RESTON, Va. - An Italian study featured in the March issue of The Journal of Nuclear Medicine demonstrates that a novel nuclear medicine imaging agent targeting copper accumulation in tumors can detect prostate cancer recurrence early in patients with biochemical relapse (rising prostate-specific antigen [PSA] level).
Copper tends to be more concentrated in tumors, making it a good imaging biomarker. For this study of 50 patients, researchers conducted PET/CT scans comparing the new imaging agent, copper-64 chloride ( 64 CuCl 2 ), with fluorine-18-choline ( 18 F-Choline). Multiparametric magnetic resonance imaging (mpMRI) was also conducted. In addition to calculating the detection rate of each imaging modality, the biodistribution, kinetics of the lesions and radiation dosimetry of 64 CuCl 2 were evaluated.
"This is the first time this novel agent has been compared with 18 F-Choline-PET/CT in a considerable number of prostate cancer patients with biochemical relapse," explains Arnoldo Piccardo, of E.O. Ospedali Galliera in Genoa, Italy. He points out, "Early detection of prostate cancer relapse may improve the clinical management of patients, for example implementing early salvage radiotherapy."
The effective dose of 64 CuCl 2 was determined to be 5.7 mSv, similar to those of other established PET tracers (although higher than for 18 F-Choline, which is 4 mSv). Unlike 18 F-Choline, 64 CuCl 2 is neither accumulated in, nor excreted from, the urinary tract (main uptake is in the liver); this allows for thorough pelvic assessment, increasing the possibility of identifying small lesions close to the bladder. No adverse reactions were observed after the injection of 64 CuCl 2 , and results show that 64 CuCl 2 -PET/CT has a higher detection rate than 18 F-Choline-PET/CT in patients with low levels of PSA (<1 ng/ml).
"This study determined that the biodistribution of 64 CuCl 2 is more suitable than that of 18 F-Choline for exploring the pelvis and prostatic bed," says Piccardo. "In patients with biochemical relapse and a low PSA level, 64 CuCl 2 -PET/CT shows a significantly higher detection rate than 18 F-Choline-PET/CT." He reports, "Larger trials with this PET tracer are expected to further define its capabilities and role in the management of prostate cancer."
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Authors of " 64 CuCl 2 PET/CT in Prostate Cancer Relapse" include Arnoldo Piccardo (1), Francesco Paparo, Matteo Puntoni, Sergio Righi, Gianluca Bottoni, Lorenzo Bacigalupo, Silvia Zanardi, Andrea DeCensi, Giulia Ferrarazzo, Monica Gambaro, Filippo Grillo Ruggieri, Fabio Campodonico, Simona Sola, and Manlio Cabria, E.O. Galliera Hospital, Genoa, Italy; Laura Tomasello, IRCCS San Martino IST, University of Genoa, Genoa, Italy; Luca Timossi, E.O. Evangelico Internazionale Hospital, Genoa, Italy; and Egesta Lopci, Humanitas Research Hospital, Milano, Italy.
Please visit the SNMMI Media Center to view the PDF of the study, including images, and more information about molecular imaging and personalized medicine. To schedule an interview with the researchers, please contact Laurie Callahan at (703) 652-6773 or lcallahan@snmmi.org . Current and past issues of The Journal of Nuclear Medicine can be found online at http://jnm.snmjournals.org .
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Journal of Nuclear Medicine