Head-to-Head Comparison of ⁶⁸Ga-P16-093 and ⁶⁸Ga-PSMA-617 PET/CT in Patients With Primary Prostate Cancer A Pilot Study

PurposeWe aimed to compare the diagnostic performance of Ga-68-P16-093 and Ga-68-PSMA-617 PET/CT in primary prostate cancer (PCa) patients.Patients and MethodsThirty untreated primary PCa patients were enrolled. Each patient underwent Ga-68-P16-093 and Ga-68-PSMA-617 PET/CT within a week. In addition to visual analysis, SUV was measured for semiquantitative comparison and correlation analysis.Results(68)Ga-P16-093 PET/CT detected more positive tumors than Ga-68-PSMA-617 PET/CT (67 vs 56, P = 0.002), especially for intraprostatic lesions (29 vs 24, P = 0.025) and lymph node metastases (23 vs 17, P = 0.034). Further, Ga-68-P16-093 PET/CT exhibited significantly higher SUVmax of matched tumors (18.3 +/- 14.4 vs 13.9 +/- 11.8, P < 0.001). Besides, the SUVmax of high-risk patients (based on D'Amico classification) on Ga-68-P16-093 PET/CT was significantly higher than that of low- and intermediate-risk PCa patients (20.9 +/- 9.9 vs 8.9 +/- 9.1 vs 10.1 +/- 5.2, P = 0.007). The SUVmax of tumor measured by Ga-68-P16-093 PET/CT had a moderate association with biopsy Gleason score (r = 0.462, P = 0.005) and prostate-specific antigen value (r = 0.491, P = 0.002), and significantly correlated with PSMA expression (r = 0.732, P < 0.001).Conclusions(68)Ga-P16-093 PET/CT exhibited higher tumor uptake and potentially better tumor detection capability than Ga-68-PSMA-617 PET/CT, which suggested that Ga-68-P16-093 may be more suitable in the diagnosis and staging of primary PCa patients.