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PSMA Gallium

Sangeeta Taneja, Amarnath Jena, Rajesh Taneja, Aru Singh, Aashim Ahuja
OBJECTIVE: The purpose of this study is to assess whether temporal changes in68 Ga-prostate-specific membrane antigen (PSMA)-HBED-CC uptake and multiparametric MRI parameters derived using PET/MRI can aid in characterization of benign and malignant prostate lesions. MATERIALS AND METHODS: Thirty-five men with 29 malignant and six benign prostate lesions undergoing complete clinical workup including histologic analysis were enrolled for this retrospective study. All had undergone simultaneous whole-body68 Ga-PSMAHBED-CC PET/MRI...
March 12, 2018: AJR. American Journal of Roentgenology
Shelvin Kumar Vadi, Rajender Kumar, Bhagwant Rai Mittal, Harmandeep Singh, Shrawan Kumar Singh
Gallium-prostate-specific membrane antigen (Ga-PSMA) is well established in the imaging of prostate cancer (PC). Here, we report a case of castration-resistant PC who underwent Ga-PSMA PET/CT for recurrence evaluation, which revealed metastatic lesions in distant lymph nodes and additionally an unusual metastatic deposit in the inguinal canal. The second Ga-PSMA PET/CT done after oral hormonal therapy yielded a favorable response. This pattern of distant metastatic spread is a rare presentation of PC, and PSMA PET/CT revealed the unusual metastasis in the inguinal canal with a timely therapy culminating in favorable disease response...
February 21, 2018: Clinical Nuclear Medicine
Shelvin Kumar Vadi, Rajender Kumar, Bhagwant Rai Mittal, Ashwin Singh Parihar, Shrawan Kumar Singh
An 85-year-old man with prostate cancer for metastatic workup underwent Gallium Prostate-Specific Membrane Antigen (Ga-PSMA) PET/CT (Ga-PSMA PET/CT), which revealed unusual tracer uptake in the shaft and glans of penis as well as multiple systemic metastases in liver, skeletal, and lymph nodes. The penile lesion was proved to be metastatic adenocarcinoma from prostate on fine needle aspiration cytology. The patient underwent Lutetium (Lu)-labeled PSMA radioligand therapy, which also revealed diffuse tracer uptake in the penile shaft as well as other metastatic sites...
February 21, 2018: Clinical Nuclear Medicine
Nat P Lenzo, Danielle Meyrick, J Harvey Turner
Over 90% of prostate cancers over-express prostate specific membrane antigen (PSMA) and these tumor cells may be accurately targeted for diagnosis by 68 Ga-PSMA-positron emission tomography/computed tomography ( 68 Ga-PSMA-PET/CT) imaging. This novel molecular imaging modality appears clinically to have superseded CT, and appears superior to MR imaging, for the detection of metastatic disease. 68 Ga-PSMA PET/CT has the ability to reliably stage prostate cancer at presentation and can help inform an optimal treatment approach...
February 11, 2018: Diagnostics
Koramadai Karuppusamy Kamaleshwaran, Barani Kumar Pollachi Balasundararaj, Raghi Jose, Ajit Sugunan Shinto
Gallium-68 prostate-specific membrane antigen positron emission tomography/computed tomography (Ga-68 PSMA PET/CT) is a promising diagnostic tool for patients with prostate cancer. Penile metastasis from prostate cancer is a rare phenomenon that infrequently manifests as malignant priapism. We present a case of 79-year-old patient diagnosed as a case of adenocarcinoma prostate presenting with penile metastases imaged using Ga-68 PSMA PET/CT.
