Stanford Nuclear Medicine Wins Aunt Minnie 2016 Best Radiology Image

Image is of an 83-year-old man initially presenting with a T2b nodule and prostate-specific antigen (PSA) level of 5.4, confirmed Gleason 5+4 prostate adenocarcinoma, and treated with intensity-modulated pelvic radiotherapy and androgen blockade. After PSA nadir of 0.11, biochemical recurrence occurred with PSA of 1.83 and negative conventional imaging. Patient was followed for 40 months under watch-and-wait strategy due to no identification of sites of recurrent disease despite increasing PSA up to 18.7 at the time of positive gallium-68 PSMA 11 and gallium-68 RM2 (both show retroperitoneal lymph nodes while all other studies are negative). This long follow-up illustrates the great need in the U.S. of prostate-specific PET radiopharmaceuticals such as Ga-68 PSMA 11 and Ga-68 RM2. This image was presented in the highlights lecture at the SNMMI annual meeting.

November 2, 2016

A PET image series from the Division of Nuclear Medicine and Molecular Imaging has won the Best Radiology Image in this year's Minnies awards, recognizing excellence in radiology. The image examines two new PET radiotracers, gallium-68 PSMA-11 and gallium-68 RM2, to determine their effectiveness in identifying rising levels of prostate-specific antigen (PSA), which signals prostate cancer recurrence. Existing imaging modalities such as CT, ultrasound, and MRI are already used to determine prostate cancer recurrence, but they have limited sensitivity and specificity. The two agents target different biological processes and have different distribution patterns in the body. Some patients might benefit from having both scans performed, however. In addition, the agents could be labeled with lutetium-177 for therapeutic uses.

The winning image was associated with a paper titled "Pilot Comparison of 68Ga-RM2 PET and 68Ga-PSMA-11 PET in Patients with Biochemically Recurrent Prostate Cancer," which was published in the April 2016 issue of The Journal of Nuclear Medicine.

Neither of the gallium-68 agents have been approved yet by the U.S. Food and Drug Administration (FDA). The radiotracers cannot be used clinically until approved by the FDA.

Upon receiving word of the award, Dr. Iagaru said, "The Stanford team wants to acknowledge the efforts and support of the Clinical Trials Network at SNMMI, nuclear medicine colleagues in Heidelberg, Munich, Bologna, Melbourne, and São Paulo, and at UCSF, UCLA, MSKCC and Mayo, as well as many others worldwide who work together to bring new PET agents to their patients. This award is a recognition of the hard work of the entire nuclear medicine community."