PSMA-Therapie

Als erstes Schweizer Zentrum wird bei uns die PSMA-Therapie seit 2019 angeboten und bei Patienten mit metastasiertem, kastrationsresistentem Prostatakarzinom routinemässig durchgeführt.

PSMA (Prostataspezifisches Membranantigen) ist ein transmembraner Rezeptor, welcher auf Zellen des Prostatakarzinoms häufig signifikant überproduziert wird. In der nuklearmedizinischen Therapie werden Liganden des PSMA mit einem therapeutisch radioaktiven Metall (in der Regel 177Lutetium) beladen und in die Blutbahn gespritzt. Von dort aus wird der radioaktive PSMA-Ligand zu allen Herden des Prostatakarzinoms transportiert, die PSMA produzieren. Die radioaktiven PSMA-Liganden docken in der Folge an PSMA und werden anschliessend in das Innere der Prostatakarzinom-Zellen transportiert, wo sie sich stark anreichern (Abbildung 1 und Video 1). Die Prostata-Karzinomzellen werden auf diese Weise lokal bestrahlt und schrumpfen stark in ca. 1/3 der Fälle (Abbildung 2) oder werden zumindest für eine gewisse Zeit in ihrem Wachstum gebremst (1/3 der Fälle). In ca. 1/3 der Fälle zeigt sich jedoch kein zufriedenstellender therapeutischer Effekt.

Abbildung 1: In der nuklearmedizinischen Therapie werden Liganden des PSMA mit einem therapeutisch radioaktiven Metall (in der Regel 177Lutetium) beladen und in die Blutbahn gespritzt.  Von dort aus gelangen sie zu allen Herden des Prostatakarzinoms, die PSMA produzieren. Die radioaktiven PSMA-Liganden docken in der Folge an das PSMA und werden anschliessend in das Innere der Prostatakarzinom-Zellen transportiert, wo sie sich stark anreichern. Die Karzinomzellen werden auf diese Weise lokal bestrahlt und gehen zugrunde.

Abbildung 2: Patient mit Status nach 6 Zyklen PSMA-Therapie mit 177Lu-PSMA-Ligand (Inselspital Bern). Nach anfänglich rapidem PSA-Abfall (linkes Teilbild mit dem PSA-Kurvendiagramm) konnte die Tumormasse im Körper des Patienten über mehrere Monate auf niedrigen Niveau stabil gehalten werden.

Die therapeutische Strahlung der PSMA-Liganden reicht im Gewebe nur wenige Millimeter weit, so dass das Tumor-umgebende Gewebe nur unbedeutend belastet wird.

In Folge der PSMA-Therapie kann sich die Lebensqualität bedeutend verbessern und die Lebenserwartung erhöht werden. Eine Heilung vom Tumor ist jedoch wie bei vielen metastasierten Krebsarten nicht zu erwarten.

Ob ein Patient für eine PSMA-Therapie in Frage kommt, muss zuvor über eine entsprechende Bildgebung (PSMA-PET/CT) gezeigt werden (Abb. 3).

Die Therapiezyklen werden in der Regel in Abständen von 6-8 Wochen so lange durchgeführt, bis der Tumor entweder nicht mehr suffizient auf die Therapie anspricht oder die Nebenwirkungen der Therapie (s.u.) deutlich in den Vordergrund rücken. Die PSMA-Therapie muss unter stationären Bedingungen durchgeführt werden. Während der gesamten stationären Verweildauer (3 Tage) dürfen die Patienten aus Strahlenschutzgründen die Station nicht verlassen und sollten keine Besucher empfangen.

Nebenwirkungen: Insgesamt ist die 177Lu-PSMA-Therapie während der ersten drei Zyklen hervorragend verträglich. Relevante Nebenwirkungen werden zumeist ab dem vierten Zyklus symptomatisch. Diese äussern sich in zunächst milden, pro weiteren Zyklus zunehmenden Geschmacksveränderungen und Mundtrockenheit aufgrund von Schäden an den Speicheldrüsen. Auch eine relevante Abnahme der Blutzellen sowie in geringem Masse Augentrockenheit können dazu kommen. Weitere Nebenwirkungen sind selten.

Abbildung 3: Patient mit multiplen Metastasen eines Prostatakarzinoms in der PSMA-PET/CT. Aufgrund der starken Speicherung des PSMA-Liganden in den Tumorherden ist eine PSMA-Therapie möglich.