January 2018: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
Christoph Rischpler, Teresa Isabel Beck, Shozo Okamoto, Anna Melissa Schlitter, Karina Knorr, Markus Schwaiger, Jürgen Gschwend, Tobias Maurer, Philipp T Meyer, Matthias Eiber
The study aims to investigate the presence of physiological prostate-specific membrane antigen (PSMA)-ligand uptake on positron-emission-tomography (PET) in cervical, coeliac and sacral ganglia of the sympathetic trunk as a pitfall for lymph node metastases in prostate cancer imaging. Methods: 407 patients who underwent "Glu-NH-CO-NH-Lys" radio-labeled with [68Ga]gallium N,N-bis[2-hydroxy-5-(carboxyethyl)benzyl]ethylenediamine-N,N-diacetic acid (68Ga-PSMA-HBED-CC) PET (combined with a diagnostic computed tomography (CT)) were retrospectively analyzed...
January 25, 2018: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Michael S Hofman, Rodney J Hicks, Tobias Maurer, Matthias Eiber
Prostate-specific membrane antigen (PSMA) is a transmembrane glycoprotein that is overexpressed in prostate cancer. Radiolabeled small molecules that bind with high affinity to its active extracellular center have emerged as a potential new diagnostic standard of reference for prostate cancer, resulting in images with extraordinary tumor-to-background contrast. Currently, gallium 68 (68 Ga)-PSMA-11 (or HBED-PSMA) is the most widely used radiotracer for PSMA positron emission tomography (PET)/computed tomography (CT) or PSMA PET/magnetic resonance (MR) imaging...
January 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Victor Tang, Patrina Campbell, David A Pattison
Lymphangitic carcinomatosis (LC) refers to the rare process of diffuse malignant invasion of the pulmonary lymphatics. We describe the first reported case of LC visualised with Gallium-68 Prostate-Specific Membrane Antigen positron emission tomography (68Ga-PSMA-PET) and its clinical significance in a 53-year-old man with prostate carcinoma. This case highlights the ability of 68Ga-PSMA-PET for prostate carcinoma characterisation and the importance of always considering atypical patterns of metastatic disease...
December 29, 2017: Urology
Jeremie Calais, Wolfgang P Fendler, Ken Herrmann, Matthias Eiber, Francesco Ceci
Purpose: This is a head-to-head comparison between Gallium-68 Prostate Specific Membrane Antigen (68 Ga-PSMA-11) and18 F-Fluciclovine Positron Emission Tomography/Computed Tomography (PET/CT) in a series of 10 patients with prostate cancer (PCa) recurrence. Methods: 288 patients with PCa recurrence were enrolled in a prospective study of68 Ga-PSMA-11 PET/CT imaging for recurrent disease localization (NCT02940262). We retrospectively identified 10 patients who underwent clinical indicated18 F-Fluciclovine PET/CT prior enrollment...
December 14, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Jérémie Calais, Wolfgang P Fendler, Matthias Eiber, Jeannine Gartmann, Fang-I Chu, Nicholas G Nickols, Robert R Reiter, Matthew B Rettig, Leonard S Marks, Thomas E Ahlering, Lynda Huynh, Roger Slavik, Pawan Gupta, Andrew Quon, Martin S Allen-Auerbach, Johannes Czernin, Ken Herrmann
Purpose: In this prospective survey of referring physicians, we investigated whether and how Gallium-68 Prostate Specific Membrane Antigen Positron Emission Tomography/Computed Tomography (PSMA-11 PET/CT) affects the actually implemented management of prostate cancer patients wih biochemical recurrence (BCR). Methods: We conducted a prospective survey of physicians (NCT02940262) who referred 161 patients with prostate cancer BCR (median Prostate Specific Antigen (PSA) value 1.7 ng/ml (range 0.05-202)). Referring physicians completed one questionnaire prior to the scan to indicate the treatment plan without PSMA-11 PET/CT information (Q1; n = 101); one immediately after the scan to denote intended management changes (Q2; n = 101); and one 3 to 6 months later to document the final implemented management (Q3; n = 56)...
