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

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 [F-18]rhPSMA-7.3 with PET/MRI for quantitative imaging of neo-vascularization in GBM bearing mice and human tumor tissue and compare it to [F-18]FET and [F-18]fluciclovine using PET pharmacokinetic modeling (PKM). Methods [F-18]rhPSMA-7.3, [F-18]FET, and [F-18]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 [F-18]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. [F-18]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 [F-18]FET and LA indicated reversible binding. V-T increased (p < 0.001, tumor, 21 to 28 days) for [F-18]FET (0.5-1.4) and [F-18]fluciclovine (0.84-1.5). Conclusion [F-18]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 [F-18]rhPSMA-7.3 in GBM, contradicting cellular trapping. Finally, [F-18]fluciclovine was superior to [F-18]FET rendering it more suitable for PET imaging of GBM.