ABSTRACT
OBJECTIVE: To assess the feasibility of gallium 68 (Ga)-prostate specific membrane antigen (PSMA) PET/computed tomography (CT) to identify patients who truly harbor clinically significant prostate cancer (PCa) in a cohort of patients with clinical and biochemical/radiological suspicion of PCa. PATIENTS AND METHODS: A total of 118 patients with suspected PCa who underwent Ga-PSMA PET/CT between May 2015 and June 2016 were prospectively included. Final decision on performing biopsy was left to the referring urologist after considering the clinical data, scan findings and discussion with the patient. RESULTS: Overall, 51 patients were scan negative, among whom six underwent biopsy but was negative for malignancy. In 45 patients, an immediate biopsy could be avoided and put on follow-up. None of these patients were documented to have PCa in the short average follow-up of 6 months. Among 67 patients who were scan positive, 56 patients underwent transrectal ultrasonography-guided biopsy, and malignancy could be documented in 46 of them. In addition, comprehensive initial staging information could be obtained in them, with organ-confined disease demonstrated in 33 patients and metastatic disease in 13 patients. CONCLUSION: Ga-PSMA PET/CT can act as a gate keeper in selecting patients with suspected PCa who should undergo an immediate transrectal ultrasonography-guided biopsy and who could be kept on active surveillance.
Subject(s)
Edetic Acid/analogs & derivatives , Oligopeptides , Positron Emission Tomography Computed Tomography , Prostatic Neoplasms/diagnostic imaging , Aged , Aged, 80 and over , Gallium Isotopes , Gallium Radioisotopes , Humans , Image Processing, Computer-Assisted , Image-Guided Biopsy , Male , Middle Aged , Prostatic Neoplasms/pathology , UltrasonographySubject(s)
Lutetium/administration & dosage , Prostatic Neoplasms/radiotherapy , Radiopharmaceuticals/administration & dosage , Antigens, Surface/administration & dosage , Glutamate Carboxypeptidase II/administration & dosage , Humans , Lutetium/therapeutic use , Male , Radioisotopes/administration & dosage , Radiopharmaceuticals/therapeutic useABSTRACT
Lutetium-177 is a widely used therapeutic radionuclide in targeted therapy and it is important to know its specific activity at the time of radiopharmaceutical preparation, especially for radiolabeling peptides. However, there are no direct methods for the experimental determination of the specific activity which can be readily applied in a hospital radiopharmacy. A new technique based on the 'saturation assay' principle using DOTA as the binding agent for the estimation of specific activity of (177)Lu is reported. The studies demonstrate the proof of principle of this new assay technique. The method is general and can be modified and applied for the estimation of specific activity of other metallic radionuclides by using DOTA or other suitable chelating agents.
Subject(s)
Heterocyclic Compounds, 1-Ring/chemistry , Lutetium/chemistry , Radioisotopes/chemistry , Chelating Agents/chemistry , Ligands , Peptides/chemistryABSTRACT
This article presents a concise review of the production of no-carrier-added (NCA) (177)Lu by the 'indirect' route by irradiating ytterbium-176 ((176)Yb)-enriched targets. The success of this production method depends on the ability to separate the microscopic amounts of NCA (177)Lu from bulk irradiated ytterbium targets. The presence of Yb(+3) from the target in the final processed (177)Lu will adversely affect the quality of (177)Lu by decreasing the specific activity and competing with Lu(+3) complexation since ytterbium will follow the same coordination chemistry. Ytterbium and lutetium are adjacent members of the lanthanide family with very similar chemical properties which makes the separation of one from the other a challenging task. This review provides a summary of the methods developed for the separation and purification of NCA (177)Lu from neutron irradiated (176)Yb-enriched targets, a critical assessment of recent developments and a discussion of the current status of this (177)Lu production method.
Subject(s)
Lutetium/chemistry , Radioisotopes/chemistry , Ytterbium/chemistry , Isotopes/chemistry , NeutronsABSTRACT
Lutetium-177 ((177)Lu) is a late entrant into the nuclear medicine therapy arena but is expected to become one of the most widely used therapeutic radionuclides. This paper analyses the reason for the increasing preference of (177)Lu as a therapeutic radionuclide. While the radionuclidic properties favor its use for several therapeutic applications, the potential for large scale production of (177)Lu is also an important aspect for its acceptability as a therapeutic radionuclide. This introductory discussion also summarizes some developing clinical uses and suggested future directions for applications of (177)Lu.
Subject(s)
Lutetium/therapeutic use , Nuclear Medicine/methods , Radioisotopes/therapeutic use , Drug Design , HumansABSTRACT
Vasoactive intestinal peptide (VIP) receptors are expressed abundantly on many types of tumors and, hence, radiolabeled VIP analogues are being explored for tumor imaging and therapy. Here, we report synthesis of three VIP analogues and their radiolabeling with (99m)Tc via a novel tricarbonyl synthon. The radiolabeled product could be prepared in high yields (>95%) and stability. In vitro studies showed significant uptake of (99m)Tc(CO)((3))-VP05 in human colon carcinoma cells. Biodistribution studies in animal tumor model showed 0.4-1%ID/g tumor uptake.
