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- Title
Gallium-68 prostate-specific membrane antigen ([<sup>68</sup>Ga]Ga-PSMA-11) PET for imaging of thyroid cancer: a feasibility study.
- Authors
Lawhn-Heath, Courtney; Yom, Sue S.; Liu, Chienying; Villanueva-Meyer, Javier E.; Aslam, Maya; Smith, Raven; Narwal, Manpreet; Juarez, Roxanna; Behr, Spencer C.; Pampaloni, Miguel Hernandez; Chan, Jason W.; Glastonbury, Christine M.; Hope, Thomas A.; Flavell, Robert R.
- Abstract
Background: Prostate-specific membrane antigen (PSMA) is expressed in the microvasculature of thyroid cancer. This suggests the potential use of PSMA as a diagnostic agent in patients with aggressive forms of thyroid cancer. The purpose of the current study was to determine the feasibility and utility of [68Ga]Ga-PSMA-11 PET/MRI in thyroid cancer patients. Methods: Eligible patients for this prospective pilot study were adults with a history of pathology-proven thyroid cancer who had abnormal radiotracer uptake on an 2-[18F]FDG PET and/or 131I scintigraphy performed in the 12 months prior to study enrollment. Patients underwent a [68Ga]Ga-PSMA-11 PET/MRI, and comparison was made to the prior qualifying 2-[18F]FDG PET CT/MRI for lesion location and relative intensity. Results: Twelve patients underwent [68Ga]Ga-PSMA-11 PET/MRI, one of which was excluded from analysis due to debulking surgery prior to the PSMA PET. Of the remaining patients, 7/11 had differentiated disease (3 papillary, 2 follicular, 2 Hurthle cell) and 4/11 had dedifferentiated disease (2 poorly differentiated papillary, 2 anaplastic). Out of 43 lesions, 41 were visually 2-[18F]FDG positive (uptake greater than background, detection rate 95.3%) and 28 were PSMA positive (uptake greater than background, detection rate 65.1%). Uptake was heterogeneous between patients, and in some cases within patients. 3/11 patients (1 poorly differentiated papillary, 2 follicular) had PSMA uptake which was greater than FDG uptake. For the remaining 8 patients, 2-[18F]FDG uptake was greater than PSMA. Using one eligibility guideline in the prostate cancer literature for PSMA radioligand therapy (RLT), 8/11 could be considered eligible for possible future PSMA RLT. This was not predictable based on thyroid cancer subtype. Conclusions: [68Ga]Ga-PSMA-11 PET demonstrated lower detection rate when compared to 2-[18F]FDG PET for thyroid cancer lesion visualization. Thyroid cancer subtype alone may not be sufficient to predict PSMA uptake, and radiotracer uptake may vary between patients and even within patients.
- Subjects
THYROID cancer; PROSTATE-specific membrane antigen; FEASIBILITY studies; RADIONUCLIDE imaging; CANCER patients; POSITRON emission tomography
- Publication
EJNMMI Research, 2020, Vol 10, Issue 1, pN.PAG
- ISSN
2191-219X
- Publication type
Article
- DOI
10.1186/s13550-020-00720-3