TY  - JOUR
A1  - Werner, Rudolf A.
A1  - Derlin, Thorsten
A1  - Lapa, Constantin
A1  - Sheikbahaei, Sara
A1  - Higuchi, Takahiro
A1  - Giesel, Frederik L.
A1  - Behr, Spencer
A1  - Drzezga, Alexander
A1  - Kimura, Hiroyuki
A1  - Buck, Andreas K.
A1  - Bengel, Frank M.
A1  - Pomper, Martin G.
A1  - Gorin, Michael A.
A1  - Rowe, Steven P.
T1  - \(^{18}\)F-labeled, PSMA-targeted radiotracers: leveraging the advantages of radiofluorination for prostate cancer molecular imaging
JF  - Theranostics
N2  - Prostate-specific membrane antigen (PSMA)-targeted PET imaging for prostate cancer with \(^{68}\)Ga-labeled compounds has rapidly become adopted as part of routine clinical care in many parts of the world. However, recent years have witnessed the start of a shift from \(^{68}\)Ga- to \(^{18}\)F-labeled PSMA-targeted compounds. The latter imaging agents have several key advantages, which may lay the groundwork for an even more widespread adoption into the clinic. First, facilitated delivery from distant suppliers expands the availability of PET radiopharmaceuticals in smaller hospitals operating a PET center but lacking the patient volume to justify an onsite \(^{68}\)Ge/\(^{68}\)Ga generator. Thus, such an approach meets the increasing demand for PSMA-targeted PET imaging in areas with lower population density and may even lead to cost-savings compared to in-house production. Moreover, \(^{18}\)F-labeled radiotracers have a higher positron yield and lower positron energy, which in turn decreases image noise, improves contrast resolution, and maximizes the likelihood of detecting subtle lesions. In addition, the longer half-life of 110 min allows for improved delayed imaging protocols and flexibility in study design, which may further increase diagnostic accuracy. Moreover, such compounds can be distributed to sites which are not allowed to produce radiotracers on-site due to regulatory issues or to centers without access to a cyclotron. In light of these advantageous characteristics, \(^{18}\)F-labeled PSMA-targeted PET radiotracers may play an important role in both optimizing this transformative imaging modality and making it widely available. We have aimed to provide a concise overview of emerging \(^{18}\)F-labeled PSMA-targeted radiotracers undergoing active clinical development. Given the wide array of available radiotracers, comparative studies are needed to firmly establish the role of the available \(^{18}\)F-labeled compounds in the field of molecular PCa imaging, preferably in different clinical scenarios.
KW  - Radiofluorine
KW  - prostate-specific membrane antigen
KW  - prostate cancer
KW  - \(^{18}\)F
KW  - PSMA
KW  - \(^{68}\)Ga
KW  - theranostics
KW  - radioligand therapy
Y1  - 2020
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-202559
SN  - 1838-7640
VL  - 10
IS  - 1
ER  - 
TY  - JOUR
A1  - Werner, Rudolf A.
A1  - Andree, Christian
A1  - Javadi, Mehrbod S.
A1  - Lapa, Constantin
A1  - Buck, Andreas K.
A1  - Higuchi, Takahiro
A1  - Pomper, Martin G.
A1  - Gorin, Michael A.
A1  - Rowe, Steven P.
A1  - Pienta, Kenneth J.
T1  - A Voice From the Past: Re-Discovering the Virchow Node with PSMA-targeted \(^{18}\)F-DCFPyL PET Imaging
JF  - Urology - The Gold Journal
N2  - No abstract available.
KW  - 18F-DCFPyL
KW  - PET
KW  - PSMA-PET
KW  - Positron Emission Tomography
KW  - Prostate Cancer
KW  - Virchow Node
Y1  - 2018
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-164632
SN  - 0090-4295
VL  - 117
ER  - 
TY  - JOUR
A1  - Garg, Tushar
A1  - Werner, Rudolf A.
A1  - Chung, Hyun Woo
A1  - Khatri, Wajahat
A1  - Pienta, Kenneth J.
A1  - Pomper, Martin G.
A1  - Gorin, Michael A.
A1  - Saad, Elie
A1  - Rowe, Steven P.