Eigene Publikationen auf dem Gebiet PSMA-Diagnostik und -Therapie:

76) Vollnberg B, Alberts I, Genitsch V, Rominger A, Afshar-Oromieh A. Assessment of malignancy and PSMA expression of uncertain bone foci in [18F]PSMA-1007 PET/CT for prostate cancer-a single-centre experience of PET-guided biopsies. Eur J Nucl Med Mol Imaging. 2022 Apr 28. doi: 10.1007/s00259-022-05745-5. Online ahead of print.

75) Mingels C, Bohn KP, Rominger A, Afshar-Oromieh A, Alberts I. Diagnostic accuracy of [18F]PSMA-1007 PET/CT in biochemical recurrence of prostate cancer. Eur J Nucl Med Mol Imaging. 2022 Jan 24. doi: 10.1007/s00259-022-05693-0. Online ahead of print.

74) Neels OC, Kopka K, Liolios C, Afshar-Oromieh A. Radiolabeled PSMA Inhibitors. Cancers (Basel). 2021 Dec 13;13(24):6255. doi: 10.3390/cancers13246255.

73) Birindelli G, Drobnjakovic M, Morath V, Steiger K, D'Alessandria C, Gourni E, Afshar-Oromieh A, Weber W, Rominger A, Eiber M, Shi K. In silico study on radiobiological efficacy of Ac-225 and Lu-177 for PSMA-guided radiotherapy. Annu Int Conf IEEE Eng Med Biol Soc. 2021 Nov;2021:4497-4500. doi: 10.1109/EMBC46164.2021.9630297.

72) Alberts I, Mingels C, Zacho HD, Lanz S, Schöder H, Rominger A, Zwahlen M, Afshar-Oromieh A. Comparing the clinical performance and cost efficacy of [68Ga]Ga-PSMA-11 and [18F]PSMA-1007 in the diagnosis of recurrent prostate cancer: a Markov chain decision analysis. Eur J Nucl Med Mol Imaging. 2021 Nov 13. doi: 10.1007/s00259-021-05620-9. Online ahead of print.

71) Bohn KP, Alberts I, Mingels C, Rominger A, Afshar-Oromieh A. PSMA-Ligand Uptake in Disseminated Epidermoid Cysts in a PSMA PET/CT of a Patient With Recurrent Prostate Cancer. Clin Nucl Med. 2021 Dec 1;46(12):e598-e599. doi: 10.1097/RLU.0000000000003749.

70) Birindelli G, Drobnjakovic M, Morath V, Steiger K, D'Alessandria C, Gourni E, Afshar-Oromieh A, Weber W, Rominger A, Eiber M, Shi K. Is Hypoxia a Factor Influencing PSMA-Directed Radioligand Therapy?-An In Silico Study on the Role of Chronic Hypoxia in Prostate Cancer. Cancers (Basel). 2021 Jul 8;13(14):3429. doi: 10.3390/cancers13143429.

69) Alberts I, Prenosil G, Mingels C, Bohn KP, Viscione M, Sari H, Rominger A, Afshar-Oromieh A. Feasibility of late acquisition [68Ga]Ga-PSMA-11 PET/CT using a long axial field-of-view PET/CT scanner for the diagnosis of recurrent prostate cancer-first clinical experiences. Eur J Nucl Med Mol Imaging. 2021 Dec;48(13):4456-4462. doi: 10.1007/s00259-021-05438-5. Epub 2021 Jun 21.

68) Seifert R, Alberts IL, Afshar-Oromieh A, Rahbar K. Prostate Cancer Theranostics: PSMA Targeted Therapy. PET Clin. 2021 Jul;16(3):391-396. doi: 10.1016/j.cpet.2021.03.004.

67) Alberts IL, Seifert R, Rahbar K, Afshar-Oromieh A. Prostate Cancer Theranostics: From Target Description to Imaging. PET Clin. 2021 Jul;16(3):383-390. doi: 10.1016/j.cpet.2021.03.003.

66) Alberts I, Hünermund JN, Sachpekidis C, Mingels C, Fech V, Bohn KP, Rominger A, Afshar-Oromieh A. The influence of digital PET/CT on diagnostic certainty and interrater reliability in [68Ga]Ga-PSMA-11 PET/CT for recurrent prostate cancer. Eur Radiol. 2021 Oct;31(10):8030-8039. doi: 10.1007/s00330-021-07870-5. Epub 2021 Apr 15.

