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Fedrigo R, Coope R, Rahmim A, Bénard F, Uribe CF. Development of the quantitative PET prostate phantom (Q3P) for improved quality assurance of 18F-PSMA PET imaging in metastatic prostate cancer. Med Phys 2024; 51:4311-4323. [PMID: 38348927 DOI: 10.1002/mp.16977] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 01/12/2024] [Accepted: 01/23/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Phantoms are commonly used to evaluate and compare the performance of imaging systems given the known ground truth. Positron emission tomography (PET) scanners are routinely validated using the NEMA image quality phantom, in which lesions are modeled using 10 to 37 mm fillable spheres. The NEMA phantom neglects, however, to model focal (3-10-mm), high-uptake lesions that are increasingly observed in prostate-specific membrane antigen (PSMA) PET images. PSMA-targeting radiopharmaceuticals allow for enhanced detection of metastatic prostate cancers. As such, there is significant need to develop an updated phantom which considers both the quantitative and lesion detectability of this new paradigm in oncological PET imaging. PURPOSE In this work, we present the Quantitative PET Prostate Phantom (Q3P); a portable and modular phantom that can be used to improve and harmonize imaging protocols for 18F-PSMA PET scans. METHODS A one-piece cylindrical phantom was designed effectively in two halves, which we call modules. Module 1 was designed to mimic lesions in the presence of background, and Module 2 mimicked very high contrast conditions (i.e., very low background) that can be observed in 18F-PSMA PET scans. Shell-less radioactive spheres (3-16-mm) were cast using epoxy resin mixed with sodium-22 (22Na), a long half-life positron emitter with positron range similar to 18F. To establish realistic lesion contrast, the 22Na spheres were mounted in a cylindrical chamber that can be filled with an 18F background (module 1). Thirteen exchangeable spherical cavity inserts (3-37-mm) were machined in two parts and solvent welded together, and filled with 18F (50 kBq/mL) to model lesions with very high contrast (module 2). Five 2.5-min PET scans were acquired on a 5-ring GE Discovery MI PET/CT scanner (General Electric, USA). Lesions were segmented using 41% of SUVmax fixed thresholding (41% FT) and recovery coefficients (RCs) were computed from 5 noise realizations. RESULTS The manufactured phantom is portable (5.7 kg) and scan preparation takes less than 40 min. The total 22Na activity is 250 kBq, allowing it to be shipped as an exempt package under International Atomic Energy Agency (IAEA) regulations. Recovery coefficients, computed using PSF modeling and no post-reconstruction smoothing, were 130.3% (16 mm), 147.1% (10 mm), 87.2% (6 mm), and 7.0% (3 mm) for RCmax, which decreased to 91.1% (16 mm), 90.6% (10 mm), 53.2% (6 mm), and 3.6% (3 mm) for RCmean in the 22Na spheres. Comparatively, 18F sphere recovery was 110.7% (17 mm), 123.6% (10 mm), 106.5% (7 mm), and 23.3% (3 mm) for RCmax, which was reduced to 76.7% (17 mm), 77.7% (10 mm), 66.8% (7 mm), and 13.5% (3 mm), for RCmean. CONCLUSIONS A standardized imaging phantom was developed for lesion quantification assessment in 18F-PSMA PET images. The phantom is configurable, providing users with the opportunity to modify background activity levels or sphere sizes according to clinical demands. Distributed to the community, the Q3P phantom has the potential to enable better assessment of lesion quantification and harmonization of 18F-PSMA PET imaging, which may lead to more robust predictive metrics and better outcome prediction in metastatic prostate cancer.
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Affiliation(s)
- Roberto Fedrigo
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Robin Coope
- Canada's Michael Smith Genome Science Centre, BC Cancer, Vancouver, British Columbia, Canada
| | - Arman Rahmim
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Functional Imaging, BC Cancer, Vancouver, British Columbia, Canada
| | - François Bénard
- Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Functional Imaging, BC Cancer, Vancouver, British Columbia, Canada
- Department of Molecular Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada
| | - Carlos F Uribe
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada
- Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Functional Imaging, BC Cancer, Vancouver, British Columbia, Canada
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Bodar YJL, Boevé LMS, van Leeuwen PJ, Baars PC, Nieuwenhuijzen JA, van Haarst EP, Oddens JR, Donswijk ML, van Riel LAMJG, Scheltema MJ, Meijer D, Hendrikse NH, Oprea-Lager DE, Vis AN. Using prostate-specific membrane antigen positron-emission tomography to guide prostate biopsies and stage men at high-risk of prostate cancer. BJU Int 2023; 132:705-712. [PMID: 37620288 DOI: 10.1111/bju.16167] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
OBJECTIVE To assess whether a diagnostic pathway in which prostate-specific membrane antigen (PSMA) positron-emission tomography (PET)/computed tomography (CT) is used as a single imaging modality is feasible to guide targeted biopsy and to detect clinically significant prostate cancer (csPCa) in biopsy-naïve men at high-risk of disease. PATIENTS AND METHODS A total of 60 men with a prostate-specific antigen (PSA) level of 20-50 ng/mL underwent 18 F-PSMA(DCFPyL)-PET/CT prior to prostate biopsies in this prospective, non-randomised cohort study. Magnetic resonance imaging (MRI) was not performed. Using a 12-segment mapping model of the prostate, PSMA-guided targeted biopsy was performed along with systematic biopsies. The detection rate of PCa and csPCa was assessed for combined systematic and targeted biopsy, and for targeted biopsy only. csPCa was defined as a prostate biopsy with an International Society of Uropathology (ISUP) Grade Group ≥2. RESULTS Lesions suspicious for PCa in the prostate gland were observed on all PSMA-PET/CTs. A total of 27/60 men (45%) already had metastatic disease on staging 18 F-PSMA(DCFPyL)-PET/CT. Combined PSMA-guided targeted and systematic biopsies detected PCa in 56/60 (93.3%) patients, with 52 of them (92.9%) having csPCa. PSMA-guided targeted biopsy, if performed as a single biopsy modality, identified PCa in 52/60 men (86.7%) and in 27/27 men (100%) men with metastases. CONCLUSIONS Using the PSMA-driven single imaging modality pathway in biopsy-naïve men at high-risk of PCa, a substantial number of diagnostic MRI scans could be avoided while at the same time obtaining adequate targeting, staging, and detection of csPCa.
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Affiliation(s)
- Yves J L Bodar
- Department of Urology, Amsterdam University Medical Centres, Amsterdam, The Netherlands
- Department of Radiology and Nuclear medicine, Amsterdam University Medical Centres (VU University), Amsterdam, The Netherlands
- Prostate Cancer Network, Amsterdam, The Netherlands
| | - Liselotte M S Boevé
- Department of Urology, Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, The Netherlands
| | - Pim J van Leeuwen
- Prostate Cancer Network, Amsterdam, The Netherlands
- Department of Urology, Netherlands Cancer Institute (NCI), Amsterdam, The Netherlands
| | - Phillippe C Baars
- Department of Radiology and Nuclear Medicine, Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, The Netherlands
| | - Jakko A Nieuwenhuijzen
- Department of Urology, Amsterdam University Medical Centres, Amsterdam, The Netherlands
- Prostate Cancer Network, Amsterdam, The Netherlands
| | - Ernst P van Haarst
- Department of Urology, Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, The Netherlands
| | - Jorg R Oddens
- Department of Urology, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Maarten L Donswijk
- Department of Radiology and Nuclear Medicine, Netherlands Cancer Institute (NCI), Amsterdam, The Netherlands
| | - Luigi A M J G van Riel
- Department of Urology, Amsterdam University Medical Centres, Amsterdam, The Netherlands
- Prostate Cancer Network, Amsterdam, The Netherlands
| | - Matthijs J Scheltema
- Department of Urology, Amsterdam University Medical Centres, Amsterdam, The Netherlands
- Prostate Cancer Network, Amsterdam, The Netherlands
| | - Dennie Meijer
- Department of Urology, Amsterdam University Medical Centres, Amsterdam, The Netherlands
- Department of Radiology and Nuclear medicine, Amsterdam University Medical Centres (VU University), Amsterdam, The Netherlands
- Prostate Cancer Network, Amsterdam, The Netherlands
| | - N Harry Hendrikse
- Department of Radiology and Nuclear medicine, Amsterdam University Medical Centres (VU University), Amsterdam, The Netherlands
- Department of Clinical Pharmacology and Pharmacy, Amsterdam University Medical Centres (VU University), Amsterdam, The Netherlands
| | - Daniela E Oprea-Lager
- Department of Radiology and Nuclear medicine, Amsterdam University Medical Centres (VU University), Amsterdam, The Netherlands
| | - André N Vis
- Department of Urology, Amsterdam University Medical Centres, Amsterdam, The Netherlands
- Prostate Cancer Network, Amsterdam, The Netherlands
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Oprea-Lager DE, Gontier E, García-Cañamaque L, Gauthé M, Olivier P, Mitjavila M, Tamayo P, Robin P, García Vicente AM, Bouyeure AC, Bailliez A, Rodríguez-Fernández A, Mahmoud SB, Vallejo-Casas JA, Maksud P, Merlin C, Blanc-Durand P, Drouet C, Tissot H, Vierasu I, Vander Borght T, Boos E, Chossat F, Hodolic M, Rousseau C. [ 18F]DCFPyL PET/CT versus [ 18F]fluoromethylcholine PET/CT in Biochemical Recurrence of Prostate Cancer (PYTHON): a prospective, open label, cross-over, comparative study. Eur J Nucl Med Mol Imaging 2023; 50:3439-3451. [PMID: 37341747 PMCID: PMC10542307 DOI: 10.1007/s00259-023-06301-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 06/05/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE Primary objective was to compare the per-patient detection rates (DR) of [18F]DCFPyL versus [18F]fluoromethylcholine positron emission tomography/computed tomography (PET/CT), in patients with first prostate cancer (PCa) biochemical recurrence (BCR). Secondary endpoints included safety and impact on patient management (PM). METHODS This was a prospective, open label, cross-over, comparative study with randomized treatment administration of [18F]DCFPyL (investigational medicinal product) or [18F]fluoromethylcholine (comparator). Men with rising prostate-specific antigen (PSA) after initial curative therapy were enrolled. [18F]DCFPyL and [18F]fluoromethylcholine PET/CTs were performed within a maximum time interval of 12 days. DR was defined as the percentage of positive PET/CT scans identified by 3 central imaging readers. PM was assessed by comparing the proposed pre-PET/CT treatment with the local treatment", defined after considering both PET/CTs. RESULTS A total of 205 patients with first BCR after radical prostatectomy (73%; median PSA = 0.46 ng/ml [CI 0.16;27.0]) or radiation therapy (27%; median PSA = 4.23 ng/ml [CI 1.4;98.6]) underwent [18F]DCFPyL- and/or [18F]fluoromethylcholine -PET/CTs, between July and December 2020, at 22 European sites. 201 patients completed the study. The per-patient DR was significantly higher for [18F]DCFPyL- compared to [18F]fluoromethylcholine -PET/CTs (58% (117/201 patients) vs. 40% (81/201 patients), p < 0.0001). DR increased with higher PSA values for both tracers (PSA ≤ 0.5 ng/ml: 26/74 (35%) vs. 22/74 (30%); PSA 0.5 to ≤ 1.0 ng/ml: 17/31 (55%) vs. 10/31 (32%); PSA 1.01 to < 2.0 ng/ml: 13/19 (68%) vs. 6/19 (32%);PSA > 2.0: 50/57 (88%) vs. 39/57 (68%) for [18F]DCFPyL- and [18F]fluoromethylcholine -PET/CT, respectively). [18F]DCFPyL PET/CT had an impact on PM in 44% (90/204) of patients versus 29% (58/202) for [18F]fluoromethylcholine. Overall, no drug-related nor serious adverse events were observed. CONCLUSIONS The primary endpoint of this study was achieved, confirming a significantly higher detection rate for [18F]DCFPyL compared to [18F]fluoromethylcholine, in men with first BCR of PCa, across a wide PSA range. [18F]DCFPyL was safe and well tolerated.
