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

Eur J Nucl Med Mol Imaging. 2016 Aug;43(9):1611-20. doi: 10.1007/s00259-016-3419-0. Epub 2016 Jun 3.

Abstract

Purpose: The clinical introduction of (68)Ga-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 (68)Ga-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 (68)Ga-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 (68)Ga-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 (68)Ga-PSMA-11 PET is 0.023 mSv/MBq. A 3-h delay after injection was optimal timing for (68)Ga-PSMA-11 PET/CT in this patient cohort.

Keywords: Dosimetry; HBED-CC; PET/CT; PSMA-11; Prostate cancer; Prostate-specific membrane antigen.

MeSH terms

  • Aged
  • Edetic Acid / analogs & derivatives*
  • Humans
  • Male
  • Middle Aged
  • Oligopeptides*
  • Positron Emission Tomography Computed Tomography / methods*
  • Prostatic Neoplasms / diagnostic imaging*
  • Radiometry
  • Recurrence
  • Retrospective Studies
  • Time Factors
  • Whole Body Imaging

Substances

  • Oligopeptides
  • gallium 68 PSMA-11
  • Edetic Acid