65) Alberts I, Hünermund JN, Prenosil G, Mingels C, Bohn KP, Viscione M, Sari H, Vollnberg B, Shi K, Afshar-Oromieh A, Rominger A. Clinical performance of long axial field of view PET/CT: a head-to-head intra-individual comparison of the Biograph Vision Quadra with the Biograph Vision PET/CT. Eur J Nucl Med Mol Imaging. 2021 Jul;48(8):2395-2404. doi: 10.1007/s00259-021-05282-7. Epub 2021 Apr 2.

64) Alberts IL, Seide SE, Mingels C, Bohn KP, Shi K, Zacho HD, Rominger A, Afshar-Oromieh A. Comparing the diagnostic performance of radiotracers in recurrent prostate cancer: a systematic review and network meta-analysis. Eur J Nucl Med Mol Imaging. 2021 Aug;48(9):2978-2989. doi: 10.1007/s00259-021-05210-9. Epub 2021 Feb 6.

63) Alberts I, Niklas-Hünermund J, Sachpekidis C, Zacho HD, Mingels C, Dijkstra L, Bohn KP, Läppchen T, Gourni E, Rominger A, Afshar-Oromieh A. Combination of Forced Diuresis with Additional Late Imaging in 68Ga-PSMA-11 PET/CT: Effects on Lesion Visibility and Radiotracer Uptake. J Nucl Med. 2021 Sep 1;62(9):1252-1257. doi: 10.2967/jnumed.120.257741. Epub 2021 Feb 5.

62) Afshar-Oromieh A, da Cunha ML, Wagner J, Haberkorn U, Debus N, Weber W, Eiber M, Holland-Letz T, Rauscher I. Performance of [68Ga]Ga-PSMA-11 PET/CT in patients with recurrent prostate cancer after prostatectomy-a multi-centre evaluation of 2533 patients. Eur J Nucl Med Mol Imaging. 2021 Aug;48(9):2925-2934. doi: 10.1007/s00259-021-05189-3. Epub 2021 Feb 4.

61) Mingels C, Sachpekidis C, Bohn KP, Hünermund JN, Schepers R, Fech V, Prenosil G, Rominger A, Afshar-Oromieh A, Alberts I. The influence of colour scale in lesion detection and patient-based sensitivity in [68Ga]Ga-PSMA-PET/CT. Nucl Med Commun. 2021 May 1;42(5):495-502. doi: 10.1097/MNM.0000000000001364.

60) Rahbar K, Afshar-Oromieh A, Seifert R, Wagner S, Schäfers M, Bögemann M, Weckesser M. Do fasting or high caloric drinks affect the physiological uptake of fluorine-18 prostate-specific membrane antigen-1007 in liver and bowel? World J Nucl Med. 2019 Nov 7;19(3):220-223. doi: 10.4103/wjnm.WJNM_6_19. eCollection 2020 Jul-Sep.

59) Zacho HD, Ravn S, Afshar-Oromieh A, Fledelius J, Ejlersen JA, Petersen LJ. Added value of (68)Ga-PSMA PET/CT for the detection of bone metastases in patients with newly diagnosed prostate cancer and a previous (99m)Tc bone scintigraphy. EJNMMI Res. 2020 Apr 8;10(1):31. doi: 10.1186/s13550-020-00618-0.

58) Fech V, Sachpekidis C, Alberts I, Rominger A, Afshar-Oromieh A. Atypical metastatic pattern of prostate cancer detected with 68Ga-PSMA PET/CT. Nuklearmedizin. 2020 Apr;59(2):85-86. doi: 10.1055/a-1108-1275. Epub 2020 Mar 18.

57) Alberts I, Sachpekidis C, Dijkstra L, Prenosil G, Gourni E, Boxler S, Gross T, Thalmann G, Rahbar K, Rominger A, Afshar-Oromieh A. The role of additional late PSMA-ligand PET/CT in the differentiation between lymph node metastases and ganglia. Eur J Nucl Med Mol Imaging. 2020 Mar;47(3):642-651. doi: 10.1007/s00259-019-04552-9. Epub 2019 Dec 21.

56) Zhao Y, Gafita A, Vollnberg B, Tetteh G, Haupt F, Afshar-Oromieh A, Menze B, Eiber M, Rominger A, Shi K. Deep neural network for automatic characterization of lesions on 68Ga-PSMA-11 PET/CT. Eur J Nucl Med Mol Imaging. 2019 Dec 7.