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Affiliation(s)
- Daniela-Elena Oprea-Lager
- Department of Radiology & Nuclear Medicine, Amsterdam University Medical Centers, VU University Medical Center, Cancer Center Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
| | - Eric Gontier
- Service de Médecine Nucléaire, Centre de Cancérologie de La Sarthe, Le Mans, France
| | - Lina García-Cañamaque
- Servicio de Medicina Nuclear, Grupo HM Hospitales, Universidad CEU San Pablo, Madrid, Spain
| | - Mathieu Gauthé
- Service de Médecine Nucléaire, Hôpital Tenon, Paris, France
| | | | - Mercedes Mitjavila
- Servicio de Medicina Nuclear, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Pilar Tamayo
- Servicio de Medicina Nuclear, IBSAL, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Philippe Robin
- Service de Médecine Nucléaire, Centre Hospitalier Universitaire de Brest, Brest, France
- UMR 1304, Inserm, Univ Brest, CHRU Brest, GETBO, Brest, France
| | | | | | - Alban Bailliez
- Service de Médecine Nucléaire Humanitep, Groupement Des Hôpitaux de L'Institut Catholique de Lille, Hôpital Saint-Philibert, Lomme, France
- Service de Médecine Nucléaire, Hôpital Privé Le Bois, Iris Imagerie, Lille, France
| | - Antonio Rodríguez-Fernández
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de Las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria IBS, Granada, Spain
| | - Sinan Ben Mahmoud
- Service de médecine nucléaire, Hôpital de Mercy, CHR Metz-Thionville, Thionville, France
| | - Juan Antonio Vallejo-Casas
- UGC Medicina Nuclear, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Philippe Maksud
- Service de médecine nucléaire Hôpital de la Pitié-Salpétriére, Sorbonne-Université, Paris, France
| | - Charles Merlin
- Service de médecine nucléaire, Centre Jean Perrin, Clermont-Ferrand, France
- Imagerie moléculaire et stratégies théranostiques, UMR1240, Université Clermont Auvergne, Inserm, Clermont-Ferrand, France
| | - Paul Blanc-Durand
- Service de médecine nucléaire, CHU H. Mondor, Créteil, France; Université Paris Est Créteil (U-PEC), Créteil, France
| | - Clément Drouet
- Service de médecine nucléaire, Centre Georges-François-Leclerc, Dijon, France
| | - Hubert Tissot
- Service de médecine nucléaire, Institut Curie, Paris, France
| | - Irina Vierasu
- Department of Nuclear Medicine, HUB, Hôpital Erasme Université libre de Bruxelles (ULB), Brussels, Belgium
| | | | | | | | | | - Caroline Rousseau
- Univ Nantes, Univ Angers, INSERM, CNRS, CRCI2NA, Nantes, France
- Service de médecine nucléaire, Institut de cancérologie de l'Ouest, Saint-Herblain, France
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McInturff EL, France SP, Leverett CA, Flick AC, Lindsey EA, Berritt S, Carney DW, DeForest JC, Ding HX, Fink SJ, Gibson TS, Gray K, Hubbell AK, Johnson AM, Liu Y, Mahapatra S, McAlpine IJ, Watson RB, O'Donnell CJ. Synthetic Approaches to the New Drugs Approved During 2021. J Med Chem 2023; 66:10150-10201. [PMID: 37528515 DOI: 10.1021/acs.jmedchem.3c00501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
Each year, new drugs are introduced to the market, representing structures that have affinity for biological targets implicated in human diseases and conditions. These new chemical entities (NCEs), particularly small molecules and antibody-drug conjugates, provide insight into molecular recognition and serve as potential leads for the design of future medicines. This annual review is part of a continuing series highlighting the most likely process-scale synthetic approaches to 35 NCEs that were first approved anywhere in the world during 2021.
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Affiliation(s)
- Emma L McInturff
- Groton Laboratories, Pfizer Worldwide Research and Development, 445 Eastern Point Road, Groton, Connecticut 06340, United States
| | - Scott P France
- Process Research & Development, Merck & Co., Inc., Rahway, New Jersey 07065, United States
| | - Carolyn A Leverett
- Groton Laboratories, Pfizer Worldwide Research and Development, 445 Eastern Point Road, Groton, Connecticut 06340, United States
| | - Andrew C Flick
- Takeda Pharmaceuticals, 9625 Towne Centre Drive, San Diego, California 92121, United States
| | - Erick A Lindsey
- Takeda Pharmaceuticals, 9625 Towne Centre Drive, San Diego, California 92121, United States
| | - Simon Berritt
- Groton Laboratories, Pfizer Worldwide Research and Development, 445 Eastern Point Road, Groton, Connecticut 06340, United States
| | - Daniel W Carney
- Takeda Pharmaceuticals, 9625 Towne Centre Drive, San Diego, California 92121, United States
| | - Jacob C DeForest
- La Jolla Laboratories, Pfizer Worldwide Research and Development, 10777 Science Center Drive, San Diego, California 92121, United States
| | - Hong X Ding
- Pharmacodia (Beijing) Co. Ltd., Beijing, 100085, China
| | - Sarah J Fink
- Takeda Pharmaceuticals, 125 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Tony S Gibson
- Takeda Pharmaceuticals, 9625 Towne Centre Drive, San Diego, California 92121, United States
| | - Kaitlyn Gray
- Groton Laboratories, Pfizer Worldwide Research and Development, 445 Eastern Point Road, Groton, Connecticut 06340, United States
| | - Aran K Hubbell
- Groton Laboratories, Pfizer Worldwide Research and Development, 445 Eastern Point Road, Groton, Connecticut 06340, United States
| | - Amber M Johnson
- Groton Laboratories, Pfizer Worldwide Research and Development, 445 Eastern Point Road, Groton, Connecticut 06340, United States
| | - Yiyang Liu
- Groton Laboratories, Pfizer Worldwide Research and Development, 445 Eastern Point Road, Groton, Connecticut 06340, United States
| | - Subham Mahapatra
- Groton Laboratories, Pfizer Worldwide Research and Development, 445 Eastern Point Road, Groton, Connecticut 06340, United States
| | - Indrawan J McAlpine
- Genesis Therapeutics, 11568 Sorrento Valley Road, Suite 8, San Diego, California 92121, United States
| | - Rebecca B Watson
- La Jolla Laboratories, Pfizer Worldwide Research and Development, 10777 Science Center Drive, San Diego, California 92121, United States
| | - Christopher J O'Donnell
- Groton Laboratories, Pfizer Worldwide Research and Development, 445 Eastern Point Road, Groton, Connecticut 06340, United States
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de Bie KCC, Veerman H, Bodar YJL, Meijer D, van Leeuwen PJ, van der Poel HG, Donswijk ML, Vis AN, Oprea-Lager DE. Higher Preoperative Maximum Standardised Uptake Values (SUV max) Are Associated with Higher Biochemical Recurrence Rates after Robot-Assisted Radical Prostatectomy for [ 68Ga]Ga-PSMA-11 and [ 18F]DCFPyL Positron Emission Tomography/Computed Tomography. Diagnostics (Basel) 2023; 13:2343. [PMID: 37510087 PMCID: PMC10378114 DOI: 10.3390/diagnostics13142343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/01/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
This study aimed to investigate the association between the 68Ga- or 18F-radiolabeled prostate-specific membrane antigen (PSMA) tracer expression, represented by the maximum standardised uptake value (SUVmax) of the dominant intraprostatic lesion, and biochemical recurrence (BCR) in primary prostate cancer (PCa) patients prior to robot-assisted radical prostatectomy (RARP). This was a retrospective, multi-centre cohort study of 446 patients who underwent [68Ga]Ga-PSMA-11 (n = 238) or [18F]DCFPyL (n = 206) Positron Emission Tomography/Computed Tomography (PET/CT) imaging prior to RARP. SUVmax was measured in the dominant intraprostatic PCa lesions. [18F]DCFPyL patients were scanned 60 ([18F]DCFPyL-60; n = 106) or 120 ([18F]DCFPyL-120; n = 120) minutes post-injection of a radiotracer and were analysed separately. To normalise the data, SUVmax was log transformed for further analyses. During a median follow-up of 24 months, 141 (30.4%) patients experienced BCR. Log2SUVmax was a significant predictor for BCR (p < 0.001). In the multivariable analysis accounting for these preoperative variables: initial prostate-specific antigen (PSA), radiologic tumour stage (mT), the biopsy International Society of Urological Pathology grade group (bISUP) and the prostate imaging and reporting data system (PI-RADS), Log2SUVmax was found to be an independent predictor for BCR in [68Ga]Ga-PSMA-11 (HR 1.32, p = 0.04) and [18F]DCFPyL-120 PET/CT scans (HR 1.55, p = 0.04), but not in [18F]DCFPyL-60 ones (HR 0.92, p = 0.72). The PSMA expression of the dominant intraprostatic lesion proved to be an independent predictor for BCR in patients with primary PCa who underwent [68Ga]Ga-PSMA-11 or [18F]DCFPyL-120 PET/CT scans, but not in those who underwent [18F]DCFPyL-60 PET/CT scans.
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Affiliation(s)
- Katelijne C. C. de Bie
- Department of Urology, VU University, Amsterdam University Medical Centers, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (H.V.); (Y.J.L.B.); (D.M.); (A.N.V.)
- Department of Radiology & Nuclear Medicine, VU University, Amsterdam University Medical Centers, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands;
- Prostate Cancer Network The Netherlands, 1066 CX Amsterdam, The Netherlands;
| | - Hans Veerman
- Department of Urology, VU University, Amsterdam University Medical Centers, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (H.V.); (Y.J.L.B.); (D.M.); (A.N.V.)
- Prostate Cancer Network The Netherlands, 1066 CX Amsterdam, The Netherlands;
- Department of Urology, Antoni van Leeuwenhoek Hospital—The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Yves J. L. Bodar
- Department of Urology, VU University, Amsterdam University Medical Centers, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (H.V.); (Y.J.L.B.); (D.M.); (A.N.V.)
- Department of Radiology & Nuclear Medicine, VU University, Amsterdam University Medical Centers, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands;
- Prostate Cancer Network The Netherlands, 1066 CX Amsterdam, The Netherlands;
| | - Dennie Meijer
- Department of Urology, VU University, Amsterdam University Medical Centers, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (H.V.); (Y.J.L.B.); (D.M.); (A.N.V.)
- Department of Radiology & Nuclear Medicine, VU University, Amsterdam University Medical Centers, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands;
- Prostate Cancer Network The Netherlands, 1066 CX Amsterdam, The Netherlands;
| | - Pim J. van Leeuwen
- Prostate Cancer Network The Netherlands, 1066 CX Amsterdam, The Netherlands;
- Department of Urology, Antoni van Leeuwenhoek Hospital—The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Henk G. van der Poel
- Prostate Cancer Network The Netherlands, 1066 CX Amsterdam, The Netherlands;
- Department of Urology, Antoni van Leeuwenhoek Hospital—The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Maarten L. Donswijk
- Department of Radiology and Nuclear Medicine, Antoni van Leeuwenhoek Hospital—The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands;
| | - André N. Vis
- Department of Urology, VU University, Amsterdam University Medical Centers, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (H.V.); (Y.J.L.B.); (D.M.); (A.N.V.)
