68Ga-PSMA Cerenkov luminescence imaging in primary prostate cancer: first-in-man series

Judith olde Heuvel*, Berlinda J. de Wit-van der Veen, Henk G. van der Poel, Elise M. Bekers, Maarten R. Grootendorst, Kunal N. Vyas, Cornelis H. Slump, Marcel P.M. Stokkel

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

18 Citations (Scopus)
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Abstract

Purpose: Currently, approximately 11–38% of prostate cancer (PCa) patients undergoing radical prostatectomy have a positive surgical margin (PSM) on histopathology. Cerenkov luminescence imaging (CLI) using 68Ga-prostate-specific membrane antigen (68Ga-PSMA) is a novel technique for intraoperative margin assessment. The aim of this first-in-man study was to investigate the feasibility of intraoperative 68Ga-PSMA CLI. In this study, feasibility was defined as the ability to distinguish between a positive and negative surgical margin, imaging within 45 min and low radiation exposure to staff.

Methods: Six patients were included in this ongoing study. Following perioperative i.v. injection of ~ 100 MBq 68Ga-PSMA, the prostate was excised and immediately imaged ex vivo. Different acquisition protocols were tested, and hotspots on CLI images from the intact prostate were marked for comparison with histopathology.

Results: By using an acquisition protocol with 150 s exposure time, 8 × 8 binning and a 550 nm shortpass filter, PSMs and negative surgical margins (NSMs) were visually correctly identified on CLI in 3 of the 5 patients. Two patients had a hotspot on CLI from cancer ' 0.1 mm from the excision margin.

Conclusion: Overall, the study showed that 68Ga-PSMA CLI is a feasible and low-risk technique for intraoperative margin assessment in PCa. The remaining patients in this ongoing study will be used to assess the diagnostic accuracy of the technique. Trial registration: NL8256 registered at www.trialregister.nl on 04/11/20109.

Original languageEnglish
Pages (from-to)2624-2632
Number of pages9
JournalEuropean journal of nuclear medicine and molecular imaging
Volume47
Issue number11
DOIs
Publication statusPublished - 1 Oct 2020

Keywords

  • 68-Gallium-PSMA intraoperative assessment
  • Cerenkov imaging
  • Positive surgical margin
  • Primary prostate cancer

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