T1  - Association of true positivity with serum prostate-specific antigen levels and other clinical factors in indeterminate PSMA-RADS-3A lesions identified on \(^{18}\)F-DCFPyL PET/CT scans
JF  - Tomography
N2  - The use of prostate-specific membrane antigen targeted PET imaging for the evaluation of prostate cancer has increased significantly in the last couple of decades. When evaluating these imaging findings based on the PSMA reporting and data system version 1.0, which categorize lesions based on their likelihood of prostate cancer involvement, PSMA-RADS-3A lesions are commonly seen, which are indeterminate for the presence of disease. A total of 28 patients with 171 PSMA-RADS-3A lesions on \(^{18}\)F-DCFPyL PET/CT scans from June 2016 to May 2017 who had follow-up cross-sectional imaging over time were included in this study. The PSA levels of patients with PSMA-RADS-3A lesions were categorized into four groups, 0–0.2, 0.2–1, 1–2, and >2 ng/mL. The pre-operative Gleason score of these patients was categorized into two groups, Gleason score < 7 or ≥7. The median age for these patients was 72.5 years (range 59–81). The median PSA value for patients with positive lesions was significantly higher than those with negative lesions (5.8 ng/mL vs. 0.2 ng/mL, p < 0.0001). The lesion positivity rate was significantly higher in patients with PSA > 1 ng/mL (18.2% vs. 81.9%, p < 0.001). On ROC analysis, the highest classification accuracy was seen at PSA ≥ 0.6 ng/mL of 80.12% (95% CI = 73.69–86.16%), and the area under the curve was 71.32% (95% CI = 61.9–80.7%, p < 0.0001). A total of 96.4% (108/112) of patients with positive lesions and 86.4% (51/59) of patients with negative lesions had a PSMA-RADS-4/5 lymph node on the initial \(^{18}\)F-DCFPyL PET/CT scan (p = 0.02). In patients with a Gleason score ≥ 7, the presence of positive PSMA-RADS-3A lesions was higher, compared to negative PSMA-RADS-3A lesions (p = 0.049). Higher PSA levels in patients with PSMA-RADS-3A lesions can point towards the presence of true positivity. PSA levels may be considered in deciding whether to call an indeterminate lesion on PSMA PET.
KW  - prostate cancer
KW  - prostate-specific antigen
KW  - PSMA-RADS
KW  - \(^{18}\)F-DCFPyL PET/CT
KW  - Gleason score
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-290510
SN  - 2379-139X
VL  - 8
IS  - 6
SP  - 2639
EP  - 2647
ER  - 
TY  - JOUR
A1  - Khatri, Wajahat
A1  - Chung, Hyun Woo
A1  - Werner, Rudolf A.
A1  - Leal, Jeffrey P.
A1  - Pienta, Kenneth J.
A1  - Lodge, Martin A.
A1  - Gorin, Michael A.
A1  - Pomper, Martin G.
A1  - Rowe, Steven P.
T1  - Effect of point-spread function reconstruction for indeterminate PSMA-RADS-3A lesions on PSMA-targeted PET imaging of men with prostate cancer
JF  - Diagnostics
N2  - Purpose: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is emerging as an important modality for imaging patients with prostate cancer (PCa). As with any imaging modality, indeterminate findings will arise. The PSMA reporting and data system (PSMA-RADS) version 1.0 codifies indeterminate soft tissue findings with the PSMA-RADS-3A moniker. We investigated the role of point-spread function (PSF) reconstructions on categorization of PSMA-RADS-3A lesions. Methods: This was a post hoc analysis of an institutional review board approved prospective trial. Around 60 min after the administration of 333 MBq (9 mCi) of PSMA-targeted \(^{18}\)F-DCFPyL, patients underwent PET/computed tomography (CT) acquisitions from the mid-thighs to the skull vertex. The PET data were reconstructed with and without PSF. Scans were categorized according to PSMA-RADS version 1.0, and all PSMA-RADS-3A lesions on non-PSF images were re-evaluated to determine if any could be re-categorized as PSMA-RADS-4. The maximum standardized uptake values (SUVs) of the lesions, mean SUVs of blood pool, and the ratios of those values were determined. Results: A total of 171 PSMA-RADS-3A lesions were identified in 30 patients for whom both PSF reconstructions and cross-sectional imaging follow-up were available. A total of 13/171 (7.6%) were re-categorized as PSMA-RADS-4 lesions with PSF reconstructions. A total of 112/171 (65.5%) were found on follow-up to be true positive for PCa, with all 13 of the re-categorized lesions being true positive on follow-up. The lesions that were re-categorized trended towards having higher SUV\(_{max}\)-lesion and SUV\(_{max}\)-lesion/SUV\(_{mean}\)-blood-pool metrics, although these relationships were not statistically significant. Conclusions: The use of PSF reconstructions for \(^{18}\)F-DCFPyL PET can allow the appropriate re-categorization of a small number of indeterminate PSMA-RADS-3A soft tissue lesions as more definitive PSMA-RADS-4 lesions. The routine use of PSF reconstructions for PSMA-targeted PET may be of value at those sites that utilize this technology.