- Prostate Cancer Network The Netherlands, 1066 CX Amsterdam, The Netherlands;
| | - Daniela E. Oprea-Lager
- Department of Radiology & Nuclear Medicine, VU University, Amsterdam University Medical Centers, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands;
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Wijngaarden JE, Huisman MC, Jauw YWS, van Dongen GAMS, Greuter HNJM, Schuit RC, Cleveland M, Gootjes EC, Vugts DJ, Menke-van der Houven van Oordt CW, Boellaard R. Validation of simplified uptake measures against dynamic Patlak K i for quantification of lesional 89Zr-Immuno-PET antibody uptake. Eur J Nucl Med Mol Imaging 2023; 50:1897-1905. [PMID: 36820891 PMCID: PMC10199860 DOI: 10.1007/s00259-023-06151-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/12/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE Positron emission tomography imaging of zirconium-89-labelled monoclonal antibodies (89Zr-Immuno-PET) allows for visualisation and quantification of antibody uptake in tumours in vivo. Patlak linearization provides distribution volume (VT) and nett influx rate (Ki) values, representing reversible and irreversible uptake, respectively. Standardised uptake value (SUV) and tumour-to-plasma/tumour-to-blood ratio (TPR/TBR) are often used, but their validity depends on the comparability of plasma kinetics and clearances. This study assesses the validity of SUV, TPR and TBR against Patlak Ki for quantifying irreversible 89Zr-Immuno-PET uptake in tumours. METHODS Ten patients received 37 MBq 10 mg 89Zr-anti-EGFR with 500 mg/m2 unlabelled mAbs. Five patients received two doses of 37 MBq 89Zr-anti-HER3: 8-24 mg for the first administration and 24 mg-30 mg/kg for the second. Seven tumours from four patients showed 89Zr-anti-EGFR uptake, and 18 tumours from five patients showed 89Zr-anti-HER3 uptake. SUVpeak, TPRpeak and TBRpeak values were obtained from one to six days p.i. Patlak linearization was applied to tumour time activity curves and plasma samples to obtain Ki. RESULTS For 89Zr-anti-EGFR, there was a small variability along the linear regression line between SUV (- 0.51-0.57), TPR (- 0.06‒0.11) and TBR (- 0.13‒0.16) on day 6 versus Ki. Similar doses of 89Zr-anti-HER3 showed similar variability for SUV (- 1.3‒1.0), TPR (- 1.1‒0.53) and TBR (- 1.5‒0.72) on day 5 versus Ki. However, for the second administration of 89Zr-anti-HER3 with a large variability in administered mass doses, SUV showed a larger variability (- 1.4‒2.3) along the regression line with Ki, which improved when using TPR (- 0.38-0.32) or TBR (- 0.56‒0.46). CONCLUSION SUV, TPR and TBR at late time points were valid for quantifying irreversible lesional 89Zr-Immuno-PET uptake when constant mass doses were administered. However, for variable mass doses, only TPR and TBR provided reliable values for irreversible uptake, but not SUV, because SUV does not take patient and mass dose-specific plasma clearance into account.
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Affiliation(s)
- Jessica E Wijngaarden
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands.
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands.
| | - Marc C Huisman
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - Yvonne W S Jauw
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
- Department of Hematology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
| | - Guus A M S van Dongen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - Henri N J M Greuter
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - Robert C Schuit
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - Matthew Cleveland
- Bioimaging In Vitro/In Vivo Translation (IVIVT), GlaxoSmithKline, Stevenage, UK
| | - Elske C Gootjes
- Department of Medical Oncology, RadboudUMC, Geert Grooteplein Zuid 10, Nijmegen, The Netherlands
| | - Daniëlle J Vugts
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - C Willemien Menke-van der Houven van Oordt
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
- Department of Medical Oncology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
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Lindemann M, Oteiza A, Martin-Armas M, Guttormsen Y, Moldes-Anaya A, Berzaghi R, Bogsrud TV, Bach-Gansmo T, Sundset R, Kranz M. Glioblastoma PET/MRI: kinetic investigation of [ 18F]rhPSMA-7.3, [ 18F]FET and [ 18F]fluciclovine in an orthotopic mouse model of cancer. Eur J Nucl Med Mol Imaging 2023; 50:1183-1194. [PMID: 36416908 PMCID: PMC9931868 DOI: 10.1007/s00259-022-06040-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 11/11/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Glioblastoma multiforme (GBM) is the most common glioma and standard therapies can only slightly prolong the survival. Neo-vascularization is a potential target to image tumor microenvironment, as it defines its brain invasion. We investigate [18F]rhPSMA-7.3 with PET/MRI for quantitative imaging of neo-vascularization in GBM bearing mice and human tumor tissue and compare it to [18F]FET and [18F]fluciclovine using PET pharmacokinetic modeling (PKM). METHODS [18F]rhPSMA-7.3, [18F]FET, and [18F]fluciclovine were i.v. injected with 10.5 ± 3.1 MBq, 8.0 ± 2.2 MBq, 11.5 ± 1.9 MBq (n = 28, GL261-luc2) and up to 90 min PET/MR imaged 21/28 days after surgery. Regions of interest were delineated on T2-weighted MRI for (i) tumor, (ii) brain, and (iii) the inferior vena cava. Time-activity curves were expressed as SUV mean, SUVR and PKM performed using 1-/2-tissue-compartment models (1TCM, 2TCM), Patlak and Logan analysis (LA). Immunofluorescent staining (IFS), western blotting, and autoradiography of tumor tissue were performed for result validation. RESULTS [18F]rhPSMA-7.3 showed a tumor uptake with a tumor-to-background-ratio (TBR) = 2.1-2.5, in 15-60 min. PKM (2TCM) confirmed higher K1 (0.34/0.08, p = 0.0012) and volume of distribution VT (0.24/0.1, p = 0.0017) in the tumor region compared to the brain. Linearity in LA and similar k3 = 0.6 and k4 = 0.47 (2TCM, tumor, p = ns) indicated reversible binding. K1, an indicator for vascularization, increased (0.1/0.34, 21 to 28 days, p < 0.005). IFS confirmed co-expression of PSMA and tumor vascularization. [18F]fluciclovine showed higher TBR (2.5/1.8, p < 0.001, 60 min) and VS (1.3/0.7, p < 0.05, tumor) compared to [18F]FET and LA indicated reversible binding. VT increased (p < 0.001, tumor, 21 to 28 days) for [18F]FET (0.5-1.4) and [18F]fluciclovine (0.84-1.5). CONCLUSION [18F]rhPSMA-7.3 showed to be a potential candidate to investigate the tumor microenvironment of GBM. Following PKM, this uptake was associated with tumor vascularization. In contrast to what is known from PSMA-PET in prostate cancer, reversible binding was found for [18F]rhPSMA-7.3 in GBM, contradicting cellular trapping. Finally, [18F]fluciclovine was superior to [18F]FET rendering it more suitable for PET imaging of GBM.
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Affiliation(s)
- Marcel Lindemann
- PET Imaging Center Tromsø, University Hospital of North Norway (UNN), Tromsø, Norway
- Nuclear Medicine and Radiation Biology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ana Oteiza
- PET Imaging Center Tromsø, University Hospital of North Norway (UNN), Tromsø, Norway
- Nuclear Medicine and Radiation Biology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Montserrat Martin-Armas
- PET Imaging Center Tromsø, University Hospital of North Norway (UNN), Tromsø, Norway
- Nuclear Medicine and Radiation Biology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Yngve Guttormsen
- PET Imaging Center Tromsø, University Hospital of North Norway (UNN), Tromsø, Norway
- Nuclear Medicine and Radiation Biology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Angel Moldes-Anaya
- PET Imaging Center Tromsø, University Hospital of North Norway (UNN), Tromsø, Norway
- Nuclear Medicine and Radiation Biology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Rodrigo Berzaghi
- Nuclear Medicine and Radiation Biology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Trond Velde Bogsrud
- PET Imaging Center Tromsø, University Hospital of North Norway (UNN), Tromsø, Norway
- PET Center, Aarhus University Hospital, Aarhus, Denmark
| | - Tore Bach-Gansmo
- PET Imaging Center Tromsø, University Hospital of North Norway (UNN), Tromsø, Norway
| | - Rune Sundset
- PET Imaging Center Tromsø, University Hospital of North Norway (UNN), Tromsø, Norway
- Nuclear Medicine and Radiation Biology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Mathias Kranz
- PET Imaging Center Tromsø, University Hospital of North Norway (UNN), Tromsø, Norway.
- Nuclear Medicine and Radiation Biology, UiT The Arctic University of Norway, Tromsø, Norway.
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Bodar YJL, Luining WI, Keizer B, Meijer D, Vellekoop A, Schaaf M, Hendrikse NH, Van Moorselaar RJA, Oprea-Lager DE, Vis AN. A prospective, multicenter head-to-head comparative study in patients with primary high-risk prostate cancer investigating the bone lesion detection of conventional imaging and 18F-PSMA-PET/CT. Urol Oncol 2022; 41:205.e17-205.e24. [PMID: 36588019 DOI: 10.1016/j.urolonc.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/04/2022] [Accepted: 12/16/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) is an emerging staging tool for patients with primary high-risk prostate cancer (PCa). Patients with primary metastatic disease are staged using PSMA-PET/CT imaging, while previously published randomized clinical trials relied on conventional imaging (i.e., bone scintigraphy (BS) results. The aim of this study was to compare the ability of bone metastatic lesion detection and changes in staging for 18F-PSMA-PET/CT versus BS in high-risk PCa patients. METHODS 79 patients with high-risk PCa were prospectively staged using BS and subsequent 18F-PSMA-PET/CT before initial therapy. Patients who presented with a BS showing no metastases represented Group 1, and patients with a BS showing low-volume disease according to the CHAARTED criteria (<4 bone metastases, no metastases outside vertebral column or pelvis and no visceral metastases) represented Group 2. Metastatic risk group according to CHAARTED and treatment strategies based on both imaging modalities were assessed. RESULTS A change of CHAARTED risk group was observed in 9/70 (12.8%) of patients in Group 1. In Group 2, a change of risk group was found in 66.7% of patients, due to either upstaging (4/9 patients (44.4%)) and downstaging (2/9 patients (22.2%)). Treatment changes due to use of a different imaging modality occurred in almost 20% of patients. CONCLUSION In patients with negative for cancer results on BS, upstaging on 18F-PSMA-PET/CT occurred only infrequently. Moreover, 18F-PSMA-PET/CT resulted in both upstaging and downstaging in a substantial subset of patients with low-volume metastatic disease on BS. Treatment changes occurred in almost 20% of cases depending on imaging results.
