Nuclear medicine communications · 2025
Synthesis and clinical evaluation of cyclotron-produced [ 68 Ga]PSMA-11 and [ 18 F]PSMA-1007 for prostate cancer imaging.
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Ahmad Fadzil Muhammad Fakhrurazi Bin, Rohani Mohd Fazrin Bin Mohd, Onny Muhammad Adib Abdul, Ashhar Zarif, Said Mohamad Aminudin Bin, Mahamood Mazurin, Afinde Nik Muhammad Fitri Nik, Ail Noratikah Mat, Safee Zaitulhusna Md, Razali Nor Idayu, Noor Hamdi, Abdul Aziz Mohd Firdaus, Ali Norsalita, Yaacob Nurul Ain, Abdul Rahman Radziatul Shahirah, Ng Chen Siew, Selvarajoo Tharmasilen
Аннотация
OBJECTIVE: To compare the radiochemical synthesis, stability, and clinical performance of cyclotron-produced [ 18 F]PSMA-1007 and [⁶⁸Ga]PSMA-11 for prostate-specific membrane antigen (PSMA)-targeted PET/computed tomography (CT) imaging in prostate cancer.
METHODS: Six production runs each of [¹⁸F]PSMA-1007 and [⁶⁸Ga]PSMA-11 were conducted using a cyclotron-based system. Radiochemical yield, radiochemical purity, and product stability were evaluated according to European Pharmacopeia standards. Thirty-five patients with prostate cancer underwent dual-tracer PET/CT imaging within 30 days. Images were assessed for lesion detectability, biodistribution, and pitfalls by three independent nuclear medicine physicians using semiquantitative metrics.
RESULTS: [¹⁸F]PSMA-1007 demonstrated substantially higher end-of-synthesis activity (mean: 75.68 GBq) compared with [⁶⁸Ga]PSMA-11 (mean: 1.76 GBq), with both achieving high RCP (>98%) and comparable synthesis durations. Stability testing confirmed [¹⁸F]PSMA-1007 remained radiochemically stable for up to 9 h. Clinically, both tracers showed high concordance in PSMA-avid lesion detection. [¹⁸F]PSMA-1007 exhibited superior contrast in prostate and skeletal lesions because of minimal urinary excretion but also revealed higher rates of benign uptake in ganglia and nonspecific bone sites, leading to increased discordant findings (104 vs. 47 lesions).
CONCLUSION: [¹⁸F]PSMA-1007 provides significant advantages in production scalability and lesion detectability, particularly in skeletal and pelvic regions; however, its higher rate of benign uptake necessitates careful interpretation to avoid false positives. While both tracers are clinically effective, tracer selection should be guided by logistical feasibility, clinical context, and interpretive considerations.
METHODS: Six production runs each of [¹⁸F]PSMA-1007 and [⁶⁸Ga]PSMA-11 were conducted using a cyclotron-based system. Radiochemical yield, radiochemical purity, and product stability were evaluated according to European Pharmacopeia standards. Thirty-five patients with prostate cancer underwent dual-tracer PET/CT imaging within 30 days. Images were assessed for lesion detectability, biodistribution, and pitfalls by three independent nuclear medicine physicians using semiquantitative metrics.
RESULTS: [¹⁸F]PSMA-1007 demonstrated substantially higher end-of-synthesis activity (mean: 75.68 GBq) compared with [⁶⁸Ga]PSMA-11 (mean: 1.76 GBq), with both achieving high RCP (>98%) and comparable synthesis durations. Stability testing confirmed [¹⁸F]PSMA-1007 remained radiochemically stable for up to 9 h. Clinically, both tracers showed high concordance in PSMA-avid lesion detection. [¹⁸F]PSMA-1007 exhibited superior contrast in prostate and skeletal lesions because of minimal urinary excretion but also revealed higher rates of benign uptake in ganglia and nonspecific bone sites, leading to increased discordant findings (104 vs. 47 lesions).
CONCLUSION: [¹⁸F]PSMA-1007 provides significant advantages in production scalability and lesion detectability, particularly in skeletal and pelvic regions; however, its higher rate of benign uptake necessitates careful interpretation to avoid false positives. While both tracers are clinically effective, tracer selection should be guided by logistical feasibility, clinical context, and interpretive considerations.
Предметные рубрики MeSH
MaleHumansProstatic NeoplasmsGallium RadioisotopesPositron Emission Tomography Computed TomographyOligopeptidesCyclotronsGallium IsotopesFluorine RadioisotopesAgedMiddle AgedRadiochemistryChemistry Techniques, SyntheticTissue DistributionHeterocyclic Compounds, 1-RingGlutaratesNiacinamidePhosphinic Acids