55) Farolfi A, Ilhan H, Gafita A, Calais J, Barbato F, Weber M, Afshar-Oromieh A, Spohn F, Wetter A, Rischpler C, Hadaschik B, Pianori D, Fanti S, Haberkorn U, Eiber M, Herrmann K, Fendler WP. Mapping prostate cancer lesions pre/post unsuccessful salvage lymph node dissection using repeat PSMA-PET. J Nucl Med. 2019 Dec 5. pii: jnumed.119.235374.

54) Alberts I, Prenosil G, Sachpekidis C, Weitzel T, Shi K, Rominger A, Afshar-Oromieh A. Digital versus analogue PET in [68Ga]Ga-PSMA-11 PET/CT for recurrent prostate cancer: a matched-pair comparison. Eur J Nucl Med Mol Imaging. 2019 Dec 2.

53) Alberts I, Sachpekidis C, Fech V, Rominger A, Afshar-Oromieh A. PSMA-negative prostate cancer and the continued value of choline-PET/CT. Nuklearmedizin. 2019 Nov 25.

52) Sachpekidis C, Afshar-Oromieh A, Kopka K, Strauss DS, Pan L, Haberkorn U, Dimitrakopoulou-Strauss A. 18F-PSMA-1007 multiparametric, dynamic PET/CT in biochemical relapse and progression of prostate cancer. Eur J Nucl Med Mol Imaging. 2019 Nov 14.

51) Afshar-Oromieh A, Alberts I, Sachpekidis C, Rominger A. Prostate-specific membrane antigen (PSMA)-based diagnostics and treatment of prostate cancer. Urologe A. 2019 Dec;58(12):1429-1434. 

50) Haupt F, Dijkstra L, Alberts I, Sachpekidis C, Fech V, Boxler S, Gross T, Holland-Letz T, Zacho HD, Haberkorn U, Rahbar K, Rominger A, Afshar-Oromieh A. 68Ga-PSMA-11 PET/CT in patients with recurrent prostate cancer-a modified protocol compared with the common protocol. Eur J Nucl Med Mol Imaging. 2019 Nov 1.

49) Alberts I, Sachpekidis C, Gourni E, Boxler S, Gross T, Thalmann G, Rahbar K, Rominger A, Afshar-Oromieh A. Dynamic patterns of [68Ga]Ga-PSMA-11 uptake in recurrent prostate cancer lesions. Eur J Nucl Med Mol Imaging. 2020 Jan;47(1):160-167.

48) Sachpekidis C, Alberts I, Rominger A, Afshar-Oromieh A. 68Ga-Prostate-Specific Membrane Antigen Uptake in a Malignant Pleural Effusion From Metastatic Prostate Cancer After Pleurodesis. Clin Nucl Med. 2019 Jul 5.

47) Farolfi A, Gafita A, Calais J, Eiber M, Afshar-Oromieh A, Spohn F, Barbato F, Weber M, Ilhan H, Cervati V, Wetter A, Hadaschik B, Briganti A, Walz J, Pianori D, Fanti S, Haberkorn U, Herrmann K, Fendler WP. 68Ga-PSMA-11 PET Detects Residual Prostate Cancer after Prostatectomy in a Multicenter Retrospective Study. J Urol. 2019 Jun 24:101097JU0000000000000417.

46) Petersen LJ, Nielsen JB, Langkilde NC, Petersen A, Afshar-Oromieh A, De Souza NM, De Paepe K, Fisker RV, Arp DT, Carl J, Haberkorn U, Zacho HD. 68Ga-PSMA PET/CT compared with MRI/CT and diffusion-weighted MRI for primary lymph node staging prior to definitive radiotherapy in prostate cancer: a prospective diagnostic test accuracy study. World J Urol. 2019 Jun 12.

45) Fech V, Alberts I, Rominger A, Afshar-Oromieh A. PSMA-ligand PET allows a more accurate therapeutic response evaluation of bone metastases in prostate cancer compared to computed tomography. Nuklearmedizin. 2019 May 13.

44) Murray JR, Kopka K, Afshar-Oromieh A. Imaging and radiotherapy for recurrent prostate cancer: An evolutionary partnership. adiother Oncol. 2018 Oct 15. pii: S0167-8140(18)33499-6.    

