Fluorine-18 PSMA Noninferior to Gallium-68 PSMA for Detecting Prostate Cancer

Fluorine-18 (18F)-labelled prostate-specific membrane antigen (PSMA)-11 is noninferior to gallium-68 (68Ga)-PSMA-11 positron emission tomography (PET)/computed tomography (CT) for detecting prostate cancer, according to a study published online June 8 in European Urology.

Kathia De Man, MD, from Ghent University Hospital in Belgium, and colleagues examined 18F-PSMA-11 in a trial that was powered for noninferiority of 18F-PSMA-11 over 68Ga-PSMA-11 PET/CT in terms of the number of positive PET scans. A total of 82 patients with primary or biochemical recurrence were randomly assigned in a double-blind crossover to receive both 18F-PSMA-11 and 68Ga-PSMA-11. All scans were reviewed and scored by three independent experienced nuclear physicians.

The researchers found that the primary end point was met, with the proportions of positive scans rated by three readers 67/67%, 65/65%, and 73/70 percent for 18F-PSMA-11/68Ga-PSMA-11 PET/CT. For the reference reader, the miPSMA expression score was higher for 18F-PSMA-11 than 68Ga-PSMA-11. Identical estimated sensitivity was seen in follow-up data for both 18F-PSMA-11 and 68Ga-PSMA-11 scans (0.92, 0.83, and 0.92 for the three readers). At the patient level, fair to good agreement was obtained among readers, demonstrated by a Light’s kappa value of 0.59 for both 18F-PSMA-11 and 68Ga-PSMA-11.

18F-PSMA-11 is a good and cost-efficient alternative in the detection and staging of prostate cancer,” the authors write.

Two authors disclosed financial ties to the biopharmaceutical industry.