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Affiliation(s)
- Y J L Bodar
- Department of Urology, Amsterdam University Medical Centres (VU University), Noord Holland, The Netherlands; Department of Radiology & Nuclear Medicine, Amsterdam University Medical Centres (VU University), Noord Holland, The Netherlands; Prostate Cancer Network, Noord Holland, The Netherlands.
| | - W I Luining
- Department of Urology, Amsterdam University Medical Centres (VU University), Noord Holland, The Netherlands; Department of Radiology & Nuclear Medicine, Amsterdam University Medical Centres (VU University), Noord Holland, The Netherlands; Prostate Cancer Network, Noord Holland, The Netherlands
| | - B Keizer
- Department of Urology, Dijklander Hospital, Noord Holland, The Netherlands
| | - D Meijer
- Department of Urology, Amsterdam University Medical Centres (VU University), Noord Holland, The Netherlands; Department of Radiology & Nuclear Medicine, Amsterdam University Medical Centres (VU University), Noord Holland, The Netherlands; Prostate Cancer Network, Noord Holland, The Netherlands
| | - A Vellekoop
- Department of Urology, Amstelland Hospital, Noord Holland, The Netherlands
| | - M Schaaf
- Department of Urology, Bovenij hospital, Noord Holland, The Netherlands
| | - N H Hendrikse
- Department of Radiology & Nuclear Medicine, Amsterdam University Medical Centres (VU University), Noord Holland, The Netherlands
| | - R J A Van Moorselaar
- Department of Urology, Amsterdam University Medical Centres (VU University), Noord Holland, The Netherlands; Prostate Cancer Network, Noord Holland, The Netherlands
| | - D E Oprea-Lager
- Department of Radiology & Nuclear Medicine, Amsterdam University Medical Centres (VU University), Noord Holland, The Netherlands
| | - A N Vis
- Department of Urology, Amsterdam University Medical Centres (VU University), Noord Holland, The Netherlands; Prostate Cancer Network, Noord Holland, The Netherlands
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9
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Prostate-Specific Membrane Antigen Targeted Pet/CT Imaging in Patients with Colon, Gastric and Pancreatic Cancer. Cancers (Basel) 2022; 14:cancers14246209. [PMID: 36551695 PMCID: PMC9777210 DOI: 10.3390/cancers14246209] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/08/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Current imaging modalities frequently misjudge disease stage in colorectal, gastric and pancreatic cancer. As treatment decisions are dependent on disease stage, incorrect staging has serious consequences. Previous preclinical research and case reports indicate that prostate-specific membrane antigen (PSMA)-targeted PET/CT imaging might provide a solution to some of these challenges. This prospective clinical study aims to assess the feasibility of [18F]DCFPyL PET/CT imaging to target and visualize primary colon, gastric and pancreatic cancer. In this prospective clinical trial, patients with colon, gastric and pancreatic cancer were included and underwent both [18F]DCFPyL and [18F]FDG PET/CT scans prior to surgical resection or (for gastric cancer) neoadjuvant therapy. Semiquantitative analysis of immunohistochemical PSMA staining was performed on the surgical resection specimens, and the results were correlated to imaging parameters. The results of this study demonstrate detection of the primary tumor by [18F]DCFPyL PET/CT in 7 out of 10 patients with colon, gastric and pancreatic cancer, with a mean tumor-to-blood pool ratio (TBR) of 3.3 and mean SUVmax of 3.6. However, due to the high surrounding uptake, visual distinction of these tumors was difficult, and the SUVmax and TBR on [18F]FDG PET/CT were significantly higher than on [18F]DCFPyL PET/CT. In addition, no correlation between PSMA expression in the resection specimen and SUVmax on [18F]DCFPyL PET/CT was found. In conclusion, the detection of several gastrointestinal cancers using [18F]DCFPyL PET/CT is feasible. However, low tumor expression and high uptake physiologically in organs/background hamper the clear distinction of the tumor. As a result, [18F]FDG PET/CT was superior in detecting colon, gastric and pancreatic cancers.
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10
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Lu M, Lindenberg L, Mena E, Turkbey B, Seidel J, Ton A, McKinney Y, Eclarinal P, Merino M, Pinto P, Choyke P, Adler S. A Pilot Study of Dynamic 18F-DCFPyL PET/CT Imaging of Prostate Adenocarcinoma in High-Risk Primary Prostate Cancer Patients. Mol Imaging Biol 2022; 24:444-452. [PMID: 34724140 PMCID: PMC10572101 DOI: 10.1007/s11307-021-01670-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The primary aim of this study was to investigate the pharmacokinetics of 18F-DCFPyL, an 18F-labeled PSMA-based ligand, and to explore the utility of early time point positron emission tomography (PET) imaging extracted from PET data to distinguish malignant primary prostate from benign prostate tissue. PROCEDURES Ten consecutive patients with biopsy-proven high-risk prostate cancer underwent a dynamic 18F-DCFPyL PET/CT scan of the pelvis for the first 45 min post-injection (p.i.) followed by a static PET/CT at 2 h p.i. 18F-DCFPyL uptake values and kinetics were compared between benign prostate tissue and prostate cancer, including quantitative pharmacokinetic PET parameters extracted from 18F-DCFPyL time activity curves generated from dynamic data using a two-tissue compartment model and Patlak plots. RESULTS 18F-DCFPyL uptake values were significantly higher in primary prostate tumors than those in benign prostatic hyperplasia (BPH) and normal prostate tissue at 5 min, 30 min, and 120 min p.i. (P = 0.0002), when examining both SUVmax and SUVmean values. The two-tissue compartment model found an overall influx value (Ki) of 0.063 in primary prostate cancer, demonstrating a Ki over 15-fold higher in malignant prostate tissue compared with BPH (Ki = 0.004) and normal prostate tissue (Ki = 0.005) (P = 0.0001). CONCLUSION High-risk primary prostate cancer is readily identified on dynamic and static, delayed, 18F-DCFPyL PET images. The tumor-to-background ratio increases over time, with optimal 18F-DCFPyL PET/CT imaging at 120 min p.i. for evaluation of prostate cancer, but not necessarily ideal for clinical application. Primary prostate cancer demonstrates different uptake kinetics in comparison to BPH and normal prostate tissue. The 15-fold difference in Ki between prostate cancer and non-cancer (BPH and normal) tissues translates to an ability to distinguish prostate cancer from normal tissue at time points as early as 5 to 10 min p.i.
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Affiliation(s)
- Michelle Lu
- Molecular Imaging Branch, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Liza Lindenberg
- Molecular Imaging Branch, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Esther Mena
- Molecular Imaging Branch, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Baris Turkbey
- Molecular Imaging Branch, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Jurgen Seidel
- Clinical Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Anita Ton
- Molecular Imaging Branch, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Yolanda McKinney
- Molecular Imaging Branch, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Philip Eclarinal
- Molecular Imaging Branch, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Maria Merino
- Laboratory of Pathology, National Cancer Institute, Bethesda, MD, USA
| | - Peter Pinto
- Urologic Oncology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Peter Choyke
- Molecular Imaging Branch, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Stephen Adler
- Clinical Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA.
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11
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Pantel AR, Viswanath V, Muzi M, Doot RK, Mankoff DA. Principles of Tracer Kinetic Analysis in Oncology, Part II: Examples and Future Directions. J Nucl Med 2022; 63:514-521. [PMID: 35361713 PMCID: PMC8973282 DOI: 10.2967/jnumed.121.263519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 02/17/2022] [Indexed: 11/29/2022] Open
Abstract
Learning Objectives: On successful completion of this activity, participants should be able to (1) describe examples of the application of PET tracer kinetic analysis to oncology; (2) list applications research and possible clinical applications in oncology where kinetic analysis is helpful; and (3) discuss future applications of kinetic modeling to cancer research and possible clinical cancer imaging practice.Financial Disclosure: This work was supported by KL2 TR001879, R01 CA211337, R01 CA113941, R33 CA225310, Komen SAC130060, R50 CA211270, and K01 DA040023. Dr. Pantel is a consultant or advisor for Progenics and Blue Earth Diagnostics and is a meeting participant or lecturer for Blue Earth Diagnostics. Dr. Mankoff is on the scientific advisory boards of GE Healthcare, Philips Healthcare, Reflexion, and ImaginAb and is the owner of Trevarx; his wife is the chief executive officer of Trevarx. The authors of this article have indicated no other relevant relationships that could be perceived as a real or apparent conflict of interest.CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through April 2025.Kinetic analysis of dynamic PET imaging enables the estimation of biologic processes relevant to disease. Through mathematic analysis of the interactions of a radiotracer with tissue, information can be gleaned from PET imaging beyond static uptake measures. Part I of this 2-part continuing education paper reviewed the underlying principles and methodology of kinetic modeling. In this second part, the benefits of kinetic modeling for oncologic imaging are illustrated through representative case examples that demonstrate the principles and benefits of kinetic analysis in oncology. Examples of the model types discussed in part I are reviewed here: a 1-tissue-compartment model (15O-water), an irreversible 2-tissue-compartment model (18F-FDG), and a reversible 2-tissue-compartment model (3'-deoxy-3'-18F-fluorothymidine). Kinetic approaches are contrasted with static uptake measures typically used in the clinic. Overall, this 2-part review provides the reader with background in kinetic analysis to understand related research and improve the interpretation of clinical nuclear medicine studies with a focus on oncologic imaging.
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Affiliation(s)
- Austin R Pantel
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania; and
| | - Varsha Viswanath
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania; and
| | - Mark Muzi
- Department of Radiology, University of Washington, Seattle, Washington
| | - Robert K Doot
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania; and
| | - David A Mankoff
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania; and
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12
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Tian A, Lin R, Yu J, Zhang F, Zheng Q, Yuan X, Sun Z, Zhong Z. The differential diagnostic value of dual-phase 18F-DCFPyL PET/CT in prostate carcinoma. Prostate Cancer Prostatic Dis 2022; 25:351-358. [PMID: 35422099 PMCID: PMC9184273 DOI: 10.1038/s41391-022-00534-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 03/21/2022] [Accepted: 03/29/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Binding of 18F-DCFPyL at prostate cancer (PC) cells increases over time. The dual-phase protocol may be helpful in separating benign lesions from malignant ones associated with prostate cancer. The purpose of this study was to retrospectively analyze the incremental diagnostic value of 18F-DCFPyL dual-time imaging in patients with prostate cancer. METHOD 114 prostate-related malignant lesions and 43 benign lesions in 38 patients with prostate cancer were retrospectively analyzed. Maximum standardized uptake value (SUVmax) for benign and prostate-related malignant lesions were calculated at min 60 and min 120 of PET/CT imaging. In order to calculate SUV ratio, the SUVmax of left gluteus maximus was measured at the same time. The difference of SUVmax metrics and SUV ratio between malignant and benign lesions was statistically analyzed, the cut-off value of ROC curve was calculated, and the diagnostic efficacy of SUVmax index and SUV ratio at two time points was compared. RESULTS SUVmax metrics and SUV ratio of early and delayed imaging of PC-related malignant lesions were significantly higher than those of benign lesions (p < 0.05). In terms of individual indicators, the highest accuracy and sensitivity was in the delayed SUV ratio (89.2% and 94.7%), the best specificity was in the early SUVmax (93.0%). When the individual and combined indicators were compared together, the SUV ratio in the delay period still showed the best diagnostic sensitivity and accuracy, and the best specificity were SUVmax early and ▵SUVmax, SUVmax early and RI. CONCLUSIONS Uptake of 18F-DCFPyL increased over time in prostate-associated malignant lesions compared with benign tissue. For single-phase imaging, 2-hour (delayed) imaging has better diagnostic performance. However, the dual-phase imaging (1 and 2 h) are helpful in the differential diagnosis of prostate-associated malignant lesions and benign lesions.