43) Zacho HD, Nielsen JB, Afshar-Oromieh A, Haberkorn U, deSouza N, De Paepe K, Dettmann K, Langkilde NC, Haarmark C, Fisker RV, Arp DT, Carl J, Jensen JB, Petersen LJ. Prospective comparison of 68Ga-PSMA PET/CT, 18F-sodium fluoride PET/CT and diffusion weighted-MRI at for the detection of bone metastases in biochemically recurrent prostate cancer. Eur J Nucl Med Mol Imaging. 2018 Oct;45(11):1884-1897. doi: 10.1007/s00259-018-4058-4.

42) Ahmadzadehfar H, Essler M, Rahbar K, Afshar-Oromieh A. Radionuclide Therapy for Bone Metastases: Utility of Scintigraphy and PET Imaging for Treatment Planning. PET Clin. 2018 Oct;13(4):491-503.

41) Hope TA, Afshar-Oromieh A, Eiber M, Emmett L, Fendler WP, Lawhn-Heath C, Rowe SP. Imaging Prostate Cancer With Prostate-Specific Membrane Antigen PET/CT and PET/MRI: Current and Future Applications. AJR Am J Roentgenol. 2018 Aug;211(2):286-294. doi: 10.2214/AJR.18.19957.

40) Rahbar K, Afshar-Oromieh A, Seifert R, Wagner S, Schäfers M, Bögemann M, Weckesser M. Diagnostic performance of 18F-PSMA-1007 PET/CT in patients with biochemical recurrent prostate cancer. Eur J Nucl Med Mol Imaging. 2018 Jul 20.

39) Afshar-Oromieh A, Debus N, Uhrig M, Hope TA, Evans MJ, Holland-Letz T, Giesel FL, Kopka K, Hadaschik B, Kratochwil C, Haberkorn U. Impact of long-term androgen deprivation therapy on PSMA ligand PET/CT in patients with castration-sensitive prostate cancer. Eur J Nucl Med Mol Imaging. 2018 Jul 7.

38) Rahbar K, Afshar-Oromieh A, Bögemann M, Wagner S, Schäfers M, Stegger L, Weckesser M. 18F-PSMA-1007 PET/CT at 60 and 120 minutes in patients with prostate cancer: biodistribution, tumour detection and activity kinetics. Eur J Nucl Med Mol Imaging. 2018 Mar 14.

37) Afshar-Oromieh A, Sattler LP, Steiger K, Holland-Letz T, da Cunha ML, Mier W, Neels O, Kopka K, Weichert W, Haberkorn U. Tracer uptake in mediastinal and paraaortal thoracic lymph nodes as a potential pitfall in image interpretation of PSMA ligand PET/CT. Eur J Nucl Med Mol Imaging. 2018 Mar 1.

36) Rahbar K, Afshar-Oromieh A, Jadvar H, Ahmadzadehfar H. PSMA Theranostics: Current Status and Future Directions. Mol Imaging. 2018 Jan-Dec;17:1536012118776068.

35) Rathke H, Afshar-Oromieh A, Giesel FL, Kremer C, Flechsig P, Haufe S, Mier W, Holland-Letz T, de Bucourt M, Armor T, Babich J, Haberkorn U, Kratochwil C. Intra-individual comparison of Tc-99m-MDP bone scan and the PSMA-ligand Tc-99m-MIP-1427 in patients with osseous metastasized prostate cancer. J Nucl Med. 2018 Jan 25.

34) Kratochwil C, Schmidt K, Afshar-Oromieh A, Bruchertseifer F, Rathke H, Morgenstern A, Haberkorn U, Giesel FL. Targeted alpha therapy of mCRPC: Dosimetry estimate of 213Bismuth-PSMA-617. Eur J Nucl Med Mol Imaging. 2017 Sep 11.

33) Sheikhbahaei S, Afshar-Oromieh A, Eiber M, Solnes LB, Javadi MS, Ross AE, Pienta KJ, Allaf ME, Haberkorn U, Pomper MG, Gorin MA, Rowe SP. Pearls and pitfalls in clinical interpretation of prostate-specific membrane antigen (PSMA)-targeted PET imaging. Eur J Nucl Med Mol Imaging. 2017 Aug 1.

32) W.P. Fendler, S. Reinhardt, H. Ilhan, A. Delker, G. Böning, F.J. Gildehaus, C. Stief, P. Bartenstein, C. Gratzke, S. Lehner, A. Rominger. Preliminary experience with dosimetry, response and patient reported outcome after 177Lu-PSMA-617 therapy for metastatic castration-resistant prostate cancer. Oncotarget (2017) 8(2):3581-3590.

