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Prostate Cancer Treatment and Research · Journal article
Ejnmmi Research · August 18, 2026
Encouraging direction, but not yet definitive.
This small prospective intraindividual comparison in 10 patients with mCRPC shows that [99mTc]Tc-PSMA-GCK01 SPECT/CT has comparable biodistribution to [68Ga]PSMA-11 PET/CT for normal organs and can identify lesions >2 cm. The authors conclude SPECT could serve as a cost-effective alternative to PET for PSMA-RLT patient stratification, but the finding requires validation in larger, multicentre cohorts before clinical adoption.
Prospective intraindividual head-to-head comparison study. Ten patients with advanced-stage metastatic castration-resistant prostate cancer (mCRPC) prior to PSMA-targeted radioligand therapy. Intervention: [99mTc]Tc-PSMA-GCK01 SPECT/CT. Compared with: [68Ga]PSMA-11 PET/CT. n = 10. Monocentric (single centre); specific location not stated.
Renal tracer uptake was significantly higher with [68Ga]PSMA-11 than with [99mTc]Tc-PSMA-GCK01 [68Ga]PSMA-11 displayed a trend toward higher uptake in normal organs compared to [99mTc]Tc-PSMA-GCK01 In salivary glands and liver, no statistically significant difference in uptake between the two tracers
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
If validated in larger studies, [99mTc]Tc-PSMA-GCK01 SPECT/CT could reduce PET scanner bottlenecks and lower costs for patient phenotyping in PSMA-RLT selection, provided lesion size ≥2 cm is accepted as clinically adequate. Clinicians should await multicentre confirmation before adoption.
Small prospective intraindividual comparison showing [99mTc]Tc-PSMA-GCK01 SPECT/CT has comparable biodistribution to [68Ga]PSMA-11 PET/CT for lesion phenotyping in mCRPC, but limited by sample size (n=10) and single centre, requiring larger validation before clinical implementation.
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Quoted from the source exactly as published.
If validated in larger studies, [99mTc]Tc-PSMA-GCK01 SPECT/CT could reduce PET scanner bottlenecks and lower costs for patient phenotyping in PSMA-RLT selection, provided lesion size ≥2 cm is accepted as clinically adequate. Clinicians should await multicentre confirmation before adoption.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Abstract. Background PSMA-PET/CT became an important means for prostate cancer management. The high-resolution and signal-to-noise ratio of PET is mandatory in primary staging or biochemical relapse that often present with tiny lesions. PSMA-PET is also used to select patients for PSMA-targeted radioligand-therapy, but scanner availability increasingly becomes a bottleneck. The resolution of PSMA-SPECT/CT might be sufficient to tailor PSMA positive vs. negative disease and would help overcome supply limitations. This prospective, monocentric study evaluates the biodistribution and tumor uptake of [ 99m Tc]Tc-PSMA-GCK01 in an intra-individual head-to-head comparison with [ 68 Ga]PSMA-11 to assess its suitability for phenotyping prior to RLT. Results A cohort of ten patients (median age, 68 y; range, 56–85 y) with advanced-stage, metastatic prostate cancer underwent both unenhanced [ 68 Ga]PSMA-11 PET/CT and [ 99m Tc]Tc-PSMA-GCK01 SPECT/CT scans with a mean time interval of 6 days (± 1). The tracer uptake in malignant lesions and normal organs was assessed visually and semi-quantitatively using spherical VOIs by two nuclear medicine physicians in consensus. Compared to [ 99m Tc]Tc-PSMA-GCK01, [ 68 Ga]PSMA-11 displayed a trend toward higher uptake in normal organs. Renal tracer uptake was significantly higher with [ 68 Ga]PSMA-11 than with [ 99m Tc]Tc-PSMA-GCK01. In the salivary glands and liver, there was no statistically significant difference in uptake between the two tracers, although [ 99m Tc]Tc-PSMA-GCK01 displayed a trend toward lower uptake. Conclusion Our study demonstrates intraindividual comparability of [ 99m Tc]Tc-PSMA-GCK01 and [ 68 Ga]PSMA-11 with respect to normal-organ distribution including typical reference organs such as the liver or salivary glands. If only lesions > 2 cm are considered, [ 99m Tc]Tc-PSMA-GCK01 PSMA-SPECT is a viable, cost-effective alternative to [ 68 Ga]PSMA-11 to stratify patients toward or against PSMA-RLT.
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