Comparison of 18F-FDG, 68Ga-PSMA-11 and 18F-PSMA-1007 in PET for prostate cancer

Abstract

Prostate cancer is the second most incident neoplasm in men, except for non-melanoma skin cancer, and has the second highest mortality rate in Brazil. Early diagnosis increases the chances of cure and enables a less aggressive treatment for the patient. Nuclear Medicine presents effective alternatives for prostate cancer diagnosis, such as Positron Emission Tomography (PET) or PET and Computed Tomography (PET/CT) imaging. The aim of this study is to compare the advantages and disadvantages of the radiopharmaceuticals 18F-FDG, 68Ga-PSMA-11 and 18F-PSMA-1007 used for PET or PET/CT in the diagnosis of this type of cancer. Compared to 18F-FDG, 68Ga-PSMA-11 has some advantages such as its availability by means of generators, the independent production of a cyclotron facility and its theranostic potential. The disadvantages compared to 18F-FDG are the scalability of 18F-FDG production compared to limited generator production. Despite its favorable characteristics, the radiopharmaceutical 18F-FDG has limitations in the diagnosis of some types of tumors, such as prostate cancer. The recently studied radiopharmaceutical 18F-PSMA-1007 has shown potential in the identification of small lesions in cases of prostate cancer and local recurrence. All the favorable and unfavorable aspects of these three radiopharmaceuticals are presented in this work.