Role of 64CuCl2 PET/CT in staging of prostate cancer

The presence of an elevated copper concentration in cancer cells may be potentially used to differentiate healthy from transformed cells. In this study, we aimed to look at the possible role of (CuCl2)-Cu-64 PET/CT in staging of patients with prostate cancer (PC). Seven patients affected by histologically confirmed PC have been prospectively enrolled. Three patients underwent adrenal deprivation therapy (ADT) at time of imaging. The remaining four patients had no ADT, surgery, or external beam radiation therapy (EBRT). In all patients, up to three (CuCl2)-Cu-64 PET/CT scans 10 min, 1 h and 3 h (and an additional scan 24 h in 2 patients) after administration of mean 339 MBq (CuCl2)-Cu-64 were performed and analyzed for presence of disease. Additionally, dosimetric calculations were performed. All patients underwent a multiparametric magnetic resonance imaging (mMRI) for confirmation of disease. Lesions specifically in the pelvic area could be easily delineated, which was due to the absence of urinary excretion of the tracer. (CuCl2)-Cu-64 uptake was higher in primary tumors of patients without ADT than in patients under bicalutamide therapy. In two patients with suspected lymphadenopathy at MRI (> 10 mm diameter), there was no enhanced (CuCl2)-Cu-64 uptake. In other two patients, there was focal enhanced uptake in involved pelvic lymph nodes, one of which with a normal size of < 10 mm. The preliminary results of this study show a high uptake of (CuCl2)-Cu-64 in PC and involved regional lymph nodes indicating to a great potential of (CuCl2)-Cu-64 PET/CT for primary staging of patients with prostate cancer.