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Evaluation of [18F]PSMA-1007 uptake variability in patients with prostate cancer

Trägårdh, Elin LU orcid ; Larsson, Måns ; Minarik, David LU ; Enqvist, Olof and Edenbrandt, Lars (2025) In Clinical Physiology and Functional Imaging 45(4).
Abstract

Background: The biodistribution of PSMA-ligands is of interest in radionuclide therapy planning. We investigated the variability of [18F]PSMA-1007 uptake in organs at risk and in relation to tumour burden in prostate cancer patients. Methods: A total of 1086 patients who underwent PSMA PET-CT for staging or recurrence of prostate cancer were included. Total lesion volume (TLV) and total lesion uptake (TLU) were calculated from manual segmentations. The mean standardized uptake value (SUVmean) in the organs at risk kidneys, liver, parotid glands and spleen was obtained. Correlations between TLV/TLU and SUVmean in normal tissues were calculated using Spearman rank correlation. SUVmean in normal... (More)

Background: The biodistribution of PSMA-ligands is of interest in radionuclide therapy planning. We investigated the variability of [18F]PSMA-1007 uptake in organs at risk and in relation to tumour burden in prostate cancer patients. Methods: A total of 1086 patients who underwent PSMA PET-CT for staging or recurrence of prostate cancer were included. Total lesion volume (TLV) and total lesion uptake (TLU) were calculated from manual segmentations. The mean standardized uptake value (SUVmean) in the organs at risk kidneys, liver, parotid glands and spleen was obtained. Correlations between TLV/TLU and SUVmean in normal tissues were calculated using Spearman rank correlation. SUVmean in normal tissues was stratified into groups based on TLV. Results: The median (IQR) SUVmean of the kidneys, liver, parotid glands, and spleen was 13.1 (IQR 4.6), 11.8 (4.4), 18.6 (6.8) and 11.3 (5.8), respectively. The median TLV was 3.8 cm3 (9.7) and median TLU was 31.2 cm3 (106.3). There was no significant correlation between TLV or TLU and SUVmean for the liver, parotid glands, or spleen, but a weak negative correlation between TLV/TLU and SUVmean in the kidneys (r = −0.011, p = 0.0005; r = −0.09, p = 0.003). There was a tendency towards a lower SUVmean in the kidneys and parotid glands in patients with a very high TLV. Conclusions: There was a large uptake variability in organs at risk, which demonstrates the need for individual pretherapy dosimetry. There may be a tumour sink effect in the kidneys and parotid glands in patients with a very high TLV.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
PET, tumour sink effect, prostate cancer, PSMA, radioligand therapy, [18F]PSMA−1007
in
Clinical Physiology and Functional Imaging
volume
45
issue
4
article number
e70016
publisher
Wiley-Blackwell
external identifiers
  • scopus:105008230414
  • pmid:40517368
ISSN
1475-0961
DOI
10.1111/cpf.70016
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 The Author(s). Clinical Physiology and Functional Imaging published by John Wiley & Sons Ltd on behalf of Scandinavian Society of Clinical Physiology and Nuclear Medicine.
id
51c544c2-f5e5-403b-a1f2-4361bf4fb98b
date added to LUP
2025-12-15 12:21:18
date last changed
2025-12-16 03:00:14
@article{51c544c2-f5e5-403b-a1f2-4361bf4fb98b,
  abstract     = {{<p>Background: The biodistribution of PSMA-ligands is of interest in radionuclide therapy planning. We investigated the variability of [<sup>18</sup>F]PSMA-1007 uptake in organs at risk and in relation to tumour burden in prostate cancer patients. Methods: A total of 1086 patients who underwent PSMA PET-CT for staging or recurrence of prostate cancer were included. Total lesion volume (TLV) and total lesion uptake (TLU) were calculated from manual segmentations. The mean standardized uptake value (SUV<sub>mean</sub>) in the organs at risk kidneys, liver, parotid glands and spleen was obtained. Correlations between TLV/TLU and SUV<sub>mean</sub> in normal tissues were calculated using Spearman rank correlation. SUV<sub>mean</sub> in normal tissues was stratified into groups based on TLV. Results: The median (IQR) SUV<sub>mean</sub> of the kidneys, liver, parotid glands, and spleen was 13.1 (IQR 4.6), 11.8 (4.4), 18.6 (6.8) and 11.3 (5.8), respectively. The median TLV was 3.8 cm<sup>3</sup> (9.7) and median TLU was 31.2 cm<sup>3</sup> (106.3). There was no significant correlation between TLV or TLU and SUV<sub>mean</sub> for the liver, parotid glands, or spleen, but a weak negative correlation between TLV/TLU and SUV<sub>mean</sub> in the kidneys (r = −0.011, p = 0.0005; r = −0.09, p = 0.003). There was a tendency towards a lower SUV<sub>mean</sub> in the kidneys and parotid glands in patients with a very high TLV. Conclusions: There was a large uptake variability in organs at risk, which demonstrates the need for individual pretherapy dosimetry. There may be a tumour sink effect in the kidneys and parotid glands in patients with a very high TLV.</p>}},
  author       = {{Trägårdh, Elin and Larsson, Måns and Minarik, David and Enqvist, Olof and Edenbrandt, Lars}},
  issn         = {{1475-0961}},
  keywords     = {{PET, tumour sink effect; prostate cancer; PSMA; radioligand therapy; [18F]PSMA−1007}},
  language     = {{eng}},
  number       = {{4}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Clinical Physiology and Functional Imaging}},
  title        = {{Evaluation of [18F]PSMA-1007 uptake variability in patients with prostate cancer}},
  url          = {{http://dx.doi.org/10.1111/cpf.70016}},
  doi          = {{10.1111/cpf.70016}},
  volume       = {{45}},
  year         = {{2025}},
}