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PSMA-PET/CT for imaging prostate cancer (PC) has spread worldwide since its clinical introduction in 2011. The majority of experiences have been collected for PSMA-PET-imaging of recurrent PC. Data for primary staging of high-risk PC are highly promising. Meanwhile, a plethora of PSMA-ligands are available for clinical use (e.g. 68Ga-PSMA-11, 68GaPSMA-I&T, 68Ga-PSMA-617, 18F-DCFBC, 18F-DCFPyL, 18F-PSMA-1007, 18F-rhPSMA-7 and 18F-JK-PSMA-7). However, an official approval is available only for 68Ga-PSMA-11 (approved by the US FDA in 2020) and 18F-DCFPyL (approved by the US FDA in 2021). Recommendations for acquisition times vary from 1-2h p.i. It has been shown that for the majority of tumour lesions, the contrast in PSMAPET/CT increases with time. Therefore, additional late imaging can help to clarify unclear findings. PSMA-PET/CT should be performed prior to commencing an androgen deprivation therapy (ADT) since (long term) ADT reduces the visibility of PC lesions. Following injection of PSMA-ligands, hydration and forced diuresis are recommended for PSMA-ligands with primarily excretion via the kidneys in order to increase the visibility of tumour lesions adjacent to the urinary bladder. PSMA-ligands are physiologically taken up in multiple normal organs. For some 18F-labelled PSMA-ligands, presence of unspecific focal bone uptake has been reported. When using these tracers, focal bone uptake without CT-correlate should be interpreted with great caution. Besides prostate cancer, practically all solid tumors express PSMA in their neovasculature thereby taking up PSMA-ligands, although usually at a lower extent compared to PC. Also multiple benign lesions and inflammatory processes (e.g. lymph nodes) take up PSMA-ligands, also usually at lower extent compared to PC.

Anna Yordanova,1 Elisabeth Eppard,2 Stefan Kürpig,2 Ralph A Bundschuh,3 Stefan Schönberger,4 Maria Gonzalez-Carmona,5 Georg Feldmann,6 Hojjat Ahmadzadehfar,1 Markus Essler1 1Department of Nuclear Medicine (Clinical Nuclear Medicine), 2Department of Nuclear Medicine (Radiochemistry), 3Department of Nuclear Medicine (Medical Physics and PET), 4Department of Paediatric Haematology and Oncology, 5Department of Medicine 1, 6Department of Medicine 3, University Hospital Bonn, Bonn, Germany Abstract: The importance of personalized medicine has been growing, mainly due to a more urgent need to avoid unnecessary and expensive treatments. In nuclear medicine, the theranostic approach is an established tool for specific molecular targeting, both for diagnostics and therapy. The visualization of potential targets can help predict if a patient will benefit from a particular treatment. Thanks to the quick development of radiopharmaceuticals and diagnostic techniques, the use of theranostic agents has been continually increasing. In this article, important milestones of nuclear therapies and diagnostics in the context of theranostics are highlighted. It begins with a well-known radioiodine therapy in patients with thyroid cancer and then progresses through various approaches for the treatment of advanced cancer with targeted therapies. The aim of this review was to provide a summary of background knowledge and current applications, and to identify the advantages of targeted therapies and imaging in nuclear medicine practices. Keywords: theranostics, nuclear medicine, personalized medicine, PET/CT, therapy, diagnostics

Carsten Meyer,1,* Claus Christian Pieper,1,* Hojjat Ahmadzadehfar,2 Nina Alexandra Lampe,1 Eva Maria E Matuschek,1 Thomas Adrian Maschke,1 Simon Jonas Enkirch,1 Markus Essler,2 Ulrich Spengler,3 Hans Heinz Schild1 1Department of Radiology, University of Bonn, Sigmund-Freud-Strasse, Bonn, Germany, 2Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse, Bonn, Germany, 3Department of Internal Medicine I, University of Bonn, Sigmund-Freud-Strasse, Bonn,Germany *These authors contributed equally tothis work Purpose: To determine the value of radioembolization (RE) for treatment of unresectable hepatocellular carcinoma (HCC). Patients and methods: Records of patients undergoing RE for unresectable HCC were retrospectively reviewed. Biochemical and clinical toxicities, imaging response (according to modified Response Evaluation Criteria In Solid Tumors), time-to-progression (TTP) and overall survival (OS) were analyzed. Data were stratified according to clinical and procedural parameters. Univariate and multivariate analyses were performed. Results: One hundred and fifteen patients (89 male, mean age 69.3 years) underwent 158REs (119resin-, 39 glass-based) (Barcelona Clinic Liver Cancer [BCLC]-A: 6.1%, B: 33.9%, C:60.0%). Median clinical follow-up was 5.9 (0.9–83.5) months. No grade 4 or 5 clinical toxicities were noted. Objective response rate was 35.6%; disease control rate was 76.7%. Median TTP of the treated part of the liver was 4 (0.9–45.4) months. 108/115patients died during follow-up (median OS 8.4 [0.3–82.8] months after first RE [BCLC-A: 52.8months, BCLC-B: 12.4 months, BCLC-C: 6.1 months]). On multivariate analysis, baseline Eastern Co-operative Oncology Group status

