TY - JOUR
T1 - 18F-DCFBC Prostate-Specific Membrane Antigen-Targeted PET/CT Imaging in Localized Prostate Cancer
T2 - Correlation with Multiparametric MRI and Histopathology
AU - Turkbey, Baris
AU - Mena, Esther
AU - Lindenberg, Liza
AU - Adler, Stephen
AU - Bednarova, Sandra
AU - Berman, Rose
AU - Ton, Anita T.
AU - McKinney, Yolanda
AU - Eclarinal, Philip
AU - Hill, Craig
AU - Afari, George
AU - Bhattacharyya, Sibaprasad
AU - Mease, Ronnie C.
AU - Merino, Maria J.
AU - Jacobs, Paula M.
AU - Wood, Bradford J.
AU - Pinto, Peter A.
AU - Pomper, Martin G.
AU - Choyke, Peter L.
N1 - Funding Information:
The authors thank the NExT program of the National Cancer Institute for supporting this research.
Funding Information:
Conflicts of interest and sources of funding: This project has been funded in whole or in part with federal funds from the National Cancer Institute, National Institutes of Health, under contract HHSN261200800001E. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government.
Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Purpose To assess the ability of (N-[N-[(S)-1,3-dicarboxypropyl]carbamoyl]-4-18F-fluorobenzyl-l-cysteine) (18F-DCFBC), a prostate-specific membrane antigen-Targeted PET agent, to detect localized prostate cancer lesions in correlation with multiparametric MRI (mpMRI) and histopathology. Methods This Health Insurance Portability and Accountability Act of 1996-compliant, prospective, institutional review board-Approved study included 13 evaluable patients with localized prostate cancer (median age, 62.8 years [range, 51-74 years]; median prostate-specific antigen, 37.5 ng/dL [range, 3.26-216 ng/dL]). Patients underwent mpMRI and 18F-DCFBC PET/CT within a 3 months' window. Lesions seen on mpMRI were biopsied under transrectal ultrasound/MRI fusion-guided biopsy, or a radical prostatectomy was performed. 18F-DCFBC PET/CT and mpMRI were evaluated blinded and separately for tumor detection on a lesion basis. For PET image analysis, MRI and 18F-DCFBC PET images were fused by using software registration; imaging findings were correlated with histology, and uptake of 18F-DCFBC in tumors was compared with uptake in benign prostatic hyperplasia nodules and normal peripheral zone tissue using the 80% threshold SUVmax. Results A total of 25 tumor foci (mean size, 1.8 cm; median size, 1.5 cm; range, 0.6-4.7 cm) were histopathologically identified in 13 patients. Sensitivity rates of 18F-DCFBC PET/CT and mpMRI were 36% and 96%, respectively, for all tumors. For index lesions, the largest tumor with highest Gleason score, sensitivity rates of 18F-DCFBC PET/CT and mpMRI were 61.5% and 92%, respectively. The average SUVmax for primary prostate cancer was higher (5.8 ± 4.4) than that of benign prostatic hyperplasia nodules (2.1 ± 0.3) or that of normal prostate tissue (2.1 ± 0.4) at 1 hour postinjection (P = 0.0033). Conclusions The majority of index prostate cancers are detected with 18F-DCFBC PET/CT, and this may be a prognostic indicator based on uptake and staging. However, for detecting prostate cancer with high sensitivity, it is important to combine prostate-specific membrane antigen PET/CT with mpMRI.
AB - Purpose To assess the ability of (N-[N-[(S)-1,3-dicarboxypropyl]carbamoyl]-4-18F-fluorobenzyl-l-cysteine) (18F-DCFBC), a prostate-specific membrane antigen-Targeted PET agent, to detect localized prostate cancer lesions in correlation with multiparametric MRI (mpMRI) and histopathology. Methods This Health Insurance Portability and Accountability Act of 1996-compliant, prospective, institutional review board-Approved study included 13 evaluable patients with localized prostate cancer (median age, 62.8 years [range, 51-74 years]; median prostate-specific antigen, 37.5 ng/dL [range, 3.26-216 ng/dL]). Patients underwent mpMRI and 18F-DCFBC PET/CT within a 3 months' window. Lesions seen on mpMRI were biopsied under transrectal ultrasound/MRI fusion-guided biopsy, or a radical prostatectomy was performed. 18F-DCFBC PET/CT and mpMRI were evaluated blinded and separately for tumor detection on a lesion basis. For PET image analysis, MRI and 18F-DCFBC PET images were fused by using software registration; imaging findings were correlated with histology, and uptake of 18F-DCFBC in tumors was compared with uptake in benign prostatic hyperplasia nodules and normal peripheral zone tissue using the 80% threshold SUVmax. Results A total of 25 tumor foci (mean size, 1.8 cm; median size, 1.5 cm; range, 0.6-4.7 cm) were histopathologically identified in 13 patients. Sensitivity rates of 18F-DCFBC PET/CT and mpMRI were 36% and 96%, respectively, for all tumors. For index lesions, the largest tumor with highest Gleason score, sensitivity rates of 18F-DCFBC PET/CT and mpMRI were 61.5% and 92%, respectively. The average SUVmax for primary prostate cancer was higher (5.8 ± 4.4) than that of benign prostatic hyperplasia nodules (2.1 ± 0.3) or that of normal prostate tissue (2.1 ± 0.4) at 1 hour postinjection (P = 0.0033). Conclusions The majority of index prostate cancers are detected with 18F-DCFBC PET/CT, and this may be a prognostic indicator based on uptake and staging. However, for detecting prostate cancer with high sensitivity, it is important to combine prostate-specific membrane antigen PET/CT with mpMRI.
KW - F-DCFBC PET/CT
KW - PSMA
KW - multiparametric prostate MRI
KW - prostate cancer
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U2 - 10.1097/RLU.0000000000001804
DO - 10.1097/RLU.0000000000001804
M3 - Article
C2 - 28806263
AN - SCOPUS:85032331752
SN - 0363-9762
VL - 42
SP - 735
EP - 740
JO - Clinical Nuclear Medicine
JF - Clinical Nuclear Medicine
IS - 10
ER -