31) Vera Wenter, A. Herlemann, W.P. Fendler, H. Ilhan, N. Tirichter, P. Bartenstein, C.G. Stief, C. La Fougere, N.L. Albert, A. Rominger, C. Gratzke. Radium-223 for primary bone metastases in patients with hormone-sensitive prostate cancer. Oncotarget (2017) 8(27):44131-44140

30) Schwarzenböck SM, Rauscher I, Bluemel C, Fendler WP, Rowe SP, Pomper MG, Afshar-Oromieh A, Herrmann K, Eiber M. PSMA Ligands for PET-Imaging of Prostate Cancer. J Nucl Med. 2017 Jul 7.

29) H. Ilhan, S. Reinhardt, W. Fendler, A. Todica, F. Gildehaus, C. Cyran, C. Gratzke, A. Herlemann, V. Wenter, P. Bartenstein, A. Rominger. Comparison of Ga-68 PSMA-11 PET, Tc-99m DPD bone SPECT and computed tomography for the detection of bone metastases in patients with metastatic prostate cancer. EJNMMI (2017) 44(Suppl2): S710.

28) Afshar-Oromieh A, Wolf M, Haberkorn U, Kachelrieß M, Gnirs R, Kopka K, Schlemmer HP, Freitag MT. Effects of arm truncation on the appearance of the halo artifact in 68Ga-PSMA-11 (HBED-CC) PET/MRI. Eur J Nucl Med Mol Imaging. 2017 May 15.

27) Kesch C, Vinsensia M, Radtke JP, Schlemmer HP, Heller M, Ellert E, Holland-Letz T, Duensing S, Grabe N, Afshar-Oromieh A, Wieczorek K, Schäfer M, Neels OC, Cardinale J, Kratochwil C, Hohenfellner M, Kopka K, Haberkorn U, Hadaschik BA, Giesel FL Intra-individual comparison of 18F-PSMA-1007-PET/CT, multi-parametric MRI and radical prostatectomy specimen in patients with primary prostate cancer - a retrospective, proof of concept study. J Nucl Med. 2017 May 4.

26) Freitag MT, Radtke JP, Afshar-Oromieh A, Roethke MC, Hadaschik BA, Gleave M, Bonekamp D, Kopka K, Eder M, Heusser T, Kachelriess M, Wieczorek K, Sachpekidis C, Flechsig P, Giesel F, Hohenfellner M, Haberkorn U, Schlemmer HP, Dimitrakopoulou-Strauss A. Local recurrence of prostate cancer after radical prostatectomy is at risk to be missed in 68Ga-PSMA-11-PET of PET/CT and PET/MRI: comparison with mpMRI integrated in simultaneous PET/MRI. Eur J Nucl Med Mol Imaging. 2017 May;44(5):776-787.

25) Afshar-Oromieh A, Holland-Letz T, Giesel FL, Kratochwil C, Mier W, Haufe S, Debus N, Eder M, Eisenhut M, Schäfer M, Neels O, Hohenfellner M, Kopka K, Kauczor HU, Debus J, Haberkorn U. Diagnostic performance of 68Ga-PSMA-11 (HBED-CC) PET/CT in patients with recurrent prostate cancer: evaluation in 1007 patients. Eur J Nucl Med Mol Imaging. 2017 May 12.

24) Afshar-Oromieh A, Haberkorn U, Zechmann C, Armor T, Mier W, Spohn F, Debus N, Holland-Letz T, Babich J, Kratochwil C. Repeated PSMA-targeting radioligand therapy of metastatic prostate cancer with 131I-MIP-1095. Eur J Nucl Med Mol Imaging. 2017 Jun;44(6):950-959.

23) Afshar-Oromieh A, Sattler LP, Mier W, Hadaschik B, Debus J, Holland-Letz T, Kopka K, Haberkorn U. The clinical impact of additional late PET/CT imaging with 68Ga-PSMA-11 (HBED-CC) in the diagnosis of prostate cancer. J Nucl Med. 2017 Jan 6.

22) Afshar-Oromieh A, Babich JW, Kratochwil C, Giesel FL, Eisenhut M, Kopka K, Haberkorn U. The Rise of PSMA Ligands for Diagnosis and Therapy of Prostate Cancer. J Nucl Med. 2016 Oct;57 (Suppl 3):79S-89S.