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Affiliation(s)
- Aijuan Tian
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, People's Republic of China.
| | - Runlong Lin
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, People's Republic of China
| | - Jing Yu
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, People's Republic of China
| | - Fan Zhang
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, People's Republic of China
| | - Qiang Zheng
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, People's Republic of China
| | - Xin Yuan
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, People's Republic of China
| | - Zhanhua Sun
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, People's Republic of China
| | - Zhaoyan Zhong
- Department of Nuclear Medicine, The Second Hospital of Dalian Medical University, Dalian, People's Republic of China
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13
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Li XF, Shi YM, Niu R, Shao XN, Wang JF, Shao XL, Zhang FF, Wang YT. Risk analysis in peripheral clinical T1 non-small cell lung cancer correlations between tumor-to-blood standardized uptake ratio on 18F-FDG PET-CT and primary tumor pathological invasiveness: a real-world observational study. Quant Imaging Med Surg 2022; 12:159-171. [PMID: 34993068 DOI: 10.21037/qims-21-394] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/09/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Sublobar resection is not suitable for patients with pathological invasiveness [including lymph node metastasis (LNM), visceral pleural invasion (VPI), and lymphovascular invasion (LVI)] of peripheral clinical T1 (cT1) non-small cell lung cancer (NSCLC), while primary tumor maximum standardized uptake value (SUVmax) on 18F-FDG PET-CT is related to pathological invasiveness, the significance differed among different institutions is still challenging. This study explored the relationship between the tumor-to-blood standardized uptake ratio (SUR) of 18F-FDG PET-CT and primary tumor pathological invasiveness in peripheral cT1 NSCLC patients. METHODS This retrospective study included 174 patients with suspected lung neoplasms who underwent preoperative 18F-FDG PET-CT. We compared the differences of the clinicopathological variables, metabolic and morphological parameters in the pathological invasiveness and less-invasiveness group. We performed a trend test for these parameters based on the tertiles of SUR. The relationship between SUR and pathological invasiveness was evaluated by univariate and multivariate logistics regression models (included unadjusted, simple adjusted, and fully adjusted models), odds ratios (ORs), and 95% confidence intervals (95% CIs) were calculated. A smooth fitting curve between SUR and pathological invasiveness was produced by the generalized additive model (GAM). RESULTS Thirty-eight point five percent of patients had pathological invasiveness and tended to have a higher SUR value than the less-invasiveness group [6.50 (4.82-11.16) vs. 4.12 (2.04-6.61), P<0.001]. The trend of SUVmax, mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG), mean CT value (CTmean), size of the primary tumor, neuron-specific enolase (NSE), the incidence of LNM, adenocarcinoma (AC), and poor differentiation in the tertiles of SUR value were statistically significant (P were <0.001, <0.001, 0.010, <0.001, <0.001, 0.002, 0.033, <0.001, 0.002, and <0.001, respectively). Univariate analysis showed that the risk of pathological invasiveness increased significantly with increasing SUR [OR: 1.13 (95% CI: 1.06-1.21), P<0.001], and multivariate analysis demonstrated SUR, as a continuous variable, was still significantly related to pathological invasiveness [OR: 1.09 (95% CI: 1.01-1.18), P=0.032] after adjusting for confounding covariates. GAM revealed that SUR tended to be linearly and positively associated with pathological invasiveness and E-value analysis suggested robustness to unmeasured confounding. CONCLUSIONS SUR is linearly and positively associated with primary tumor pathological invasiveness independent of confounding covariates in peripheral cT1 NSCLC patients and could be used as a supplementary risk maker to assess the risk of pathological invasiveness.
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Affiliation(s)
- Xiao-Feng Li
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China.,Department of Radiology, Xuzhou Cancer Hospital, Xuzhou, China
| | - Yun-Mei Shi
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Rong Niu
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Xiao-Nan Shao
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Jian-Feng Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Xiao-Liang Shao
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Fei-Fei Zhang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Yue-Tao Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China.,Changzhou Key Laboratory of Molecular Imaging, Changzhou, China
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14
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Poels TT, Vuijk FA, de Geus-Oei LF, Vahrmeijer AL, Oprea-Lager DE, Swijnenburg RJ. Molecular Targeted Positron Emission Tomography Imaging and Radionuclide Therapy of Pancreatic Ductal Adenocarcinoma. Cancers (Basel) 2021; 13:6164. [PMID: 34944781 PMCID: PMC8699493 DOI: 10.3390/cancers13246164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/01/2021] [Accepted: 12/05/2021] [Indexed: 12/15/2022] Open
Abstract
Pancreatic ductal adenocarcinoma (PDAC) has an inauspicious prognosis, mainly due to difficulty in early detection of the disease by the current imaging modalities. The upcoming development of tumour-specific tracers provides an alternative solution for more accurate diagnostic imaging techniques for staging and therapy response monitoring. The future goal to strive for, in a patient with PDAC, should definitely be first to receive a diagnostic dose of an antibody labelled with a radionuclide and to subsequently receive a therapeutic dose of the same labelled antibody with curative intent. In the first part of this paper, we summarise the available evidence on tumour-targeted diagnostic tracers for molecular positron emission tomography (PET) imaging that have been tested in humans, together with their clinical indications. Tracers such as radiolabelled prostate-specific membrane antigen (PSMA)-in particular, 18F-labelled PSMA-already validated and successfully implemented in clinical practice for prostate cancer, also seem promising for PDAC. In the second part, we discuss the theranostic applications of these tumour-specific tracers. Although targeted radionuclide therapy is still in its infancy, lessons can already be learned from early publications focusing on dose fractioning and adding a radiosensitiser, such as gemcitabine.
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Affiliation(s)
- Thomas T. Poels
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands;
| | - Floris A. Vuijk
- Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; (F.A.V.); (A.L.V.)
| | - Lioe-Fee de Geus-Oei
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands;
| | - Alexander L. Vahrmeijer
- Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; (F.A.V.); (A.L.V.)
| | - Daniela E. Oprea-Lager
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands;
| | - Rutger-Jan Swijnenburg
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands;
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15
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Oprea-Lager DE, Cysouw MC, Boellaard R, Deroose CM, de Geus-Oei LF, Lopci E, Bidaut L, Herrmann K, Fournier LS, Bäuerle T, deSouza NM, Lecouvet FE. Bone Metastases Are Measurable: The Role of Whole-Body MRI and Positron Emission Tomography. Front Oncol 2021; 11:772530. [PMID: 34869009 PMCID: PMC8640187 DOI: 10.3389/fonc.2021.772530] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/04/2021] [Indexed: 12/14/2022] Open
Abstract
Metastatic tumor deposits in bone marrow elicit differential bone responses that vary with the type of malignancy. This results in either sclerotic, lytic, or mixed bone lesions, which can change in morphology due to treatment effects and/or secondary bone remodeling. Hence, morphological imaging is regarded unsuitable for response assessment of bone metastases and in the current Response Evaluation Criteria In Solid Tumors 1.1 (RECIST1.1) guideline bone metastases are deemed unmeasurable. Nevertheless, the advent of functional and molecular imaging modalities such as whole-body magnetic resonance imaging (WB-MRI) and positron emission tomography (PET) has improved the ability for follow-up of bone metastases, regardless of their morphology. Both these modalities not only have improved sensitivity for visual detection of bone lesions, but also allow for objective measurements of bone lesion characteristics. WB-MRI provides a global assessment of skeletal metastases and for a one-step "all-organ" approach of metastatic disease. Novel MRI techniques include diffusion-weighted imaging (DWI) targeting highly cellular lesions, dynamic contrast-enhanced MRI (DCE-MRI) for quantitative assessment of bone lesion vascularization, and multiparametric MRI (mpMRI) combining anatomical and functional sequences. Recommendations for a homogenization of MRI image acquisitions and generalizable response criteria have been developed. For PET, many metabolic and molecular radiotracers are available, some targeting tumor characteristics not confined to cancer type (e.g. 18F-FDG) while other targeted radiotracers target specific molecular characteristics, such as prostate specific membrane antigen (PSMA) ligands for prostate cancer. Supporting data on quantitative PET analysis regarding repeatability, reproducibility, and harmonization of PET/CT system performance is available. Bone metastases detected on PET and MRI can be quantitatively assessed using validated methodologies, both on a whole-body and individual lesion basis. Both have the advantage of covering not only bone lesions but visceral and nodal lesions as well. Hybrid imaging, combining PET with MRI, may provide complementary parameters on the morphologic, functional, metabolic and molecular level of bone metastases in one examination. For clinical implementation of measuring bone metastases in response assessment using WB-MRI and PET, current RECIST1.1 guidelines need to be adapted. This review summarizes available data and insights into imaging of bone metastases using MRI and PET.
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Affiliation(s)
- Daniela E. Oprea-Lager
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Matthijs C.F. Cysouw
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Christophe M. Deroose
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium
- Nuclear Medicine & Molecular Imaging, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Lioe-Fee de Geus-Oei
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
- Biomedical Photonic Imaging Group, University of Twente, Enschede, Netherlands
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS – Humanitas Research Hospital, Milan, Italy
| | - Luc Bidaut
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- College of Science, University of Lincoln, Lincoln, United Kingdom
| | - Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen, and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Laure S. Fournier
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Paris Cardiovascular Research Center (PARCC), Institut National de la Santé et de la Recherche Médicale (INSERM), Radiology Department, Assistance Publique-Hôpitaux de Paris (AP-HP), Hopital europeen Georges Pompidou, Université de Paris, Paris, France
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
| | - Tobias Bäuerle
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Nandita M. deSouza
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- European Imaging Biomarkers Alliance (EIBALL), European Society of Radiology, Vienna, Austria
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Frederic E. Lecouvet
- Imaging Group, European Organisation of Research and Treatment in Cancer (EORTC), Brussels, Belgium
- Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
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16
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Cheng X, Ma L. Enzymatic synthesis of fluorinated compounds. Appl Microbiol Biotechnol 2021; 105:8033-8058. [PMID: 34625820 PMCID: PMC8500828 DOI: 10.1007/s00253-021-11608-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 12/31/2022]
Abstract
Fluorinated compounds are widely used in the fields of molecular imaging, pharmaceuticals, and materials. Fluorinated natural products in nature are rare, and the introduction of fluorine atoms into organic compound molecules can give these compounds new functions and make them have better performance. Therefore, the synthesis of fluorides has attracted more and more attention from biologists and chemists. Even so, achieving selective fluorination is still a huge challenge under mild conditions. In this review, the research progress of enzymatic synthesis of fluorinated compounds is summarized since 2015, including cytochrome P450 enzymes, aldolases, fluoroacetyl coenzyme A thioesterases, lipases, transaminases, reductive aminases, purine nucleoside phosphorylases, polyketide synthases, fluoroacetate dehalogenases, tyrosine phenol-lyases, glycosidases, fluorinases, and multienzyme system. Of all enzyme-catalyzed synthesis methods, the direct formation of the C-F bond by fluorinase is the most effective and promising method. The structure and catalytic mechanism of fluorinase are introduced to understand fluorobiochemistry. Furthermore, the distribution, applications, and future development trends of fluorinated compounds are also outlined. Hopefully, this review will help researchers to understand the significance of enzymatic methods for the synthesis of fluorinated compounds and find or create excellent fluoride synthase in future research.Key points• Fluorinated compounds are distributed in plants and microorganisms, and are used in imaging, medicine, materials science.• Enzyme catalysis is essential for the synthesis of fluorinated compounds.• The loop structure of fluorinase is the key to forming the C-F bond.
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Affiliation(s)
- Xinkuan Cheng
- State Key Laboratory of Food Nutrition and Safety, Key Laboratory of Industrial Microbiology, Ministry of Education, Tianjin Key Laboratory of Industry Microbiology, National and Local United Engineering Laboratory of Metabolic Control Fermentation Technology, College of Biotechnology, Tianjin University of Science & Technology, No. 29, Thirteenth Street, Binhai New District, Tianjin, 300457, China
| | - Long Ma
- State Key Laboratory of Food Nutrition and Safety, Key Laboratory of Industrial Microbiology, Ministry of Education, Tianjin Key Laboratory of Industry Microbiology, National and Local United Engineering Laboratory of Metabolic Control Fermentation Technology, College of Biotechnology, Tianjin University of Science & Technology, No. 29, Thirteenth Street, Binhai New District, Tianjin, 300457, China.