Das Ziel der vorliegenden Leitlinie ist es, den Arzt bei der Indikationsstellung, der standardisierten Durchführung, der Interpretation und der Dokumentation der Befunde einer Positronen-Emissions-Tomographie/Computertomographie (PET/CT) mit PSMA-Liganden bei Patienten mit Prostatakarzi-nom zu unterstützen. Es werden Empfehlungen zu Patientenselektion, Bilderfassung, Interpretati-on und Befundung ausgesprochen sowieLimitationen der PSMA-Liganden-PET/CT präsentiert. Die Leitlinie basiert auf einer Zusammenführung wissenschaftlicher Veröffentlichungen, Empfehlungen der Autoren und evidenzbasierter Daten.

Claus Christian Pieper,1 Carsten Meyer,1 Alois Martin Sprinkart,1 Wolfgang Block,1 Hojjat Ahmadzadehfar,2 Hans Heinz Schild,1 Petra Mürtz,1 Guido Matthias Kukuk1 1Department of Radiology, 2Department of Nuclear Medicine, University of Bonn, Bonn, Germany Purpose: To evaluate prognostic values of clinical and diffusion-weighted magnetic resonance imaging-derived intravoxel incoherent motion (IVIM) parameters in patients undergoing primary radioembolization for metastatic breast cancer liver metastases.Subjects and methods: A total of 21 females (mean age 54 years, range 43–72 years) with liver-dominant metastatic breast cancer underwent standard liver magnetic resonance imaging (1.5 T, diffusion-weighted imaging with b-values of 0, 50, and 800 s/mm2) before and 4–6 weeks after radioembolization. The IVIM model-derived estimated diffusion coefficient D’ and the perfusion fraction f’ were evaluated by averaging the values of the two largest treated metastases in each patient. Kaplan–Meier and Cox regression analyses for overall survival (OS) were performed. Investigated parameters were changes in f’- and D’-values after therapy, age, sex, Eastern Cooperative Oncology Group (ECOG) status, grading of primary tumor, hepatic tumor burden, presence of extrahepatic disease, baseline bilirubin, previous bevacizumab therapy, early stasis during radioembolization, chemotherapy after radioembolization, repeated radioembolization and Response Evaluation Criteria in Solid Tumors (RECIST) response at 6-week follow-up.Results: Median OS after radioembolization was 6 (range 1.5–54.9) months. In patients with therapy-induced decreasing or stable f’-values, median OS was significantly longer than in those with increased f’-values (7.6 [range 2.6–54.9] vs 2.6 [range 1.5–17.4] months, P1(7.6[range 2.6–54.9] vs 1.7 [range 1.5–4.5] months, P

Fragestellung: Prostataspezifisches Membranantigen (PSMA) wird von Endothelien der tumorassoziierten Gefäßen in vielen Tumoren exprimiert. Das Ziel dieser Studie war eine umfassende Evaluation des PSMA in Nierenzellkarzinom (RCC), insbesondere mit Bezug zur potenziellen Anwendung als Target[zum vollständigen Text gelangen Sie über die oben angegebene URL], 63. Kongress der Nordrhein-Westfälischen Gesellschaft für Urologie

Introduction: Prostate-specific membrane antigen (PSMA) is highly expressed on prostate epithelial cells and strongly up-regulated in prostate cancer, making it an optimal target for the treatment of metastasized prostate cancers. Radioligand therapy (RLT) with 177Lu- PSMA-DKFZ-617 (Lu-PSMA) is a novel[for full text, please go to the a.m. URL], 62. Kongress der Nordrhein-Westfälischen Gesellschaft für Urologie