18F−Prostate−Specific Membrane Antigen PET/CT imaging for potentially resectable pancreatic cancer (PANSCAN−2): a phase I/II study
Abstract Background Current diagnostic imaging modalities have limited ability to differentiate between malignant and benign pancreaticobiliary disease, and lack accuracy in detecting lymph node metastases. 18F-Prostate-Specific Membrane Antigen (PSMA) PET/CT is an imaging modality used for staging...
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BMC
2025-01-01
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| Series: | Cancer Imaging |
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| Online Access: | https://doi.org/10.1186/s40644-025-00822-y |
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| author | Jisce R. Puik Thomas T. Poels Gerrit K. J. Hooijer Matthijs C. F. Cysouw Joanne Verheij Johanna W. Wilmink Elisa Giovannetti Geert Kazemier Arantza Farina Sarasqueta Daniela E. Oprea-Lager Rutger-Jan Swijnenburg |
| author_facet | Jisce R. Puik Thomas T. Poels Gerrit K. J. Hooijer Matthijs C. F. Cysouw Joanne Verheij Johanna W. Wilmink Elisa Giovannetti Geert Kazemier Arantza Farina Sarasqueta Daniela E. Oprea-Lager Rutger-Jan Swijnenburg |
| author_sort | Jisce R. Puik |
| collection | DOAJ |
| description | Abstract Background Current diagnostic imaging modalities have limited ability to differentiate between malignant and benign pancreaticobiliary disease, and lack accuracy in detecting lymph node metastases. 18F-Prostate-Specific Membrane Antigen (PSMA) PET/CT is an imaging modality used for staging of prostate cancer, but has incidentally also identified PSMA-avid pancreatic lesions, histologically characterized as pancreatic ductal adenocarcinoma (PDAC). This phase I/II study aimed to assess the feasibility of 18F-PSMA PET/CT to detect PDAC. Methods Seventeen patients with clinically resectable PDAC underwent 18F-PSMA PET/CT prior to surgical resection. Images were analyzed both visually and (semi)quantitatively by deriving the maximum standardized uptake value (SUVmax) and tumor-to-background ratio (TBR). TBR was defined as the ratio between SUVmax of the primary tumor divided by SUVmax of the aortic blood pool. Finally, tracer uptake on PET was correlated to tissue expression of PSMA in surgical specimens. Results Out of 17 PSMA PET/CT scans, 13 scans demonstrated positive PSMA tracer uptake, with a mean SUVmax of 5.0 ± 1.3. The suspected primary tumor was detectable (TBR ≥ 2) with a mean TBR of 3.3 ± 1.3. For histologically confirmed PDAC, mean SUVmax and mean TBR were 4.9 ± 1.2 and 3.3 ± 1.5, respectively. Although eight patients had histologically confirmed regional lymph node metastases and two patients had distant metastases, none of these metastases demonstrated 18F-PSMA uptake. There was no correlation between 18F-PSMA PET/CT SUVmax and tissue expression of PSMA in surgical specimens. Conclusions 18F-PSMA PET/CT was able to detect several pancreaticobiliary cancers, including PDAC. However, uptake was generally low, not specific to PDAC and no tracer uptake was observed in lymph node or distant metastases. The added value of PSMA PET in this setting appears to be limited. Trial registration The trial is registered as PANSCAN-2 in the European Clinical Trials Database (EudraCT number: 2020–002185-14). Graphical Abstract |
| format | Article |
| id | doaj-art-aa4cbe4cbcc14e9a995f5fbe30a5613d |
| institution | Kabale University |
| issn | 1470-7330 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | Cancer Imaging |
