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J Nucl Med. 2018 Mar;59(3):444-451. doi: 10.2967/jnumed.117.195628. Epub 2017 Sep 8.

64CuCl2 PET/CT in Prostate Cancer Relapse.

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Department of Nuclear Medicine, Galliera Hospital, Genoa, Italy
Department of Radiology, E.O. Galliera Hospital, Genoa, Italy.
Clinical Trial Unit, Office of the Scientific Director, Galliera Hospital, Genoa, Italy.
Medical Physics Department, E.O. Galliera Hospital, Genoa, Italy.
Department of Nuclear Medicine, Galliera Hospital, Genoa, Italy.
Department of Oncology, E.O. Galliera Hospital, Genoa, Italy.
Department of Radiotherapy, E.O. Galliera Hospital, Genoa, Italy.
Department of Urology, E.O. Galliera Hospital, Genoa, Italy.
Department of Oncology, IRCCS San Martino IST, University of Genoa, Genoa, Italy.
Department of Urology, E.O. Evangelico Internazionale Hospital, Genoa, Italy.
Department of Histopathology, E.O. Galliera Hospital, Genoa, Italy; and.
Department of Nuclear Medicine, Humanitas Research Hospital, Milano, Italy.


Our objective was to evaluate the biodistribution, kinetics, and radiation dosimetry of 64CuCl2 in humans and to assess the ability of 64CuCl2 PET/CT to detect prostate cancer (PCa) recurrence in patients with biochemical relapse. Methods: We prospectively evaluated 50 PCa patients with biochemical relapse after surgery or external-beam radiation therapy. All patients underwent 64CuCl2 PET/CT, 18F-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 64CuCl2 were evaluated. Results: From a dosimetric point of view, an administered dose of 200 MBq for 64CuCl2 translated into a 5.7-mSv effective dose. Unlike 18F-choline, 64CuCl2 was not excreted or accumulated in the urinary tract, thus allowing thorough pelvic exploration. The maximum 64CuCl2 uptake at the sites of PCa relapse was observed 1 h after tracer injection. In our cohort, 64CuCl2 PET/CT proved positive in 41 of 50 patients, with an overall DR of 82%. The DRs of 18F-choline PET/CT and multiparametric MRI were 56% and 74%, respectively. The difference between the DRs of 64CuCl2 PET/CT and 18F-choline PET/CT was statistically significant (P < 0.001). Interestingly, on considering prostate-specific antigen (PSA) value, 64CuCl2 PET/CT had a higher DR than 18F-choline PET/CT in patients with a PSA of less than 1 ng/mL. Conclusion: The biodistribution of 64CuCl2 is more suitable than that of 18F-choline for exploring the pelvis and prostatic bed. The 64CuCl2 effective dose is like those of other established PET tracers. In patients with biochemical relapse and a low PSA level, 64CuCl2 PET/CT shows a significantly higher DR than 18F-choline PET/CT.


64CuCl2; PET/CT; dosimetry; elderly; prostate cancer


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