PSMA- and GRPR-Targeted PET: Results from 50 Patients with Biochemically Recurrent Prostate Cancer.

Baratto, Lucia; Song, Hong; Duan, Heying; Hatami, Negin; Bagshaw, Hilary P; Buyyounouski, Mark; Hancock, Steven; Shah, Sumit et al. · J Nucl Med · 2021

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Abstract

Novel radiopharmaceuticals for PET are being evaluated for the diagnosis of biochemical recurrence (BCR) of prostate cancer (PC). We compared the gastrin-releasing peptide receptor-targeting <sup>68</sup>Ga-RM2 with the prostate-specific membrane antigen (PSMA)-targeting <sup>68</sup>Ga-PSMA11 and <sup>18</sup>F-DCFPyL. <b>Methods:</b> Fifty patients underwent both <sup>68</sup>Ga-RM2 PET/MRI and <sup>68</sup>Ga-PSMA11 (<i>n</i> = 23) or <sup>18</sup>F-DCFPyL (<i>n</i> = 27) PET/CT at an interval ranging from 1 to 60 d (mean ± SD, 15.8 ± 17.7 d). SUV<sub>max</sub> was collected for all lesions. <b>Results:</b><sup>68</sup>Ga-RM2 PET was positive in 35 and negative in 15 of the 50 patients. <sup>68</sup>Ga-PSMA11/<sup>18</sup>F-DCFPyL PET was positive in 37 and negative in 13 of the 50 patients. Both scans detected 70 lesions in 32 patients. Forty-three lesions in 18 patients were identified on only 1 scan: <sup>68</sup>Ga-RM2 detected 7 more lesions in 4 patients, whereas <sup>68</sup>Ga-PSMA11/<sup>18</sup>F-DCFPyL detected 36 more lesions in 13 patients. <b>Conclusion:</b><sup>68</sup>Ga-RM2 remains a valuable radiopharmaceutical even when compared with the more widely used <sup>68</sup>Ga-PSMA11/<sup>18</sup>F-DCFPyL in the evaluation of BCR of PC. Larger studies are needed to verify that identifying patients for whom these 2 classes of radiopharmaceuticals are complementary may ultimately allow for personalized medicine.

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