SNMMI: What a New Meta-Analysis Reveals About Radiotracers for PET/CT Detection of PCa
While (68Ga)Ga-PSMA-11 offers a pooled sensitivity rate of 92 percent for prostate cancer, (18F)-based radiotracers may offer enhanced lesion detection as well as improved imaging flexibility, according to a meta-analysis presented at the Society for Nuclear Medicine and Molecular Imaging (SNMMI) conference.
In a new meta-analysis of PSMA PET/CT radiotracers, researchers point out the robust validation of (68Ga)Ga-PSMA-11 for prostate cancer (PCa) detection and acknowledge the unique attributes of the emerging (18F)-based radiotracers (18F)PSMA-1007 and (18F)DCFPyL.
For the meta-analysis, recently presented at the Society for Nuclear Medicine and Molecular Imaging (SNMMI) conference, researchers reviewed data from 34 studies and a total of 5,102 patients.
The meta-analysis authors found that (68Ga)Ga-PSMA-11 (Illuccix, Telix Pharmaceuticals) provided pooled sensitivity and specificity rates of 92 percent and 90 percent, respectively, as well as an 81 percent pooled detection rate (DR).
In a new meta-analysis comparing radiotracers for PET/CT prostate cancer detection, researchers at the SNMMI conference noted robust validation for (68Ga)Ga-PSMA-11 and found the highest pooled sensitivity and detection rates for (18F)DCFPyL.
“Its rapid renal clearance improves imaging contrast and reduces nonspecific uptake, aiding systemic disease and metastasis detection,” noted lead meta-analysis author Fereshteh Yazdanpanah, M.D., MBA, a postdoctoral research fellow affiliated with the Hospital of the University of Pennsylvania, and colleagues.
However, for patients with prostate-specific antigen (PSA) levels < 0.5 ng/mL, the researchers pointed out a 16 percent higher DR for (18F)PSMA-1007 in comparison to (68Ga)Ga-PSMA-11 (84 percent vs. 68 percent).
“(The) predominantly hepatobiliary clearance (of (18F)PSMA-1007) reduces urinary excretion, improving pelvic lesion visualization, while higher SUVmax enhances nodal and micrometastatic detection,” explained Yazdanpanah and colleagues.
(Editor’s note: For additional content from the 2025 SNMMI conference, click here.)
However, the meta-analysis authors acknowledged that limitations with (18F)PSMA-1007 include the potential for false positives due to high benign bone uptake as well as higher uptake in the coeliac ganglia that can be mistaken for lymph node metastases.
The (18F)DCFPyL radiotracer (Pylarify, Lantheus) provided an overall pooled DR of 88.8 percent as well as a DR of 94.3 percent for PCa in patients with PSA levels > 0.5 ng/mL, according to the meta-analysis. The researchers noted that (18F)DCFPyL provides “significantly lower kidney uptake” than (68Ga)Ga-PSMA-11 and better specificity than (18F)PSMA-1007.
“(The) longer half-life (110 minutes) and higher positron yield (of (18F)DCFPyL) reduce image noise and enable delayed imaging protocols, making it particularly advantageous for centers without on-site gallium generators,” added Yazdanpanah and colleagues.
Reference
- Yazdanpanah F, Mhana SAA, Werner T, Alavi A, Revheim MER. Comparison of (18F)PSMA-1007, (18F)DCFPyL, and (68Ga)Ga-PSMA-11 in PET/CT imaging for prostate cancer: a systematic review and meta-analysis. Presented at the Society for Nuclear Medicine and Molecular Imaging (SNMMI) conference June 21-24, 2025, New Orleans, La. Available at: https://www.xcdsystem.com/snmmi/program/B95p18u/index.cfm?pgid=2402&sid=47321 .
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