Nuklearmedizin 2019; 58(02): 151
DOI: 10.1055/s-0039-1683608
Poster
PET und SPECT: Prostata-Karzinom
Georg Thieme Verlag KG Stuttgart · New York

68-Gallium-PSMA-HBED-CC PET/CT imaging for recurrent/metastatic adenoid cystic carcinoma and salivary duct carcinoma

W van Boxtel
1   Radboudumc, Medical Oncology, Nijmegen
,
S Lütje
2   Radboudumc, Radiology and Nuclear Medicine, Nijmegen
,
AC van Engen-van Grunsven
3   Radboudumc, Pathology, Nijmegen
,
GW Verhaegh
4   Radboudumc, Urology, Nijmegen
,
JA Schalken
4   Radboudumc, Urology, Nijmegen
,
MA Jonker
5   Radboudumc, Health evidence, Nijmegen
,
MJ Janssen
2   Radboudumc, Radiology and Nuclear Medicine, Nijmegen
,
J Nagarajah
2   Radboudumc, Radiology and Nuclear Medicine, Nijmegen
,
M Gotthardt
2   Radboudumc, Radiology and Nuclear Medicine, Nijmegen
,
CM van Herpen
1   Radboudumc, Medical Oncology, Nijmegen
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2019 (online)

 
 

    Ziel/Aim:

    Salivary gland cancer (SGC) is a rare cancer with few treatment options. Both adenoid cystic carcinoma (ACC) and salivary duct carcinoma (SDC),the major subtypes of SGC, often show overexpression of the prostate-specific membrane antigen (PSMA). In prostate cancer, PSMA ligands labeled with radioisotopes such as Ga-68 are used for imaging and response prediction to radionuclide therapy. The aim of this study was to evaluate gallium-68-PSMA ligand uptake in patients with locally recurrent and/or metastatic (R/M) ACC and SDC and to establish the diagnostic value of gallium-68-PSMA-PET/CT imaging compared to full-dose CT imaging.

    Methodik/Methods:

    PET/CT imaging was performed at about 1h post injection of 129.0 ± 26.8 MBq of gallium-68-PSMA-HBED-CC in 15 ACC patients and 143.8 ± 44.6 MBq in 10 SDC patients including a diagnostic CT scan of the neck, chest and abdomen. Normal biodistribution and gallium-68-PSMA ligand uptake in local recurrences and metastatic lesions was evaluated. Detected lesions were compared to CT results. Maximum standardized uptake values (SUVmax) were determined.

    Ergebnisse/Results:

    In ACC patients, we found maximum SU-values ranging from 2.5 to 14.9 and a tumor/liver-ratio of 1.28 (SD 0.51, range 0.4 – 2.34). In SDC patients, the PSMA-uptake varied widely between ánd within patients, with maximum SU-values ranges from background level to 16.8 and a tumor/liver-ratio of 0.82 (SD 0.52, range 0.23 – 1.87). In addition, PSMA-PET imaging detected additional bone metastases in 2 ACC patients and additional lymph node metastases in 1 ACC patient which were not detected on a full-dose CT scan. In 1 ACC patient a local recurrence of a vulvar ACC was suspected on CT but PSMA-PET imaging was negative, which turned out to be scar tissue, eventually.

    Schlussfolgerungen/Conclusions:

    PSMA-PET imaging showed good ligand uptake in local recurrences and distant metastases of 53.3% of ACC patients and 20% of SDC patients. Based on the high uptake, these patients may be promising candidates for Lutetium-177-PSMA radioligand therapy in future. Moreover, PSMA-PET imaging has added diagnostic value compared to full-dose CT imaging.


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