Glioblastoma PET/MRI: kinetic investigation of [18F]rhPSMA-7.3, [18F]FET and [18F]fluciclovine in an orthotopic mouse model of cancer

Abstract Purpose Glioblastoma multiforme (GBM) is the most common glioma and standard therapies can only slightly prolong the survival. Neo-vascularization is a potential target to image tumor microenvironment, as it defines its brain invasion. We investigate [ 18 F]rhPSMA-7.3 with PET/MRI for quantitative imaging of neo-vascularization in GBM bearing mice and human tumor tissue and compare it to [ 18 F]FET and [ 18 F]fluciclovine using PET pharmacokinetic modeling (PKM). Methods [ 18 F]rhPSMA-7.3, [ 18 F]FET, and [ 18 F]fluciclovine were i.v. injected with 10.5 ± 3.1 MBq, 8.0 ± 2.2 MBq, 11.5 ± 1.9 MBq ( n = 28, GL261-luc2) and up to 90 min PET/MR imaged 21/28 days after surgery. Regions of interest were delineated on T2-weighted MRI for (i) tumor, (ii) brain, and (iii) the inferior vena cava. Time-activity curves were expressed as SUV mean, SUVR and PKM performed using 1-/2-tissue-compartment models (1TCM, 2TCM), Patlak and Logan analysis (LA). Immunofluorescent staining (IFS), western blotting, and autoradiography of tumor tissue were performed for result validation. Results [ 18 F]rhPSMA-7.3 showed a tumor uptake with a tumor-to-background-ratio (TBR) = 2.1–2.5, in 15–60 min. PKM (2TCM) confirmed higher K1 (0.34/0.08, p = 0.0012) and volume of distribution V T (0.24/0.1, p = 0.0017) in the tumor region compared to the brain. Linearity in LA and similar k3 = 0.6 and k4 = 0.47 (2TCM, tumor, p = ns) indicated reversible binding. K1, an indicator for vascularization, increased (0.1/0.34, 21 to 28 days, p < 0.005). IFS confirmed co-expression of PSMA and tumor vascularization. [ 18 F]fluciclovine showed higher TBR (2.5/1.8, p < 0.001, 60 min) and V S (1.3/0.7, p < 0.05, tumor) compared to [ 18 F]FET and LA indicated reversible binding. V T increased ( p < 0.001, tumor, 21 to 28 days) for [ 18 F]FET (0.5–1.4) and [ 18 F]fluciclovine (0.84–1.5). Conclusion [ 18 F]rhPSMA-7.3 showed to be a potential candidate to investigate the tumor microenvironment of GBM. Following PKM, this uptake was associated with tumor vascularization. In contrast to what is known from PSMA-PET in prostate cancer, reversible binding was found for [ 18 F]rhPSMA-7.3 in GBM, contradicting cellular trapping. Finally, [ 18 F]fluciclovine was superior to [ 18 F]FET rendering it more suitable for PET imaging of GBM.