Analysis of Pros and Cons in using [68Ga]Ga-PSMA-11 and [18F]PSMA-1007: production, costs and PET/CT applications in patients with Prostate Cancer.

The aim of this work is to compare [⁶⁸Ga]Ga-PSMA-11 and [¹⁸F]PSMA-1007 to highlight advantages and drawbacks, analyzing processes of synthesis, imaging properties related to the different pharmacokinetics features, and the consequent impact on patient eligibility for radioligand therapy (RLT). At least, economical aspects were also evaluated. 

For the production of [⁶⁸Ga]Ga-PSMA-11, two ranges of starting activity of [⁶⁸Ga]Gallium chloride and their impact on final radiochemical yeld (RCY), were considered: for the lower (X), with an average activity value of 596.55±37.97 MBq, the RCY was of 80.98±0.051 %, while for the higher range (Y), with an average starting activity value of  1436.27±68.68 MBq, the RCY was 71.48±0.038 %. This demonstrated that the increasing starting activity of [⁶⁸Ga]Gallium chloride negatively affects the RCY. Furthermore, economical evaluations suggested better advantages of [¹⁸F]PSMA-1007 vs [⁶⁸Ga]Ga-PSMA-11..From our clinical experience, comparing all diagnostic and therapeutic PSMA-inhibitors used, there are no significant differences in their binding within tumor lesions but a different uptake in normal organs.

Data resulting from this study allow us to search a new and promising approach to overcome the limitations observed in the routinary clinical activity for [⁶⁸Ga]Ga-PSMA-11.