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Local recurrence of prostate cancer after primary local therapy presents challenges for urologists and imaging procedures, especially in patients with low prostate-specific antigen (PSA) values. Recently, 68Ga prostate-specific membrane antigen (PSMA)-11 has shown promising detection rates, and is gaining adoption worldwide in clinical routine [1]. However, there are a significant number of patients in whom local recurrence cannot be differentiated from activity by urinary tracer excretion. The use of 18F–PSMA-1007 was recently presented, and showed a delayed renal excretion [2], which may aid clinicians in making meaningful decisions regarding therapy management in these patients. Here we present images of a 74-year-old prostate cancer patient after radical prostatectomy (Gleason score 9) with biochemical recurrence (PSA: 2.1 ng/dl). Images A and B show 68Ga-PSMA-11 PET-CT (A: maximum-intensity projection, MIP; B: fused axial PET-CT image). Arrows show minimal pararectal uptake close to the bladder and the ureter, for which clinical decision making is problematic. Images C and D show 18F–PSMA-1007 PET-CT of the same patient (C: MIP, D: fused axial PET-CT image). Arrows show unequivocal focal uptake representing a local recurrence, with high contrast (maximum standard uptake value: 9.9), with no distracting ureteral or vesical excretion activity. 18F–PSMA-1007 seems to be superior to 68Ga-PSMA-11 in cases of biochemical recurrence and unclear lesions close to the ureter or urinary bladder.
References
Afshar-Oromieh A, Holland-Letz T, Giesel FL, Kratochwil C, Mier W, Haufe S, et al. Diagnostic performance of 68Ga-PSMA-11 (HBED-CC) PET/CT in patients with recurrent prostate cancer: evaluation in 1007 patients. Eur J Nucl Med Mol Imaging. 2017; https://doi.org/10.1007/s00259-017-3711-7.
Giesel FL, Hadaschik B, Cardinale J, Radtke J, Vinsensia M, Lehnert W, et al. F-18 labelled PSMA-1007: biodistribution, radiation dosimetry and histopathological validation of tumor lesions in prostate cancer patients. Eur J Nucl Med Mol Imaging. 2017;44(4):678–88. https://doi.org/10.1007/s00259-016-3573-4.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
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Rahbar, K., Weckesser, M., Ahmadzadehfar, H. et al. Advantage of 18F-PSMA-1007 over 68Ga-PSMA-11 PET imaging for differentiation of local recurrence vs. urinary tracer excretion. Eur J Nucl Med Mol Imaging 45, 1076–1077 (2018). https://doi.org/10.1007/s00259-018-3952-0
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DOI: https://doi.org/10.1007/s00259-018-3952-0