We are very proud of our Ga68PSMA PET, and we believe this is a large step forward in prostate cancer imaging."
Ga68PSMA PET has been shown to be able to pinpoint prostate cancer cells with a high level of accuracy and specificity. However, it is labeled with 68-Gallium instead of the much more common 18-Fluorine. Because the half-life of Gallium-68 is only 68 minutes, the St. Antonius hospital chose to start generating the radioisotope in-house. “We are very proud of our Ga68PSMA PET, and we believe this is a large step forward in prostate cancer imaging,” says Dr. Jules Lavalaye, nuclear medicine physician at the St. Antonius. “The images are overwhelming in clarity, detecting metastases at a very early stage. We are convinced that Ga68PSMA PET will profoundly change diagnostics in prostate cancer, and improve patient outcome.”
To acquire this capability, the hospital incorporated a gallium generator and set up an entirely new labeling procedure in the nuclear medicine department. A Philips PET/CT system is used to acquire the Ga68PSMA PET images. “It was not easy to introduce the gallium generator and labeling procedure into the department,” says Lavalaye, “and it is good to emphasize the effort and investment it takes. Good cooperation with the radiopharmacists and medical physicists was essential in this. The revenue, however, is high.”
At this time, Ga68PSMA-ligand is only used for men who have increased PSA values after prostate cancer treatment, as it facilitates earlier detection of recurrence and of metastases. The gallium generator is not sitting idle, though. The St. Antonius has also adopted Gallium-68-labeled tracers for detecting neuroendocrine tumors and is working hard to bring Gallium-68 into the clinical mainstream.
For many hospitals, the high equipment investment needed is a big barrier to adopting Gallium-68 for routine use. You need hot cells and a synthesis module, and gas chromatography, high-performance liquid chromatography and atomic absorption spectrometry for quality control. To bring the promising clinical applications of Gallium-68 to more hospitals, St. Antonius pharmacists recently published a method for preparing Gallium-68-DOTA-NOC in a way that is compliant with quality regulations but does not require any of the instruments mentioned above.
You can read more about the GMP-compliant radiolabeling method the St. Antonius developed in the following article:
Vis R, Lavalaye J, van de Garde EM. GMP-compliant (68)Ga radiolabelling in a conventional small-scale radiopharmacy: a feasible approach for routine clinical use. EJNMMI Res. 2015 Apr 24;5:27
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