Analysis of Pros and Cons in Using [(68)Ga]Ga-PSMA-11 and [(18)F]PSMA-1007: Production, Costs, and PET/CT Applications in Patients with Prostate Cancer

The aim of this work is to compare [(68)Ga]Ga-PSMA-11 and [(18)F]PSMA-1007 PET/CT as imaging agents in patients with prostate cancer (PCa). Comparisons were made by evaluating times and costs of the radiolabeling process, imaging features including pharmacokinetics, and impact on patient management. The analysis of advantages and drawbacks of both radioligands might help to make a better choice based on firm data. For [(68)Ga]Ga-PSMA-11, the radiochemical yield (RCY) using a low starting activity (L, average activity of 596.55 ± 37.97 MBq) was of 80.98 ± 0.05%, while using a high one (H, average activity of 1436.27 ± 68.68 MBq), the RCY was 71.48 ± 0.04%. Thus, increased starting activities of [(68)Ga]-chloride negatively influenced the RCY. A similar scenario occurred for [(18)F]PSMA-1007. The rate of detection of PCa lesions by Positron Emission Tomography/Computed Tomography (PET/CT) was similar for both radioligands, while their distribution in normal organs significantly differed. Furthermore, similar patterns of biodistribution were found among [(18)F]PSMA-1007, [(68)Ga]Ga-PSMA-11, and [(177)Lu]Lu-PSMA-617, the most used agent for RLT. Moreover, the analysis of economical aspects for each single batch of production corrected for the number of allowed PET/CT examinations suggested major advantages of [(18)F]PSMA-1007 compared with [(68)Ga]Ga-PSMA-11. Data from this study should support the proper choice in the selection of the PSMA PET radioligand to use on the basis of the cases to study.