection. However, relatively little is known about the PSMA expression of benign neoplasms and non-prostate epithelial malignancies...
August 2016: Journal of Medical Imaging and Radiation Oncology
Thomas Ebenhan, Mariza Vorster, Biljana Marjanovic-Painter, Judith Wagener, Janine Suthiram, Moshe Modiselle, Brenda Mokaleng, Jan Rijn Zeevaart, Mike Sathekge
Prostate-specific membrane antigen (PSMA), a type II glycoprotein, is highly expressed in almost all prostate cancers. By playing such a universal role in the disease, PSMA provides a target for diagnostic imaging of prostate cancer using positron emission tomography/computed tomography (PET/CT). The PSMA-targeting ligand Glu-NH-CO-NH-Lys-(Ahx)-HBED-CC (DKFZ-PSMA-11) has superior imaging properties and allows for highly-specific complexation of the generator-based radioisotope Gallium-68 ((68)Ga). However, only module-based radiolabeling procedures are currently available...
August 14, 2015: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
Lars Budäus, Sami-Ramzi Leyh-Bannurah, Georg Salomon, Uwe Michl, Hans Heinzer, Hartwig Huland, Markus Graefen, Thomas Steuber, Clemens Rosenbaum
UNLABELLED: Prostate-specific membrane antigen (PSMA) overexpression theoretically enables targeting of prostate cancer (PCa) metastases using gallium Ga 68 ((68)Ga)-labeled PSMA ligands for positron emission tomography/computed tomography (PET/CT) imaging. Promising detection rates have been reported when using this approach for functional imaging of recurrent PCa; however, until now, the diagnostic accuracy of (68)Ga-PSMA PET/CT for preoperatively identifying lymph node metastases (LNMs) had not been assessed...
March 2016: European Urology
Martina Weineisen, Jakub Simecek, Margret Schottelius, Markus Schwaiger, Hans-Jürgen Wester
BACKGROUND: Due to its high expression in prostate cancer, PSMA (prostate-specific membrane antigen) represents an ideal target for both diagnostic imaging and endoradiotherapeutic approaches. Based on a previously published highly specific PSMA ligand ([(68)Ga]DOTA-FFK(Sub-KuE)), we developed a corresponding metabolically stable 1,4,7,10-tetraazacyclododececane,1-(glutaric acid)-4,7,10-triacetic acid (DOTAGA) construct for theranostic treatment of prostate cancer. METHODS: All ligands were synthesized by a combined solid phase and solution phase synthesis strategy...
December 2014: EJNMMI Research
Joshua J Morigi, Phillip D Stricker, Pim J van Leeuwen, Reuben Tang, Bao Ho, Quoc Nguyen, George Hruby, Gerald Fogarty, Raj Jagavkar, Andrew Kneebone, Adam Hickey, Stefano Fanti, Lisa Tarlinton, Louise Emmett
UNLABELLED: In prostate cancer with biochemical failure after therapy, current imaging techniques have a low detection rate at the prostate-specific antigen (PSA) levels at which targeted salvage therapy is effective. (11)C-choline and (18)F-fluoromethylcholine, though widely used, have poor sensitivity at low PSA levels. (68)Ga-PSMA (Glu-NH-CO-NH-Lys-(Ahx)-[(68)Ga-N,N'-bis[2-hydroxy-5-(carboxyethyl)benzyl]ethylenediamine-N,N'-diacetic acid]) has shown promising results in retrospective trials...
August 2015: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Martina Weineisen, Margret Schottelius, Jakub Simecek, Richard P Baum, Akin Yildiz, Seval Beykan, Harshad R Kulkarni, Michael Lassmann, Ingo Klette, Matthias Eiber, Markus Schwaiger, Hans-Jürgen Wester
UNLABELLED: On the basis of the high and consistent expression of prostate-specific membrane antigen (PSMA) in metastatic prostate cancer (PC), the goal of this study was the development, preclinical evaluation, and first proof-of-concept investigation of a PSMA inhibitor for imaging and therapy (PSMA I&T) for (68)Ga-based PET and (177)Lu-based endoradiotherapeutic treatment in patients with metastatic and castration-resistant disease. METHODS: PSMA I&T was synthesized in a combined solid phase and solution chemistry strategy...
August 2015: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Markus Dietlein, Carsten Kobe, Georg Kuhnert, Simone Stockter, Thomas Fischer, Klaus Schomäcker, Matthias Schmidt, Felix Dietlein, Boris D Zlatopolskiy, Philipp Krapf, Raphael Richarz, Stephan Neubauer, Alexander Drzezga, Bernd Neumaier
PURPOSE: Gallium-68 (Ga-68)-labeled tracers for imaging expression of the prostate-specific membrane antigen (PSMA) such as the [(68)Ga]Ga-PSMA-HBED-CC have already demonstrated high potential for the detection of recurrent prostate cancer. However, compared to Ga-68, a labeling with fluorine-18 (F-18) would offer advantages with respect to availability, production amount, and image resolution. [(18)F]DCFPyL is a promising F-18-labeled candidate for PSMA-positron emission tomography (PET) imaging that has been recently introduced...
August 2015: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
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