TY - JOUR
T1 - Comparison of prostate-specific membrane antigen-based 18F-DCFBC PET/CT to conventional imaging modalities for detection of hormone-naïve and castration-resistant metastatic prostate cancer
AU - Rowe, Steven P.
AU - MacUra, Katarzyna J.
AU - Ciarallo, Anthony
AU - Mena, Esther
AU - Blackford, Amanda
AU - Nadal, Rosa
AU - Antonarakis, Emmanuel S.
AU - Eisenberger, Mario A.
AU - Carducci, Michael A.
AU - Ross, Ashley E.
AU - Kantoff, Philip W.
AU - Holt, Daniel P.
AU - Dannals, Robert F.
AU - Mease, Ronnie C.
AU - Pomper, Martin G.
AU - Cho, Steve Y.
N1 - Funding Information:
We thank Akimosa Jeffrey-Kwanisai and Yavette Morton for providing dedicated clinical coordination for this trial.
Publisher Copyright:
© 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Conventional imaging modalities (CIMs) have limited sensitivity and specificity for detection of metastatic prostate cancer. We examined the potential of a first-in-class radiofluorinated smallmolecule inhibitor of prostate-specific membrane antigen (PSMA), N-[N-[(S)-1,3-dicarboxypropyl]carbamoyl]-4-18F-fluorobenzyl-L-cysteine (18F-DCFBC), to detect metastatic hormone-naïve (HNPC) and castration-resistant prostate cancer (CRPC). Methods: Seventeen patients were prospectively enrolled (9 HNPC and 8 CRPC); 16 had CIM evidence of new or progressive metastatic prostate cancer and 1 had high clinical suspicion of metastatic disease. 18F-DCFBC PET/CT imaging was obtained with 2 successive PET scans starting at 2 h after injection. Patients were imaged with CIM at approximately the time of PET. A lesion-by-lesion analysis of PET to CIM was performed in the context of either HNPC or CRPC. The patients were followed with available clinical imaging as a reference standard to determine the true nature of identified lesions on PET and CIM. Results: On the lesion-by-lesion analysis, 18F-DCFBC PET was able to detect a larger number of lesions (592 positive with 63 equivocal) than CIM (520 positive with 61 equivocal) overall, in both HNPC and CRPC patients. 18F-DCFBC PET detection of lymph nodes, bone lesions, and visceral lesions was superior to CIM. When intrapatient clustering effects were considered, 18F-DCFBC PET was estimated to be positive in a large proportion of lesions that would be negative or equivocal on CIM (0.45). On follow-up, the sensitivity of 18F-DCFBC PET (0.92) was superior to CIM (0.71). 18F-DCFBC tumor uptake was increased at the later PET time point (?2.5 h after injection), with background uptake showing a decreasing trend on later PET. Conclusion: PET imaging with 18FDCFBC, a small-molecule PSMA-targeted radiotracer, detected more lesions than CIM and promises to diagnose and stage patients with metastatic prostate cancer more accurately than current imaging methods.
AB - Conventional imaging modalities (CIMs) have limited sensitivity and specificity for detection of metastatic prostate cancer. We examined the potential of a first-in-class radiofluorinated smallmolecule inhibitor of prostate-specific membrane antigen (PSMA), N-[N-[(S)-1,3-dicarboxypropyl]carbamoyl]-4-18F-fluorobenzyl-L-cysteine (18F-DCFBC), to detect metastatic hormone-naïve (HNPC) and castration-resistant prostate cancer (CRPC). Methods: Seventeen patients were prospectively enrolled (9 HNPC and 8 CRPC); 16 had CIM evidence of new or progressive metastatic prostate cancer and 1 had high clinical suspicion of metastatic disease. 18F-DCFBC PET/CT imaging was obtained with 2 successive PET scans starting at 2 h after injection. Patients were imaged with CIM at approximately the time of PET. A lesion-by-lesion analysis of PET to CIM was performed in the context of either HNPC or CRPC. The patients were followed with available clinical imaging as a reference standard to determine the true nature of identified lesions on PET and CIM. Results: On the lesion-by-lesion analysis, 18F-DCFBC PET was able to detect a larger number of lesions (592 positive with 63 equivocal) than CIM (520 positive with 61 equivocal) overall, in both HNPC and CRPC patients. 18F-DCFBC PET detection of lymph nodes, bone lesions, and visceral lesions was superior to CIM. When intrapatient clustering effects were considered, 18F-DCFBC PET was estimated to be positive in a large proportion of lesions that would be negative or equivocal on CIM (0.45). On follow-up, the sensitivity of 18F-DCFBC PET (0.92) was superior to CIM (0.71). 18F-DCFBC tumor uptake was increased at the later PET time point (?2.5 h after injection), with background uptake showing a decreasing trend on later PET. Conclusion: PET imaging with 18FDCFBC, a small-molecule PSMA-targeted radiotracer, detected more lesions than CIM and promises to diagnose and stage patients with metastatic prostate cancer more accurately than current imaging methods.
KW - Bone scan
KW - Computed tomography
KW - Metastatic prostate cancer
KW - Positron emission tomography
KW - Prostate-specific membrane antigen
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U2 - 10.2967/jnumed.115.163782
DO - 10.2967/jnumed.115.163782
M3 - Article
C2 - 26493203
AN - SCOPUS:84958605968
SN - 0161-5505
VL - 57
SP - 46
EP - 53
JO - Journal of Nuclear Medicine
JF - Journal of Nuclear Medicine
IS - 1
ER -