December 14, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Elisabeth Eppard, Ana de la Fuente, Martina Benešová, Ambreen Khawar, Ralph A Bundschuh, Florian C Gärtner, Barbara Kreppel, Klaus Kopka, Markus Essler, Frank Rösch
BACKGROUND: Various trivalent radiometals are well suited for labeling of DOTA-conjugated variants of Glu-ureido-based prostate-specific membrane antigen (PSMA) inhibitors. The DOTA-conjugate PSMA-617 has proven high potential in PSMA radioligand therapy (PSMA-RLT) of prostate cancer as well as PET imaging when labeled with lutetium-177 and gallium-68 respectively. Considering the relatively short physical half-life of gallium-68 this positron emitter precludes prolonged acquisition periods, as required for pre-therapeutic dosimetry or intraoperative applications...
2017: Theranostics
Jeremie Calais, Johannes Czernin, Minsong Cao, Amar U Kishan, John V Hegde, Narek Shaverdian, Kiri Sandler, Fang-I Chu, Chris R King, Michael L Steinberg, Isabel Rauscher, Nina-Sophie Schmidt-Hegemann, Thorsten Poeppel, Philipp Hetkamp, Francesco Ceci, Ken Herrmann, Wolfgang P Fendler, Matthias Eiber, Nicholas G Nickols
Target volume delineations for prostate cancer (PCa) salvage radiotherapy (SRT) after radical prostatectomy are usually drawn in the absence of visibly recurrent disease.68 Ga-labeled prostate-specific membrane antigen (PSMA-11) PET/CT detects recurrent PCa with sensitivity superior to standard-of-care imaging at serum prostate-specific antigen (PSA) values low enough to affect target volume delineations for routine SRT. Our objective was to map the recurrence pattern of PCa early biochemical recurrence (BCR) after radical prostatectomy with68 Ga-PSMA-11 PET/CT in patients with serum PSA levels of less than 1 ng/mL, determine how often consensus clinical target volumes (CTVs) based on the Radiation Therapy Oncology Group (RTOG) guidelines cover68 Ga-PSMA-11 PET/CT-defined disease, and assess the potential impact of68 Ga-PSMA-11 PET/CT on SRT...
February 2018: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Michael Chaloupka, Annika Herlemann, Melvin D'Anastasi, Clemens C Cyran, Harun Ilhan, Christian Gratzke, Christian G Stief
Prostate-specific membrane antigen (PSMA) PET has been recently introduced for the diagnosis of patients with metastatic prostate cancer (PCa). Until today, staging of patients with PCa relied mostly on morphologic features, such as size or shape, resulting in low detection rates in disease recurrence. PSMA PET imaging provides molecular information and, in combination with conventional imaging, offers improved sensitivity and specificity. This review discusses the benefits and limitations of PSMA imaging in the setting of primary staging and detection of recurrent disease in comparison with standard-of-care imaging techniques...
November 2017: Urologic Clinics of North America
Maseeh uz Zaman, Nosheen Fatima, Areeba Zaman, Mahwsih Sajid, Unaiza Zaman, Sidra Zaman
Prostate cancer (PC) is the most frequent solid tumor in men and the third most common cause of cancer mortality among men in developed countries. Current imaging modalities like ultrasound (US), computerized tomography (CT), magnetic resonance imaging (MRI) and choline based positron emission (PET) tracing have disappointing sensitivity for detection of nodal metastasis and small tumor recurrence. This poses a diagnostic challenge in staging of intermediate to high risk PC and restaging of patients with biochemical recurrence (PSA >0...
October 26, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
Saima Nawaz, Gregory E D Mullen, Kavitha Sunassee, Jayanta Bordoloi, Philip J Blower, James R Ballinger
BACKGROUND: Labelling proteins with gallium-68 using bifunctional chelators is often problematic because of unsuitably harsh labelling conditions such as low pH or high temperature and may entail post-labelling purification. To determine whether tris(hydroxypyridinone) (THP) bifunctional chelators offer a potential solution to this problem, we have evaluated the labelling and biodistribution of a THP conjugate with a new single-chain antibody against the prostate-specific membrane antigen (PSMA), an attractive target for staging prostate cancer (PCa)...