21) Hope TA, Truillet CC, Ehman EC, Afshar-Oromieh A, Aggarwal R, Ryan CJ, Carroll PR, Small EJ, Evans MJ. Imaging Response to AnDr.ogen Receptor Inhibition Using 68Ga-PSMA-11 PET: First Human Experience. J Nucl Med. 2016 Sep 22.

20) Kratochwil C, Afshar-Oromieh A, Kopka K, Haberkorn U, Giesel FL. Current Status of Prostate-Specific Membrane Antigen Targeting in Nuclear Medicine: Clinical Translation of Chelator Containing Prostate-Specific Membrane Antigen Ligands Into Diagnostics and Therapy for Prostate Cancer. Semin Nucl Med. 2016 Sep;46(5):405-18.

19) Afshar-Oromieh A, Hetzheim H, Kübler W, Kratochwil C, Giesel FL, Hope TA, Eder M, Eisenhut M, Kopka K, Haberkorn U. Radiation dosimetry of (68)Ga-PSMA-11 (HBED-CC) and preliminary evaluation of optimal imaging timing. Eur J Nucl Med Mol Imaging. 2016 Aug;43(9):1611-20.

18) Giesel FL, Sterzing F, Schlemmer HP, Holland-Letz T, Mier W, Rius M, Afshar-Oromieh A, Kopka K, Debus J, Haberkorn U, Kratochwil C. Intra-individual comparison of (68)Ga-PSMA-11-PET/CT and multi-parametric MR for imaging of primary prostate cancer. Eur J Nucl Med Mol Imaging. 2016 Jul;43(8):1400-6.

17) Kratochwil C, Giesel FL, Stefanova M, Benešová M, Bronzel M, Afshar-Oromieh A, Mier W, Eder M, Kopka K, Haberkorn U. PSMA-targeted radionuclide therapy of metastatic castration-resistant prostate cancer with Lu-177 labeled PSMA-617. J Nucl Med. 2016 Mar 16.

16) Freitag MT, Radtke JP, Hadaschik BA, Kopp-Schneider A, Eder M, Kopka K, Haberkorn U, Roethke M, Schlemmer HP, Afshar-Oromieh A. Comparison of hybrid 68Ga-PSMA PET/MRI and 68Ga-PSMA PET/CT in the evaluation of lymph node and bone metastases of prostate cancer. Eur J Nucl Med Mol Imaging. 2015 Oct 28.

15) Afshar-Oromieh A, Kratochwil C, Eder M, Eisenhut M, Kopka K, Haberkorn U. Diagnosis of Recurrent Prostate Cancer with PSMA-Ligand PET/CT and Clinical Introduction of PSMA-based Radioligand Therapy. Nuklearmediziner 2015; 38(02): 124-130.

14) Afshar-Oromieh A, Hetzheim H, Kratochwil C, Benesova M, Eder M, Neels OC, Eisenhut M, Kübler W, Holland-Letz T, Giesel FL, Mier W, Kopka K, Haberkorn U. The Novel Theranostic PSMA Ligand PSMA-617 in the Diagnosis of Prostate Cancer by PET/CT: Biodistribution in Humans, Radiation Dosimetry, and First Evaluation of Tumor Lesions. J Nucl Med. 2015 Nov;56(11):1697-705.

13) Giesel FL, Fiedler H, Stefanova M, Sterzing F, Rius M, Kopka K, Moltz JH, Afshar-Oromieh A, Choyke PL, Haberkorn U, Kratochwil C. PSMA PET/CT with Glu-urea-Lys-(Ahx)-[(68)Ga(HBED-CC)] versus 3D CT volumetric lymph node assessment in recurrent prostate cancer. Eur J Nucl Med Mol Imaging. 2015 Nov;42(12):1794-800.

12) Sterzing F, Kratochwil C, Fiedler H, Katayama S, Habl G, Kopka K, Afshar-Oromieh A, Debus J, Haberkorn U, Giesel FL. 68Ga-PSMA-11 PET/CT: a new technique with high potential for the radiotherapeutic management of prostate cancer patients. Eur J Nucl Med Mol Imaging. 2015 Sep 25.

