Comparison of 18 F-DCFPyL and 68 Ga-PSMA-11 for 177 Lu-PSMA-617 therapy patient selection

Ga-PSMA-11 is recommended for the selection of patients for treatment in the package insert for Lu-PSMA-617. We aimed to compare imaging properties and post-treatment outcomes from radioligand therapy (RLT) of patients selected with Ga-PSMA-11 and F-DCFPyL. We retrospectively evaluated 80 patients undergoing PSMA RLT, who had pretreatment imaging using either Ga-PSMA-11 or F-DCFPyL. For both groups, we compared the biodistribution and lesion uptake and the PSA response to treatment. Both agents had comparable biodistribution. Patients initially imaged with F-DCFPyL had a higher PSA response (66% vs. 42%), and more patients had a PSA50 response (72% vs. 43%) compared to patients imaged with Ga-PSMA-11. F-DCFPyL and Ga-PSMA-11 had comparable biodistribution and lesion uptake. Patients imaged with F-DCFPyL demonstrated clinical benefit to PSMA RLT comparable to those imaged with Ga-PSMA-11, and either agent can be used for screening patients.