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17
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Yang DM, Alfano R, Bauman G, Thiessen JD, Chin J, Pautler S, Moussa M, Gomez JA, Rachinsky I, Gaed M, Chung KJ, Ward A, Lee TY. Short-duration dynamic [ 18F]DCFPyL PET and CT perfusion imaging to localize dominant intraprostatic lesions in prostate cancer: validation against digital histopathology and comparison to [ 18F]DCFPyL PET/MR at 120 minutes. EJNMMI Res 2021; 11:107. [PMID: 34652551 PMCID: PMC8519985 DOI: 10.1186/s13550-021-00844-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/27/2021] [Indexed: 11/10/2022] Open
Abstract
Purpose Localized prostate cancer (PCa) in patients is characterized by a dominant focus in the gland (dominant intraprostatic lesion, DIL). Accurate DIL identification may enable more accurate diagnosis and therapy through more precise targeting of biopsy, radiotherapy and focal ablative therapies. The goal of this study is to validate the performance of [18F]DCFPyL PET and CT perfusion (CTP) for detecting and localizing DIL against digital histopathological images. Methods Multi-modality image sets: in vivo T2-weighted (T2w)-MRI, 22-min dynamic [18F]DCFPyL PET/CT, CTP, and 2-h post-injection PET/MR were acquired in patients prior to radical prostatectomy. The explanted gland with implanted fiducial markers was imaged with T2w-MRI. All images were co-registered to the pathologist-annotated digital images of whole-mount mid-gland histology sections using fiducial markers and anatomical landmarks. Regions of interest encompassing DIL and non-DIL tissue were drawn on the digital histopathological images and superimposed on PET and CTP parametric maps. Logistic regression with backward elimination of parameters was used to select the most sensitive parameter set to distinguish DIL from non-DIL voxels. Leave-one-patient-out cross-validation was performed to determine diagnostic performance. Results [18F]DCFPyL PET and CTP parametric maps of 15 patients were analyzed. SUVLate and a model combining Ki and k4 of [18F]DCFPyL achieved the most accurate performance distinguishing DIL from non-DIL voxels. Both detection models achieved an AUC of 0.90 and an error rate of < 10%. Compared to digital histopathology, the detected DILs had a mean dice similarity coefficient of 0.8 for the Ki and k4 model and 0.7 for SUVLate. Conclusions We have validated using co-registered digital histopathological images that parameters from kinetic analysis of 22-min dynamic [18F]DCFPyL PET can accurately localize DILs in PCa for targeting of biopsy, radiotherapy, and focal ablative therapies. Short-duration dynamic [18F]DCFPyL PET was not inferior to SUVLate in this diagnostic task. Clinical trial registration number: NCT04009174 (ClinicalTrials.gov).
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Affiliation(s)
- Dae-Myoung Yang
- Department of Medical Biophysics, The University of Western Ontario, London, ON, Canada.,Robarts Research Institute, The University of Western Ontario, London, ON, Canada.,Imaging Program, Lawson Health Research Institute, 750 Base Line Road E, London, ON, N6C 2R5, Canada.,Department of Radiation Oncology, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA
| | - Ryan Alfano
- Department of Medical Biophysics, The University of Western Ontario, London, ON, Canada.,London Health Sciences Centre, London, ON, Canada.,Baines Imaging Research Laboratory, London, ON, Canada
| | - Glenn Bauman
- London Health Sciences Centre, London, ON, Canada.,Department of Oncology, The University of Western Ontario, London, ON, Canada
| | - Jonathan D Thiessen
- Department of Medical Biophysics, The University of Western Ontario, London, ON, Canada.,Imaging Program, Lawson Health Research Institute, 750 Base Line Road E, London, ON, N6C 2R5, Canada.,Department of Medical Imaging, The University of Western Ontario, London, ON, Canada
| | - Joseph Chin
- London Health Sciences Centre, London, ON, Canada.,Department of Oncology, The University of Western Ontario, London, ON, Canada.,Department of Surgery, The University of Western Ontario, London, ON, Canada
| | - Stephen Pautler
- Department of Oncology, The University of Western Ontario, London, ON, Canada.,Department of Surgery, The University of Western Ontario, London, ON, Canada.,St. Joseph' Health Care, London, ON, Canada
| | - Madeleine Moussa
- London Health Sciences Centre, London, ON, Canada.,Department of Pathology and Laboratory Medicine, The University of Western Ontario, London, ON, Canada
| | - Jose A Gomez
- London Health Sciences Centre, London, ON, Canada.,Department of Pathology and Laboratory Medicine, The University of Western Ontario, London, ON, Canada
| | - Irina Rachinsky
- London Health Sciences Centre, London, ON, Canada.,Department of Medical Imaging, The University of Western Ontario, London, ON, Canada
| | - Mena Gaed
- Department of Pathology and Laboratory Medicine, The University of Western Ontario, London, ON, Canada
| | - Kevin J Chung
- Department of Medical Biophysics, The University of Western Ontario, London, ON, Canada.,Robarts Research Institute, The University of Western Ontario, London, ON, Canada.,Imaging Program, Lawson Health Research Institute, 750 Base Line Road E, London, ON, N6C 2R5, Canada
| | - Aaron Ward
- Department of Medical Biophysics, The University of Western Ontario, London, ON, Canada.,London Health Sciences Centre, London, ON, Canada.,Baines Imaging Research Laboratory, London, ON, Canada.,Department of Oncology, The University of Western Ontario, London, ON, Canada
| | - Ting-Yim Lee
- Department of Medical Biophysics, The University of Western Ontario, London, ON, Canada. .,Robarts Research Institute, The University of Western Ontario, London, ON, Canada. .,Imaging Program, Lawson Health Research Institute, 750 Base Line Road E, London, ON, N6C 2R5, Canada. .,Department of Oncology, The University of Western Ontario, London, ON, Canada. .,Department of Medical Imaging, The University of Western Ontario, London, ON, Canada.
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18
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Bodar YJL, Koene BPF, Jansen BHE, Cysouw MCF, Meijer D, Hendrikse NH, Vis AN, Boellaard R, Oprea-Lager DE. SUVs Are Adequate Measures of Lesional 18F-DCFPyL Uptake in Patients with Low Prostate Cancer Disease Burden. J Nucl Med 2021; 62:1264-1269. [PMID: 33509971 DOI: 10.2967/jnumed.120.260232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 01/03/2021] [Indexed: 01/03/2023] Open
Abstract
In prostate cancer (PCa) patients, the tumor-to-blood ratio (TBR) has been validated as the preferred simplified method for lesional 18F-DCFPyL (a radiolabeled prostate-specific membrane antigen ligand) uptake quantification on PET. In contrast to SUVs, the TBR accounts for variability in arterial input functions caused by differences in total tumor burden between patients (the sink effect). However, TBR depends strongly on tracer uptake interval and has worse repeatability and is less applicable in clinical practice than SUVs. We investigated whether SUV could provide adequate quantification of 18F-DCFPyL uptake on PET/CT in a patient cohort with low PCa burden. Methods: In total, 116 patients with PCa undergoing 18F-DCFPyL PET/CT imaging were retrospectively included. All 18F-DCFPyL-avid lesions suspected of being PCa were semiautomatically delineated. SUVpeak was plotted against TBR for the most intense lesion of each patient. The correlation of SUVpeak and TBR was evaluated using linear regression and was stratified for patients undergoing PET/CT for primary staging, patients undergoing restaging at biochemical recurrence, and patients with metastatic castration-resistant PCa. Moreover, the correlation was evaluated as a function of tracer uptake time, prostate-specific antigen level, and PET-positive tumor volume. Results: In total, 436 lesions were delineated (median, 1 per patient; range, 1-66). SUVpeak correlated well with TBR in patients with PCa and a total tumor volume of less than 200 cm3 (R2 = 0.931). The correlation between SUV and TBR was not affected by disease setting, prostate-specific antigen level, or tumor volume. SUVpeak depended less on tracer uptake time than did TBR. Conclusion: For 18F-DCFPyL PET/CT, SUVpeak correlates strongly with TBR. Therefore, it is a valuable simplified, semiquantitative measurement in patients with low-volume PCa (<200 cm3). SUVpeak can therefore be applied in 18F-DCFPyL PET assessment as an imaging biomarker to characterize tumors and to monitor treatment outcomes.
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Affiliation(s)
- Yves J L Bodar
- Department of Urology, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands;
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
- Prostate Cancer Network, Noord Holland, The Netherlands; and
| | - Berend P F Koene
- Department of Urology, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
| | - Bernard H E Jansen
- Department of Urology, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
- Prostate Cancer Network, Noord Holland, The Netherlands; and
| | - Matthijs C F Cysouw
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
| | - Dennie Meijer
- Department of Urology, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
- Prostate Cancer Network, Noord Holland, The Netherlands; and
| | - N Harry Hendrikse
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
- Department of Clinical Pharmacology and Pharmacy, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
| | - André N Vis
- Department of Urology, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
- Prostate Cancer Network, Noord Holland, The Netherlands; and
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
| | - Daniela E Oprea-Lager
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
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19
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Abstract
Piflufolastat F 18 (PYLARIFY®) is an 18F-labelled diagnostic imaging agent that has been developed by Progenics Pharmaceuticals Inc., a Lantheus company, for positron emission tomography (PET) that targets prostate-specific membrane antigen (PSMA). Piflufolastat F 18 was approved in the USA on 27 May 2021 for PET of PSMA positive lesions in men with prostate cancer with suspected metastasis who are candidates for initial definitive therapy or with suspected recurrence based on elevated serum prostate specific antigen (PSA) level. This article summarizes the milestones in the development of piflufolastat F 18 leading to this approval as a radioactive diagnostic agent in prostate cancer.
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Affiliation(s)
- Susan J Keam
- Springer Nature, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand.
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20
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Lodge MA, Lesniak W, Gorin MA, Pienta KJ, Rowe SP, Pomper MG. Measurement of PET Quantitative Bias In Vivo. J Nucl Med 2021; 62:732-737. [PMID: 33037089 DOI: 10.2967/jnumed.120.251397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 09/16/2020] [Indexed: 11/16/2022] Open
Abstract
Quantitative imaging biomarkers are widely used in PET for both research and clinical applications, yet bias in the underlying image data has not been well characterized. In the absence of a readily available reference standard for in vivo quantification, bias in PET images has been inferred using physical phantoms, even though arrangements of this sort provide only a poor approximation of the imaging environment in real patient examinations. In this study, we used data acquired from patient volunteers to assess PET quantitative bias in vivo. Image-derived radioactivity concentrations in the descending aorta were compared with blood samples counted on a calibrated γ-counter. Methods: Ten patients with prostate cancer were studied using 2-(3-(1-carboxy-5-[(6-18F-fluoro-pyridine-3-carbonyl)-amino]-pentyl)-ureido)-pentanedioic acid PET/CT. For each patient, 3 whole-body PET/CT image series were acquired after a single administration of the radiotracer: shortly after injection as well as approximately 1 and 4 h later. Venous blood samples were obtained at 8 time points over an 8-h period, and whole blood was counted on a NaI γ-counter. A 10-mm-diameter, 20-mm-long cylindric volume of interest was positioned in the descending thoracic aorta to estimate the PET-derived radioactivity concentration in blood. A triexponential function was fit to the γ-counter blood data and used to estimate the radioactivity concentration at the time of each PET acquisition. Results: The PET-derived and γ-counter-derived radioactivity concentrations were linearly related, with an R 2 of 0.985, over a range of relevant radioactivity concentrations. The mean difference between the PET and γ-counter data was 4.8% ± 8.6%, with the PET measurements tending to be greater. Conclusion: Human image data acquired on a conventional whole-body PET/CT system with a typical clinical protocol differed by an average of around 5% from blood samples counted on a calibrated γ-counter. This bias may be partly attributable to residual uncorrected scatter or attenuation correction error. These data offer an opportunity for the assessment of PET bias in vivo and provide additional support for the use of quantitative imaging biomarkers.
