Ga-68-PSMA-PET/CT bei Prostatakarzinom

Zusammenfassung

Prostata-spezifisches Membran-Antigen (PSMA) wird als Zelloberflächenprotein physiologisch in der Prostata exprimiert und kommt bei Prostatakarzinomen in allen Stadien vor. Auch bei kastrationsresistenten Prostatakarzinomen tritt diese Überexpression von PSMA auf. Wegen der Enzym­aktivität von PSMA konnte man spezifische Inhibitoren entwickeln, von denen sich „Small Molecule“-Radiopharmaka ableiten. Durch Kopplung des spezifisch bindenden Motives Glutamat-Harnstoff-Lysin mit dem Chelator HBED-CC, der sehr effektiv Ga-68 komplexiert, steht ein neues Radiopharmakon für die Ga-68-PSMA-PET/CT zur Verfügung. Diese neue Untersuchungsmethode weist nach den ersten Ergebnissen bei Patienten mit Prostatakarzinomen bezüglich der Bildqualität Vorteile gegenüber der Cholin-PET/CT auf. Eine erste Studie zeigte ein kontrastreicheres PET-Signal und höhere diagnostische Treffsicherheit. Die Eigenschaften auch weiterer neuer PSMA-PET-Radiopharmaka lassen eine zunehmende Bedeutung für die Diagnostik in allen Stadien des Prostatakarzinoms erwarten. In Verbindung mit PSMA-Therapie-Radiopharmaka eröffnet sich ein neues Feld der Theragnostik.

Abstract

Prostate-specific membrane antigen (PSMA) is expressed as a cell surface protein physiologically in the prostate and can be found in all stages of prostate cancer. Even in castration-resistant prostate cancers, this overexpression of PSMA occurs. Due to the enzymatic activity of PSMA it was possible develop specific inhibitors from which “small molecule” radiopharmaceuticals were derived. By coupling the specific binding motif glutamate-urea-lysine with the chelator HBED-CC, which complexes Ga-68 very effectively, a new radiopharmaceutical is available for Ga-68-PSMA-PET/CT. According to the first results in patients with prostate carcinoma, this new diagnostic tool exhibited advantages in image quality compared to choline-PET/CT. An initial study demonstrated the higher contrast of the PET signal and an improved diagnostic accuracy. The properties of even further new PSMA PET radiopharmaceuticals can be of increasing importance for the diagnostic work-up of prostate cancer in all stages.

In conjunction with therapeutic PSMA radiopharmaceuticals, a new field of theragnostics is opened.

Schlüsselwörter

PSMA - Prostatakarzinom - PET/CT - Ga-68-Glu-NH-CO-NH-Lys(Ahx)-HBED-CC

Key words

PSMA - prostate cancer - PET/CT - Ga-68-Glu-NH-CO-NH-Lys(Ahx)-HBED-CC

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