11) Benešová M, Schäfer M, Bauder-Wüst U, Afshar-Oromieh A, Kratochwil C, Mier W, Haberkorn U, Kopka K, Eder M. Preclinical Evaluation of a Tailor-Made DOTA-Conjugated PSMA Inhibitor with Optimized Linker Moiety for Imaging and Endoradiotherapy of Prostate Cancer. J Nucl Med. 2015 Jun;56(6):914-20.

10) Kratochwil C, Giesel FL, Eder M, Afshar-Oromieh A, Benešová M, Mier W, Kopka K, Haberkorn U. [177Lu]Lutetium-labelled PSMA ligand-induced remission in a patient with metastatic prostate cancer. Eur J Nucl Med Mol Imaging. 2015 May;42(6):987-8.

9) Afshar-Oromieh A, Avtzi E, Giesel FL, Holland-Letz T, Linhart HG, Eder M, Eisenhut M, Boxler S, Hadaschik BA, Kratochwil C, Weichert W, Kopka K, Debus J, Haberkorn U. The diagnostic value of PET/CT imaging with the 68Ga-labelled PSMA-ligand HBED-CC in the diagnosis of Prostate Cancer. Eur J Nucl Med Mol Imaging. 2015 Feb;42(2):197-209.

8) Kratochwil C, Giesel FL, Eder M, Afshar-Oromieh A, Benešová M, Mier W, Kopka K, Haberkorn U. [177Lu]Lutetium-labelled PSMA ligand-induced remission in a patient with metastatic prostate cancer. Eur J Nucl Med Mol Imaging. 2015 Jan 9.

7) Zechmann CM*, Afshar-Oromieh A*, Armor T, Stubbs JB, Mier W, Hadaschik B, Joyal J, Kopka K, Debus J, Haberkorn U. Radiation dosimetry and first therapy results with a (124)I/ (131)I-labeled small molecule (MIP-1095) targeting PSMA for prostate cancer therapy. Eur J Nucl Med Mol Imaging. 2014 Jul;41(7):1280-92. (* co-first authors)

6) Eder M, Neels O, Müller M, Bauder-Wüst U, Remde Y, Schäfer M, Hennrich U, Eisenhut M, Afshar-Oromieh A, Haberkorn U, Kopka K. Novel Preclinical and Radiopharma-ceutical Aspects of [68Ga]Ga-PSMA-HBED-CC: A New PET Tracer for Imaging of Prostate Cancer. Pharmaceuticals (Basel). 2014 Jun 30;7(7):779-96.

5) Afshar-Oromieh A, Zechmann CM, Malcher A, Eder M, Eisenhut M, Linhart HG, Holland-Letz T, Hadaschik BA, Giesel FL, Debus J, Haberkorn U. Comparison of PET imaging with a (68)Ga-labelled PSMA ligand and (18)F-choline-based PET/CT for the diagnosis of recurrent prostate cancer. Eur J Nucl Med Mol Imaging. 2014 Jan;41(1):11-20.

4) Afshar-Oromieh A, Haberkorn U, Schlemmer HP, Fenche M, Eder M, Eisenhut M, Hadaschik BA, Kopp-Schneider A and Röthke M. Comparison of PET/CT and PET/MRI hybrid systems using a 68Ga-labeled PSMA-ligand for the diagnosis of recurrent prostate cancer: initial experience. Eur J Nucl Med Mol Imaging. 2013 Dec 19.

3) Afshar-Oromieh A, Haberkorn U, Hadaschik B, Habl G, Eder M, Eisenhut M, Schlemmer HP, Roethke MC. PET/MRI with a 68Ga-PSMA ligand for the detection of prostate cancer. Eur J Nucl Med Mol Imaging. 2013 Oct;40(10):1629-30. [IP 7.7]

2) Afshar-Oromieh A, Malcher A, Eder M, Eisenhut M, Linhart HG, Hadaschik B A, Holland-Letz T, Giesel FL, Kratochwil C, Haufe S, Haberkorn U and Zechmann CM. PET imaging with a [(68)Ga]gallium-labelled PSMA ligand for the diagnosis of prostate cancer: biodistribution in humans and first evaluation of tumour lesions. Eur J Nucl Med Mol Imaging. 2013 Apr;40(4):486-95.

1) Afshar-Oromieh A, Haberkorn U, Eder M, Eisenhut M, Zechmann CM. [68Ga]Gallium-labelled PSMA ligand as superior PET tracer for the diagnosis of prostate cancer: comparison with 18F-FECH. Eur J Nucl Med Mol Imaging. 2012 Jun;39(6):1085-6.