October 25, 2017: EJNMMI Research
Jaden D Evans, Krishan R Jethwa, Piet Ost, Scott Williams, Eugene D Kwon, Val J Lowe, Brian J Davis
Prostate cancer-specific positron emission tomography (pcPET) has been shown to detect sites of disease recurrence at serum prostate-specific antigen (PSA) levels that are lower than those levels detected by conventional imaging. Commonly used pcPET radiotracers in the setting of biochemical recurrence are reviewed including carbon 11/fludeoxyglucose 18 (F-18) choline, gallium 68/F-18 prostate-specific membrane antigen (PSMA), and F-18 fluciclovine. Review of the literature generally favors PSMA-based agents for the detection of recurrence as a function of low PSA levels...
July 20, 2017: Practical Radiation Oncology
Tobias Maurer, Jürgen E Gschwend, Matthias Eiber
PURPOSE OF REVIEW: With Gallium (Ga)-prostate-specific membrane antigen (PSMA) PET/computed tomography (CT) as emerging imaging technique offering superior detection rates in biochemical recurrent prostate cancer, salvage lymph node dissection has gained increasing interest in localized oligometastatic prostate cancer. Currently, PSMA-targeting small molecules cannot only be linked to positron-emitting isotopes for imaging but also be labelled with γ-radiation emitting isotopes. These modified PSMA agents are evaluated for intraoperative guidance for resection of metastatic lymph nodes...
March 2018: Current Opinion in Urology
Shruti Tulsyan, Chandan J Das, Madhavi Tripathi, Amlesh Seth, Rajeev Kumar, Chandrasekhar Bal
INTRODUCTION: We carried out this study to compare Glu-NH-CO-NH-Lys-(Ahx) [Ga(HBED-CC)] [Ga prostate-specific membrane antigen-11 (PSMA-11)] PET with multiparametric MRI (mpMRI) for the staging of high-risk prostate cancer. PATIENTS AND METHODS: This was a prospective study in which 36 patients with high-risk prostate cancer were included. The criteria for inclusion were biopsy-proven prostate cancer with a serum prostate specific antigen of at least 20 and/or Gleason's score of at least 8...
December 2017: Nuclear Medicine Communications
Ehab Al-Momani, Ina Israel, Samuel Samnick
Imaging prostate-specific membrane antigen (PSMA) using positron emission tomography (PET) has been presented so far as the most sensitive and specific with regard to prostate cancer detection, in particular in high-risk prostate cancer patients. Currently, it mainly features Gallium-68 ((68)Ga) labeled PSMA ligands, notably [(68)Ga]Glu-urea-Lys(Ahx)-HBED-CC ([(68)Ga]-PSMA-11) and [(68)Ga]DOTAGA-FFK (Sub-KuE termed ([(68)Ga]PSMA-I&T). However, (68)Ga has several shortcomings as radionuclide including a short half-life and non-ideal energies...
September 6, 2017: Applied Radiation and Isotopes
Jason Bailey, Morand Piert
PURPOSE OF THE REVIEW: Recently introduced Gallium-68 labeled PSMA-ligands such as HBED-CC ((68)Ga-PSMA) have shown promise for unmet diagnostic needs in prostate cancer. RECENT FINDINGS: (68)Ga-PSMA has demonstrated improved detection rates and specificity for prostate cancer compared to standard imaging approaches. In the setting of primary disease, (68)Ga-PSMA appears to preferentially identify treatment-relevant intermediate and high-risk prostate cancer. There is also a growing evidence that (68)Ga-PSMA positron emission tomography (PET) outperforms alternative conventional imaging methods including choline-based radiotracers for the localization of disease sites at biochemical recurrence, particularly at lower prostate-specific antigen (PSA) levels (< 1 ng/mL)...
September 9, 2017: Current Urology Reports
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