PSMA-Targeted PET Radiotracer [¹⁸F]DCFPyL as an Imaging Biomarker in Inflammatory Bowel Disease

Background: Prostate-specific membrane antigen (PSMA) is highly and specifically upregulated in active-inflamed mucosa of patients with inflammatory bowel disease (IBD). We hypothesized that this upregulation would be detectable using a PSMA-targeted positron emission tomography/computed tomography (PET/CT) imaging agent, [¹⁸F]DCFPyL, enabling non-invasive visualization of inflammation. A noninvasive means of detecting active inflammation would have high clinical value in localization and management of IBD. Study: We performed [¹⁸F]DCFPyL imaging in three IBD patients with active disease. Abnormally increased gastrointestinal [¹⁸F] DCFPyL uptake was observed in areas with endoscopic, histologic, and immunohistochemical inflammation, demonstrating partial overlap of segments of bowel with abnormal [¹⁸F]DCFPyL uptake and active inflammation. Conclusion: This study demonstrates that PSMA-targeted [¹⁸F]DCFPyL PET can effectively detect regions of inflamed mucosa in patients with IBD, suggesting its utility as a non-invasive imaging agent to assess location, extent, and disease activity in IBD.