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Piccardo, Arnoldo; Paparo, Francesco; Puntoni, Matteo; Righi, Sergio; Bottoni, Gianluca; Bacigalupo, Lorenzo; Zanardi, Silvia; DeCensi, Andrea; Ferrarazzo, Giulia; Gambaro, Monica; Ruggieri, Filippo Grillo; Campodonico, Fabio; Tomasello, Laura; Timossi, Luca; Sola, Simona; Lopci, Egesta; Cabria, Manlio
Journal of Nuclear Medicine, 03/2018, Volume: 59, Issue: 3Journal Article
Our objective was to evaluate the biodistribution, kinetics, and radiation dosimetry of CuCl in humans and to assess the ability of CuCl PET/CT to detect prostate cancer (PCa) recurrence in patients with biochemical relapse. We prospectively evaluated 50 PCa patients with biochemical relapse after surgery or external-beam radiation therapy. All patients underwent CuCl PET/CT, F-choline PET/CT, and multiparametric MRI within 15 d of each other. Experienced readers interpreted the images, and the detection rate (DR) of each imaging modality was calculated. Histopathology, when available; clinical or laboratory response; and multidisciplinary follow-up were used to confirm the site of disease. In parallel, biodistribution, kinetics of the lesions, and radiation dosimetry of CuCl were evaluated. From a dosimetric point of view, an administered dose of 200 MBq for CuCl translated into a 5.7-mSv effective dose. Unlike F-choline, CuCl was not excreted or accumulated in the urinary tract, thus allowing thorough pelvic exploration. The maximum CuCl uptake at the sites of PCa relapse was observed 1 h after tracer injection. In our cohort, CuCl PET/CT proved positive in 41 of 50 patients, with an overall DR of 82%. The DRs of F-choline PET/CT and multiparametric MRI were 56% and 74%, respectively. The difference between the DRs of CuCl PET/CT and F-choline PET/CT was statistically significant ( < 0.001). Interestingly, on considering prostate-specific antigen (PSA) value, CuCl PET/CT had a higher DR than F-choline PET/CT in patients with a PSA of less than 1 ng/mL. The biodistribution of CuCl is more suitable than that of F-choline for exploring the pelvis and prostatic bed. The CuCl effective dose is like those of other established PET tracers. In patients with biochemical relapse and a low PSA level, CuCl PET/CT shows a significantly higher DR than F-choline PET/CT.
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