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Radiation dosimetry of 68Ga-PSMA-11 (HBED-CC) and preliminary evaluation of optimal imaging timing

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The clinical introduction of 68Ga-PSMA-11 (“HBED-CC”) ligand targeting the prostate-specific membrane antigen (PSMA) has been regarded as a significant step forward in the diagnosis of prostate cancer (PCa). In this study, we provide human dosimetry and data on optimal timing of PET imaging after injection.

Methods

Four patients with recurrent PCa were referred for 68Ga-PSMA-11 PET/CT. Whole-body PET/CTlow-dose scans were conducted at 5 min, and 1, 2, 3, 4 and 5 h after injection of 152–198 MBq 68Ga-PSMA-11. Organs of moderate to high uptake were used as source organs; their total activity was determined at all measured time points. Time–activity curves were created for each source organ as well as for the remainder. The radiation exposure of a 68Ga-PSMA-11 PET was identified using the OLINDA-EXM software. In addition, tracer uptake was measured in 16 sites of metastases.

Results

The highest tracer uptake was observed in the kidneys, liver, upper large intestine, and the urinary bladder. Mean organ doses were: kidneys 0.262 ± 0.098 mGy/MBq, liver 0.031 ± 0.004 mGy/MBq, upper large intestine 0.054 ± 0.041 mGy/MBq, urinary bladder 0.13 ± 0.059 mGy/MBq. The calculated mean effective dose was 0.023 ± 0.004 mSv/MBq (=0.085 ± 0.015 rem/mCi). Most tumor lesions (n = 16) were visible at 3 h p.i., while at all other time points many were not qualitatively present (10/16 visible at 1 h p.i.).

Conclusions

The mean effective dose of a 68Ga-PSMA-11 PET is 0.023 mSv/MBq. A 3-h delay after injection was optimal timing for 68Ga-PSMA-11 PET/CT in this patient cohort.

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Acknowledgments

We express our gratitude to the Klaus Tschira Foundation (grant no. 00.198.2012) for funding our research. In addition, we would like to thank our staff, in particular Stephanie Biedenstein, Kirsten Kunze, Larissa Engel, and Peter Seybold for their help in performing this analysis.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Heidelberg University Hospital, INF 400, 69120, Heidelberg, Germany

    Ali Afshar-Oromieh, Clemens Kratochwil, Frederik L. Giesel & Uwe Haberkorn

  2. Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center, INF 280, 69120, Heidelberg, Germany

    Ali Afshar-Oromieh & Uwe Haberkorn

  3. Division of Medical Physics in Radiology, German Cancer Research Center, INF 280, 69120, Heidelberg, Germany

    Henrik Hetzheim

  4. Division of Radiation Protection and Dosimetry, German Cancer Research Center, INF 280, 69120, Heidelberg, Germany

    Wolfgang Kübler

  5. Department of Radiology and Biomedical Imaging, University of California, 505 Parnassus Avenue, M-391, Box 0628, San Francisco, CA, 94143, USA

    Thomas A. Hope

  6. Division of Radiopharmaceutical Chemistry, German Cancer Research Center, INF 280, 69120, Heidelberg, Germany

    Matthias Eder, Michael Eisenhut & Klaus Kopka

Authors
  1. Ali Afshar-Oromieh
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Corresponding author

Correspondence to Ali Afshar-Oromieh.

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Funding

This study was funded by the Klaus Tschira Foundation (grant no. 00.198.2012).

Conflict of interest

Ali Afshar-Oromieh has received honoraria from Siemens Healthcare for one educational talk. All other authors declare that they have no conflict of interest.

Ethical approval

All patients published in this manuscript signed a written informed consent form for the purpose of anonymized evaluation and publication of their data. All reported investigations were conducted in accordance with the Helsinki Declaration and with our national regulations (German Medicinal Products Act, AMG §13 2b). This evaluation was approved by the ethics committee of the University of Heidelberg (S-321-2012).

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Supplementary Table 1

SUVs of the background at different times in all four patients. (GIF 78 kb)

High Resolution (TIF 104 kb)

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Afshar-Oromieh, A., Hetzheim, H., Kübler, W. et al. Radiation dosimetry of 68Ga-PSMA-11 (HBED-CC) and preliminary evaluation of optimal imaging timing. Eur J Nucl Med Mol Imaging 43, 1611–1620 (2016). https://doi.org/10.1007/s00259-016-3419-0

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  • DOI: https://doi.org/10.1007/s00259-016-3419-0

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