KW  - prostate-specific membrane antigen
KW  - reporting and data system
KW  - positron emission tomography
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-236528
SN  - 2075-4418
VL  - 11
IS  - 4
ER  - 
TY  - JOUR
A1  - Werner, Rudolf A.
A1  - Habacha, Bilêl
A1  - Lütje, Susanne
A1  - Bundschuh, Lena
A1  - Higuchi, Takahiro
A1  - Hartrampf, Philipp
A1  - Serfling, Sebastian E.
A1  - Derlin, Thorsten
A1  - Lapa, Constantin
A1  - Buck, Andreas K.
A1  - Essler, Markus
A1  - Pienta, Kenneth J.
A1  - Eisenberger, Mario A.
A1  - Markowski, Mark C.
A1  - Shinehouse, Laura
A1  - AbdAllah, Rehab
A1  - Salavati, Ali
A1  - Lodge, Martin A.
A1  - Pomper, Martin G.
A1  - Gorin, Michael A.
A1  - Bundschuh, Ralph A.
A1  - Rowe, Steven P.
T1  - High SUVs Have More Robust Repeatability in Patients with Metastatic Prostate Cancer: Results from a Prospective Test-Retest Cohort Imaged with \(^{18}\)F-DCFPyL
JF  - Molecular Imaging
N2  - No abstract available.
KW  - SUV
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-300748
VL  - 2022
ER  - 
TY  - JOUR
A1  - Werner, Rudolf A.
A1  - Bundschuh, Ralph A.
A1  - Bundschuh, Lena
A1  - Javadi, Mehrbod S.
A1  - Higuchi, Takahiro
A1  - Weich, Alexander
A1  - Sheikhbahaei, Sara
A1  - Pienta, Kenneth J.
A1  - Buck, Andreas K.
A1  - Pomper, Martin G.
A1  - Gorin, Michael A.
A1  - Lapa, Constantin
A1  - Rowe, Steven P.
T1  - MI-RADS: Molecular Imaging Reporting and Data Systems – A Generalizable Framework for Targeted Radiotracers with Theranostic Implications
JF  - Annals of Nuclear Medicine
N2  - Both prostate-specific membrane antigen (PSMA)- and somatostatin receptor (SSTR)-targeted positron emission tomography (PET) imaging agents for staging and restaging of prostate carcinoma or neuroendocrine tumors, respectively, are seeing rapidly expanding use. In addition to diagnostic applications, both classes of radiotracers can be used to triage patients for theranostic endoradiotherapy. While interpreting PSMA- or SSTR-targeted PET/computed tomography (CT) scans, the reader has to be aware of certain pitfalls. Adding to the complexity of the interpretation of those imaging agents, both normal biodistribution, and also false-positive and -negative findings differ between PSMA- and SSTR-targeted PET radiotracers. Herein summarized under the umbrella term molecular imaging reporting and data systems (MI-RADS), two novel RADS classifications for PSMA- and SSTR-targeted PET imaging are described (PSMA- and SSTR-RADS). Both framework systems may contribute to increase the level of a reader’s confidence and to navigate the imaging interpreter through indeterminate lesions, so that appropriate workup for equivocal findings can be pursued. Notably, PSMA- and SSTR-RADS are structured in a reciprocal fashion, i.e. if the reader is familiar with one system, the other system can readily be applied as well. In the present review we will discuss the most common pitfalls on PSMA- and SSTR-targeted PET/CT, briefly introduce PSMA- and SSTR-RADS, and define a future role of the umbrella framework MI-RADS compared to other harmonization systems.
KW  - PET
KW  - Positronen-Emissions-Tomografie
KW  - prostate cancer
KW  - neuroendocrine tumor
KW  - prostate-specific membrane antigen (PSMA)
KW  - somatostatin receptor (SSTR)
KW  - positron emission tomography
KW  - theranostics
KW  - standardization
KW  - RADS
KW  - reporting and data systems
KW  - personalized medicine
Y1  - 2018
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-166995
SN  - 0914-7187
ER  -