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Affiliation(s)
- Martin A Lodge
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland; and
| | - Wojciech Lesniak
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland; and
| | - Michael A Gorin
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland; and.,James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kenneth J Pienta
- James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Steven P Rowe
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland; and.,James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Martin G Pomper
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland; and.,James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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21
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olde Heuvel J, de Wit-van der Veen BJ, Sinaasappel M, Slump CH, Stokkel MPM. Early differences in dynamic uptake of 68Ga-PSMA-11 in primary prostate cancer: A test-retest study. PLoS One 2021; 16:e0246394. [PMID: 33529259 PMCID: PMC7853454 DOI: 10.1371/journal.pone.0246394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 12/27/2020] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Dynamic PET/CT allows visualization of pharmacokinetics over the time, in contrast to static whole body PET/CT. The objective of this study was to assess 68Ga-PSMA-11 uptake in pathological lesions and benign tissue, within 30 minutes after injection in primary prostate cancer (PCa) patients in test-retest setting. MATERIALS AND METHODS Five patients, with biopsy proven PCa, were scanned dynamically in list mode for 30 minutes on a digital PET/CT-scanner directly after an intravenous bolus injection of 100 MBq 68Ga-PSMA-11. Approximately 45 minutes after injection a static whole body scan was acquired, followed by a one bed position scan of the pelvic region. The scans were repeated approximately four weeks later, without any intervention in between. Semi-quantitative assessment was performed using regions-of-interest in the prostate tumor, bladder, gluteal muscle and iliac artery. Time-activity curves were extracted from the counts in these regions and the intra-patient variability between both scans was assessed. RESULTS The uptake of the iliac artery and gluteal muscle reached a plateau after 5 and 3 minutes, respectively. The population fell apart in two groups with respect to tumor uptake: in some patients the tumor uptake reached a plateau after 5 minutes, whereas in other patients the uptake kept increasing, which correlated with larger tumor volumes on PET/CT scan. Median intra-patient variation between both scans was 12.2% for artery, 9.7% for tumor, 32.7% for the bladder and 14.1% for the gluteal muscle. CONCLUSION Dynamic 68Ga-PSMA-11 PET/CT scans, with a time interval of four weeks, are reproducible with a 10% variation in uptake in the primary prostate tumor. An uptake plateau was reached for the iliac artery and gluteal muscle within 5 minutes post-injection. A larger tumor volume seems to be related to continued tumor uptake. This information might be relevant for both response monitoring and PSMA-based radionuclide therapies.
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Affiliation(s)
- J. olde Heuvel
- Department of Nuclear Medicine, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
- Robotics and Mechatronics, Technical Medical Centre, University of Twente, The Netherlands
| | - B. J. de Wit-van der Veen
- Department of Nuclear Medicine, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - M. Sinaasappel
- Department of Medical Physics, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - C. H. Slump
- Robotics and Mechatronics, Technical Medical Centre, University of Twente, The Netherlands
| | - M. P. M. Stokkel
- Department of Nuclear Medicine, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
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22
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Yang DM, Li F, Bauman G, Chin J, Pautler S, Moussa M, Rachinsky I, Valliant J, Lee TY. Kinetic analysis of dominant intraprostatic lesion of prostate cancer using quantitative dynamic [ 18F]DCFPyL-PET: comparison to [ 18F]fluorocholine-PET. EJNMMI Res 2021; 11:2. [PMID: 33394284 PMCID: PMC7782622 DOI: 10.1186/s13550-020-00735-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 11/23/2020] [Indexed: 12/28/2022] Open
Abstract
Purpose Identification of the dominant intraprostatic lesion(s) (DILs) can facilitate diagnosis and treatment by targeting biologically significant intra-prostatic foci. A PSMA ligand, [18F]DCFPyL (2-(3-{1-carboxy-5-[(6-[18F]fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid), is better than choline-based [18F]FCH (fluorocholine) in detecting and localizing DIL because of higher tumour contrast, particularly when imaging is delayed to 1 h post-injection. The goal of this study was to investigate whether the different imaging performance of [18F]FCH and [18F]DCFPyL can be explained by their kinetic behaviour in prostate cancer (PCa) and to evaluate whether DIL can be accurately detected and localized using a short duration dynamic positron emission tomography (PET). Methods 19 and 23 PCa patients were evaluated with dynamic [18F]DCFPyL and [18F]FCH PET, respectively. The dynamic imaging protocol with each tracer had a total imaging time of 22 min and consisted of multiple frames with acquisition times from 10 to 180 s. Tumour and benign tissue regions identified by sextant biopsy were compared using standardized uptake value (SUV) and tracer kinetic parameters from kinetic analysis of time-activity curves. Results For [18F]DCFPyL, logistic regression identified Ki and k4 as the optimal model to discriminate tumour from benign tissue (84.2% sensitivity and 94.7% specificity), while only SUV was predictive for [18F]FCH (82.6% sensitivity and 87.0% specificity). The higher k3 (binding) of [18F]FCH than [18F]DCFPyL explains why [18F]FCH SUV can differentiate tumour from benign tissue within minutes of injection. Superior [18F]DCFPyL tumour contrast was due to the higher k4/k3 (more rapid washout) in benign tissue compared to tumour tissue. Conclusions DIL was detected with good sensitivity and specificity using 22-min dynamic [18F]DCFPyL PET and avoids the need for delayed post-injection imaging timepoints. The dissimilar in vivo kinetic behaviour of [18F]DCFPyL and [18F]FCH could explain their different SUV images. Clinical Trial Registration NCT04009174 (ClinicalTrials.gov).
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Affiliation(s)
- Dae-Myoung Yang
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond St, London, ON, N6A 3K7, Canada.,Robarts Research Institute, University of Western Ontario, 1151 Richmond St, London, ON, N6A 5B7, Canada.,Lawson Health Research Institute, 268 Grosvenor St, London, ON, N6A 4V2, Canada
| | - Fiona Li
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond St, London, ON, N6A 3K7, Canada.,Robarts Research Institute, University of Western Ontario, 1151 Richmond St, London, ON, N6A 5B7, Canada.,Lawson Health Research Institute, 268 Grosvenor St, London, ON, N6A 4V2, Canada
| | - Glenn Bauman
- Lawson Health Research Institute, 268 Grosvenor St, London, ON, N6A 4V2, Canada.,Department of Oncology, Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond St, London, ON, N6A 3K7, Canada
| | - Joseph Chin
- Lawson Health Research Institute, 268 Grosvenor St, London, ON, N6A 4V2, Canada.,Department of Oncology, Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond St, London, ON, N6A 3K7, Canada
| | - Stephen Pautler
- Lawson Health Research Institute, 268 Grosvenor St, London, ON, N6A 4V2, Canada.,Department of Oncology, Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond St, London, ON, N6A 3K7, Canada
| | - Madeleine Moussa
- Pathology and Laboratory Medicine, London Health Sciences Centre, 800 Commissioners Rd E, London, ON, N6A 5W9, Canada
| | - Irina Rachinsky
- Lawson Health Research Institute, 268 Grosvenor St, London, ON, N6A 4V2, Canada
| | - John Valliant
- Centre for Probe Development and Commercialization, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - Ting-Yim Lee
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond St, London, ON, N6A 3K7, Canada. .,Robarts Research Institute, University of Western Ontario, 1151 Richmond St, London, ON, N6A 5B7, Canada. .,Lawson Health Research Institute, 268 Grosvenor St, London, ON, N6A 4V2, Canada. .,Department of Oncology, Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond St, London, ON, N6A 3K7, Canada.
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23
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Van Simaeys G, Doumont G, De Maeseneire C, Passon N, Lacroix S, Lentz C, Horion A, Warnier C, Torres D, Martens C, Vierasu I, Egrise D, Goldman S. [ 18F]-JK-PSMA-7 and [ 18F]-FDG tumour PET uptake in treated xenograft human prostate cancer model in mice. Eur J Nucl Med Mol Imaging 2021; 48:1773-1784. [PMID: 33398412 DOI: 10.1007/s00259-020-05169-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 12/15/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE This preclinical study aims to evaluate the extent to which a change in prostate-specific membrane antigen (PSMA) expression of castration-resistant prostate cancer (CRPC) following standard treatment is reflected in [18F]JK-PSMA-7 PET/CT. METHODS Castrated mice supplemented with testosterone implant were xenografted with human LNCaP CRPC. After appropriate tumour growth, androgen deprivation therapy (ADT) was carried out by the removal of the implant followed by a single injection of docetaxel (400 μg/20-g mouse) 2 weeks later. [18F]JK-PSMA-7 PET/CT were performed before ADT, then before and at days 12, 26, 47 and 69 after docetaxel administration. The [18F]JK-PSMA-7 PET data were compared to corresponding unspecific metabolic [18F]FDG PET/CT and ex vivo quantification of PSMA expression estimated by flow cytometry on repeated tumour biopsies. RESULTS ADT alone had no early effect on LNCaP tumours that pursued their progression. Until day 12 post-docetaxel, the [18F]JK-PSMA7 uptake was significantly higher than that of [18F]FDG, indicating the persistence of PSMA expression at those time points. From day 26 onwards when the tumours were rapidly expanding, both [18F]JK-PSMA7 and [18F]FDG uptake continuously decreased although the decrease in [18F]JK-PSMA uptake was markedly faster. The fraction of PSMA-positive cells in tumour biopsies decreased similarly over time to reach a non-specific level after the same time period. CONCLUSION Applying PSMA-based imaging for therapy monitoring in patients with CRPC should be considered with caution since a reduction in [18F]JK-PSMA-7 PET uptake after successive ADT and chemotherapy may be related to downregulation of PSMA expression in dedifferentiated and rapidly proliferating tumour cells.
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Affiliation(s)
- Gaetan Van Simaeys
- Center for Microscopy and Molecular Imaging, Université libre de Bruxelles, Charleroi, Belgium. .,Service de médecine nucléaire, Hôpital Érasme, Université libre de Bruxelles, Brussels, Belgium.
| | - Gilles Doumont
- Center for Microscopy and Molecular Imaging, Université libre de Bruxelles, Charleroi, Belgium
| | - Coraline De Maeseneire
- Center for Microscopy and Molecular Imaging, Université libre de Bruxelles, Charleroi, Belgium
| | - Nicolas Passon
- Center for Microscopy and Molecular Imaging, Université libre de Bruxelles, Charleroi, Belgium
| | - Simon Lacroix
- Center for Microscopy and Molecular Imaging, Université libre de Bruxelles, Charleroi, Belgium.,Service de médecine nucléaire, Hôpital Érasme, Université libre de Bruxelles, Brussels, Belgium
| | | | | | | | - David Torres
- Institute for Medical Immunology, Université libre de Bruxelles, Charleroi, Belgium
| | - Corentin Martens
- Center for Microscopy and Molecular Imaging, Université libre de Bruxelles, Charleroi, Belgium.,Service de médecine nucléaire, Hôpital Érasme, Université libre de Bruxelles, Brussels, Belgium
| | - Irina Vierasu
- Service de médecine nucléaire, Hôpital Érasme, Université libre de Bruxelles, Brussels, Belgium
| | - Dominique Egrise
- Center for Microscopy and Molecular Imaging, Université libre de Bruxelles, Charleroi, Belgium.,Service de médecine nucléaire, Hôpital Érasme, Université libre de Bruxelles, Brussels, Belgium
| | - Serge Goldman
- Center for Microscopy and Molecular Imaging, Université libre de Bruxelles, Charleroi, Belgium.,Service de médecine nucléaire, Hôpital Érasme, Université libre de Bruxelles, Brussels, Belgium
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24
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Olde Heuvel J, de Wit-van der Veen BJ, Donswijk ML, Slump CH, Stokkel MPM. Day-to-day variability of [ 68Ga]Ga-PSMA-11 accumulation in primary prostate cancer: effects on tracer uptake and visual interpretation. EJNMMI Res 2020; 10:132. [PMID: 33123814 PMCID: PMC7596127 DOI: 10.1186/s13550-020-00708-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/21/2020] [Indexed: 01/22/2023] Open
Abstract
PURPOSE Prostate-specific membrane antigen (PSMA) agents, such as [68Ga]Ga-PSMA-11, have an unprecedented accuracy in staging prostate cancer (PCa) and detecting disease recurrence. PSMA PET/CT may also be used for response monitoring by displaying molecular changes, instead of morphological changes alone. However, there are still limited data available on the variability in biodistribution and intra-prostatic uptake of PSMA targeting radiotracers. Therefore, the aim of this study was to assess the repeatability of [68Ga]Ga-PSMA-11 uptake in primary PCa patients in a 4-week interval. METHODS Twenty-four primary PCa patients were prospectively included, who already were scheduled for [68Ga]Ga-PSMA-11 PET/CT scan on clinical indication (≥ cT3, Gleason score ≥ 7 or PSA ≥ 20 ng/mL). These patients received two [68Ga]Ga-PSMA-11 PET/CT scans with a 4-week interval. No treatment was started in between the scans. Semiquantitative measurements (SULmax, SULmean, and SULpeak) were determined in the prostate tumor, normal tissues, and blood pool. The repeatability coefficient of every region was determined. All scans were visually analyzed by two nuclear medicine physicians. RESULTS Within-subject coefficient of variation of [68Ga]Ga-PSMA-11 uptake between the two scans was on average 10% in the prostate tumor, normal tissues (liver, kidney, parotid), and blood pool. The repeatability coefficient of the prostate tumor was 18% for SULpeak and 22% for SULmax. Lesion uptake was visually different in 5 patients, though not clinically relevant. CONCLUSION Results of test-retest [68Ga]Ga-PSMA-11 PET/CT scans in a 4-week interval show that [68Ga]Ga-PSMA-11 uptake is repeatable, with a clinical irrelevant variation in tumor and physiological distribution. Based on the presented repeatable uptake, [68Ga]Ga-PSMA-11 PET/CT scans can potentially be used for disease surveillance and therapy response monitoring. Changes in uptake larger than the RC are therefore likely to reflect actual biological changes in PSMA expression. Trial registration NL8263 at Trialregister.nl retrospectively registered on 03-01-2020. https://www.trialregister.nl/trial/8263.
