68Ga–Prostate-Specific Membrane Antigen-11 PET/CT

Clinical Nuclear Medicine - Tập 45 Số 1 - Trang 11-18 - 2020
Jolanta Kunikowska1, Radosław Kuliński1, Kristoff Muylle2, Henryk Koziara3, Leszek Królicki1
1Nuclear Medicine Department, Medical University of Warsaw, Poland
2Department of Nuclear Medicine, University Hospital Brussels (UZ Brussel, VUB), Brussels, Belgium.
3Department of Neurosurgery, The Maria Skłodowska-Curie Memorial Cancer Center and Institute, Warsaw, Poland.

Tóm tắt

Background

Glioblastoma multiforme (GBM) is the most common and most aggressive primary tumor of the brain. After initial therapy and total resection of GBM, 80% to 90% of recurrences occur at the surgical margins. Currently, limited data are available in the literature on the possible use of 68Ga–prostate-specific membrane antigen (PSMA-11) for diagnosis of recurrence in GBM patients. The aim was to assess the feasibility and potential of 68Ga-PSMA-11 PET/CT as a diagnostic procedure in patients with histologically confirmed of GBM and suspected recurrent disease on MRI.

Results

No radiopharmaceutical-related adverse events were noted. Characterization of recurrent disease with MRI included T2-weighted fast spin-echo images, fluid-attenuated inversion recovery and diffusion-weighted imaging sequences, and gadolinium enhanced T1-weighted images. Visual interpretation of PET showed increased accumulation of 68Ga-PSMA-11 in recurrent lesion detected by T1 contrast enhanced and diffusion-weighted imaging images in all patients with a median SUVmax of the tumor of 6.5 and an SUVmean of 3.5. The median tumor-to-background brain ratio and tumor-to-liver ratio obtained from 68Ga-PSMA-11 PET/CT were 96.7 and 0.8, respectively.

Conclusions

The extremely low background uptake in normal brain tissue and consequently high tumor-to-brain ratio make 68Ga-PSMA-11 PET/CT highly promising for diagnosis of recurrent disease in GBM patients. Although PSMA expression in recurrent GBM also opens a potential way for targeted peptide therapy with α/β-emitters as well as for prediction of treatment with antiangiogenic agents, the low tumor-to-liver ratio observed in the majority of patients in this study suggests a limited role of radiolabeled PSMA ligands for targeted radionuclide therapy of recurrent GBM.

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