| spelling | doaj-art-aa4cbe4cbcc14e9a995f5fbe30a5613d2025-01-19T12:37:33ZengBMCCancer Imaging1470-73302025-01-0125111010.1186/s40644-025-00822-y18F−Prostate−Specific Membrane Antigen PET/CT imaging for potentially resectable pancreatic cancer (PANSCAN−2): a phase I/II studyJisce R. Puik0Thomas T. Poels1Gerrit K. J. Hooijer2Matthijs C. F. Cysouw3Joanne Verheij4Johanna W. Wilmink5Elisa Giovannetti6Geert Kazemier7Arantza Farina Sarasqueta8Daniela E. Oprea-Lager9Rutger-Jan Swijnenburg10Department of Surgery, Amsterdam UMC Location Vrije Universiteit AmsterdamDepartment of Surgery, Amsterdam UMC Location Vrije Universiteit AmsterdamCancer Center Amsterdam, Imaging and BiomarkersCancer Center Amsterdam, Imaging and BiomarkersCancer Center Amsterdam, Imaging and BiomarkersCancer Center Amsterdam, Imaging and BiomarkersCancer Center Amsterdam, Imaging and BiomarkersDepartment of Surgery, Amsterdam UMC Location Vrije Universiteit AmsterdamCancer Center Amsterdam, Imaging and BiomarkersCancer Center Amsterdam, Imaging and BiomarkersDepartment of Surgery, Amsterdam UMC Location Vrije Universiteit AmsterdamAbstract Background Current diagnostic imaging modalities have limited ability to differentiate between malignant and benign pancreaticobiliary disease, and lack accuracy in detecting lymph node metastases. 18F-Prostate-Specific Membrane Antigen (PSMA) PET/CT is an imaging modality used for staging of prostate cancer, but has incidentally also identified PSMA-avid pancreatic lesions, histologically characterized as pancreatic ductal adenocarcinoma (PDAC). This phase I/II study aimed to assess the feasibility of 18F-PSMA PET/CT to detect PDAC. Methods Seventeen patients with clinically resectable PDAC underwent 18F-PSMA PET/CT prior to surgical resection. Images were analyzed both visually and (semi)quantitatively by deriving the maximum standardized uptake value (SUVmax) and tumor-to-background ratio (TBR). TBR was defined as the ratio between SUVmax of the primary tumor divided by SUVmax of the aortic blood pool. Finally, tracer uptake on PET was correlated to tissue expression of PSMA in surgical specimens. Results Out of 17 PSMA PET/CT scans, 13 scans demonstrated positive PSMA tracer uptake, with a mean SUVmax of 5.0 ± 1.3. The suspected primary tumor was detectable (TBR ≥ 2) with a mean TBR of 3.3 ± 1.3. For histologically confirmed PDAC, mean SUVmax and mean TBR were 4.9 ± 1.2 and 3.3 ± 1.5, respectively. Although eight patients had histologically confirmed regional lymph node metastases and two patients had distant metastases, none of these metastases demonstrated 18F-PSMA uptake. There was no correlation between 18F-PSMA PET/CT SUVmax and tissue expression of PSMA in surgical specimens. Conclusions 18F-PSMA PET/CT was able to detect several pancreaticobiliary cancers, including PDAC. However, uptake was generally low, not specific to PDAC and no tracer uptake was observed in lymph node or distant metastases. The added value of PSMA PET in this setting appears to be limited. Trial registration The trial is registered as PANSCAN-2 in the European Clinical Trials Database (EudraCT number: 2020–002185-14). Graphical Abstracthttps://doi.org/10.1186/s40644-025-00822-yPSMAPET/CTPDACPancreatic cancerDiagnosis |
| spellingShingle | Jisce R. Puik Thomas T. Poels Gerrit K. J. Hooijer Matthijs C. F. Cysouw Joanne Verheij Johanna W. Wilmink Elisa Giovannetti Geert Kazemier Arantza Farina Sarasqueta Daniela E. Oprea-Lager Rutger-Jan Swijnenburg 18F−Prostate−Specific Membrane Antigen PET/CT imaging for potentially resectable pancreatic cancer (PANSCAN−2): a phase I/II study Cancer Imaging PSMA PET/CT PDAC Pancreatic cancer Diagnosis |
| title | 18F−Prostate−Specific Membrane Antigen PET/CT imaging for potentially resectable pancreatic cancer (PANSCAN−2): a phase I/II study |
| title_full | 18F−Prostate−Specific Membrane Antigen PET/CT imaging for potentially resectable pancreatic cancer (PANSCAN−2): a phase I/II study |
| title_fullStr | 18F−Prostate−Specific Membrane Antigen PET/CT imaging for potentially resectable pancreatic cancer (PANSCAN−2): a phase I/II study |
| title_full_unstemmed | 18F−Prostate−Specific Membrane Antigen PET/CT imaging for potentially resectable pancreatic cancer (PANSCAN−2): a phase I/II study |
| title_short | 18F−Prostate−Specific Membrane Antigen PET/CT imaging for potentially resectable pancreatic cancer (PANSCAN−2): a phase I/II study |
| title_sort | 18f prostate specific membrane antigen pet ct imaging for potentially resectable pancreatic cancer panscan 2 a phase i ii study |
| topic | PSMA PET/CT PDAC Pancreatic cancer Diagnosis |
| url | https://doi.org/10.1186/s40644-025-00822-y |
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