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Affiliation(s)
- Judith Olde Heuvel
- Department of Nuclear Medicine, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Berlinda J de Wit-van der Veen
- Department of Nuclear Medicine, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
| | - Maarten L Donswijk
- Department of Nuclear Medicine, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Cornelis H Slump
- Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Marcel P M Stokkel
- Department of Nuclear Medicine, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
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25
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Bodar YJL, Jansen BHE, van der Voorn JP, Zwezerijnen GJC, Meijer D, Nieuwenhuijzen JA, Boellaard R, Hendrikse NH, Hoekstra OS, van Moorselaar RJA, Oprea-Lager DE, Vis AN. Detection of prostate cancer with 18F-DCFPyL PET/CT compared to final histopathology of radical prostatectomy specimens: is PSMA-targeted biopsy feasible? The DeTeCT trial. World J Urol 2020; 39:2439-2446. [PMID: 33079250 PMCID: PMC8332599 DOI: 10.1007/s00345-020-03490-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/07/2020] [Indexed: 11/01/2022] Open
Abstract
PURPOSE In primary prostate cancer (PCa) patients, accurate staging and histologic grading are crucial to guide treatment decisions. 18F-DCFPyL (PSMA)-PET/CT has been successfully introduced for (re)staging PCa, showing high accuracy to localise PCa in lymph nodes and/or osseous structures. The diagnostic performance of 18F-DCFPyL-PET/CT in localizing primary PCa within the prostate gland was assessed, allowing for PSMA-guided targeted-prostate biopsy. METHODS Thirty patients with intermediate-/high-risk primary PCa were prospectively enrolled between May 2018 and May 2019 and underwent 18F-DCFPyL-PET/CT prior to robot-assisted radical prostatectomy (RARP). Two experienced and blinded nuclear medicine physicians assessed tumour localisation within the prostate gland on PET/CT, using a 12-segment mapping model of the prostate. The same model was used by a uro-pathologist for the RARP specimens. Based on PET/CT imaging, a potential biopsy recommendation was given per patient, based on the size and PET-intensity of the suspected PCa localisations. The biopsy recommendation was correlated to final histopathology in the RARP specimen. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for clinically significant PCa (csPCa, Gleason score ≥ 3 + 4 = 7) were assessed. RESULTS The segments recommended for potential targeted biopsy harboured csPCA in 28/30 patients (93%), and covered the highest Gleason score PCa segment in 26/30 patient (87%). Overall, 122 of 420 segments (29.0%) contained csPCa at final histopathological examination. Sensitivity, specificity, PPV and NPV for csPCa per segment using 18F-DCFPyL-PET/CT were 61.4%, 88.3%, 68.1% and 84.8%, respectively. CONCLUSIONS When comparing the PCa-localisation on 18F-DCFPyL-PET/CT with the RARP specimens, an accurate per-patient detection (93%) and localisation of csPCa was found. Thus, 18F-DCFPyL-PET/CT potentially allows for accurate PSMA-targeted biopsy.
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Affiliation(s)
- Y J L Bodar
- Department of Urology, Amsterdam University Medical Centres (VU University), De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. .,Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centres (VU University), Amsterdam, The Netherlands. .,Prostate Cancer Network, Amsterdam, The Netherlands.
| | - B H E Jansen
- Department of Urology, Amsterdam University Medical Centres (VU University), De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centres (VU University), Amsterdam, The Netherlands.,Prostate Cancer Network, Amsterdam, The Netherlands
| | - J P van der Voorn
- Department of Pathology, Amsterdam University Medical Centres (VU University), Amsterdam, The Netherlands
| | - G J C Zwezerijnen
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centres (VU University), Amsterdam, The Netherlands
| | - D Meijer
- Department of Urology, Amsterdam University Medical Centres (VU University), De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centres (VU University), Amsterdam, The Netherlands.,Prostate Cancer Network, Amsterdam, The Netherlands
| | - J A Nieuwenhuijzen
- Department of Urology, Amsterdam University Medical Centres (VU University), De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.,Prostate Cancer Network, Amsterdam, The Netherlands
| | - R Boellaard
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centres (VU University), Amsterdam, The Netherlands
| | - N H Hendrikse
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centres (VU University), Amsterdam, The Netherlands.,Department of Clinical Pharmacology and Pharmacy, Amsterdam University Medical Centres (VU University), Amsterdam, The Netherlands
| | - O S Hoekstra
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centres (VU University), Amsterdam, The Netherlands
| | - R J A van Moorselaar
- Department of Urology, Amsterdam University Medical Centres (VU University), De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.,Prostate Cancer Network, Amsterdam, The Netherlands
| | - D E Oprea-Lager
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centres (VU University), Amsterdam, The Netherlands
| | - A N Vis
- Department of Urology, Amsterdam University Medical Centres (VU University), De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.,Prostate Cancer Network, Amsterdam, The Netherlands
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26
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Meijer D, Jansen BHE, Wondergem M, Bodar YJL, Srbljin S, Vellekoop AE, Keizer B, van der Zant FM, Hoekstra OS, Nieuwenhuijzen JA, Dahele M, Vis AN, Oprea-Lager DE. Clinical verification of 18F-DCFPyL PET-detected lesions in patients with biochemically recurrent prostate cancer. PLoS One 2020; 15:e0239414. [PMID: 33021980 PMCID: PMC7537873 DOI: 10.1371/journal.pone.0239414] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 09/06/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose Radiolabeled Prostate-Specific Membrane Antigen (PSMA) PET/CT is the current standard-of-care for lesion detection in patients with biochemically recurrent (BCR) prostate cancer (PCa). However, rigorous verification of detected lesions is not always performed in routine clinical practice. To aid future 18F-radiolabeled PSMA PET/CT interpretation, we aimed to identify clinical/imaging characteristics that increase the likelihood that a PSMA-avid lesion is malignant. Materials and methods 262 patients with BCR, who underwent 18F-DCFPyL PSMA PET/CT, were retrospectively analyzed. The malignant nature of 18F-DCFPyL PET-detected lesions was verified through any of the following metrics: (1) positive histopathological examination; (2) additional positive imaging; (3) a ≥50% decrease in Prostate-Specific Antigen (PSA) following irradiation of the lesion(s). Results In 226/262 PET scans (86.3%) at least one lesion suspicious for recurrent PCa was detected (‘positive scan’). In 84/226 positive scans (37.2%), at least one independent verification metric was available. PSMA PET-detected lesions were most often confirmed to be malignant (PCa) in the presence of a CT-substrate (96.5% vs. 55.6% without CT-substrate), with SUVpeak ≥3.5 (91.4% vs. 60.0% with SUVpeak<3.5), in patients with a PSA-level ≥2.0 ng/mL (83.7% vs. 65.7% in patients with PSA <2.0ng/mL) and in patients with >2 PET-positive lesions (94.1% vs. 64.2% in patients with 1–2 PET-positive lesions; p<0.001–0.03). Conclusions In this study, the clinical verification of 18F-DCFPyL PET-positive lesions in patients with BCR was performed. Diagnostic certainty of PET-detected lesions increases in the presence of characteristic abnormalities on CT, when SUVpeak is ≥3.5, when PSA-levels exceed 2.0 ng/mL or in patients with more than two PET-positive lesions.
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Affiliation(s)
- Dennie Meijer
- Department of Urology, Prostate Cancer Network Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
- * E-mail:
| | - Bernard H. E. Jansen
- Department of Urology, Prostate Cancer Network Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
| | - Maurits Wondergem
- Department of Nuclear Medicine, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands
| | - Yves J. L. Bodar
- Department of Urology, Prostate Cancer Network Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
| | - Sandra Srbljin
- Department of Nuclear Medicine, Zaans Medical Center, Zaandam, The Netherlands
| | | | - Bram Keizer
- Department of Urology, Dijklander Hospital, Hoorn, The Netherlands
| | | | - Otto S. Hoekstra
- Department of Radiology & Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
| | - Jakko A. Nieuwenhuijzen
- Department of Urology, Prostate Cancer Network Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
| | - Max Dahele
- Department of Radiation Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - André N. Vis
- Department of Urology, Prostate Cancer Network Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
| | - Daniela E. Oprea-Lager
- Department of Radiology & Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
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27
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Prospective Evaluation of 18F-DCFPyL PET/CT in Detection of High-Risk Localized Prostate Cancer: Comparison With mpMRI. AJR Am J Roentgenol 2020; 215:652-659. [PMID: 32755168 DOI: 10.2214/ajr.19.22042] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE. The purpose of this study was to assess the utility of PET with (2S)-2-[[(1S)-1-carboxy-5-[(6-(18F)fluoranylpyridine-3-carbonyl)amino]pentyl]carbamoylamino]pentanedioic acid (18F-DCFPyL), a prostate-specific membrane antigen (PSMA)-targeted radiotracer, in the detection of high-risk localized prostate cancer as compared with multiparametric MRI (mpMRI). SUBJECTS AND METHODS. This HIPAA-compliant prospective study included 26 consecutive patients with localized high-risk prostate cancer (median age, 69.5 years [range, 53-81 years]; median prostate-specific antigen [PSA] level, 18.88 ng/mL [range, 1.03-20.00 ng/mL]) imaged with 18F-DCFPyL PET/CT and mpMRI. Images from PET/CT and mpMRI were evaluated separately, and suspicious areas underwent targeted biopsy. Lesion-based sensitivity and tumor detection rate were compared for PSMA PET and mpMRI. Standardized uptake value (SUV) and PSMA PET parameters were correlated with histopathology score, and uptake in tumor was compared with that in nonmalignant tissue. On a patient level, SUV and PSMA tumor volume were correlated with PSA density. RESULTS. Forty-four tumors (one in Gleason grade [GG] group 1, 12 in GG group 2, seven in GG group 3, nine in GG group 4, and 15 in GG group 5) were identified at histopathology. Sensitivity and tumor detection rate of 18F-DCFPyL PET/CT and mpMRI were similar (PET/CT, 90.9% and 80%; mpMRI, 86.4% and 88.4%; p = 0.58/0.17). Total lesion PSMA and PSMA tumor volume showed a relationship with GG (τ = 0.27 and p = 0.08, τ = 0.30 and p = 0.06, respectively). Maximum SUV in tumor was significantly higher than that in nonmalignant tissue (p < 0.05). Tumor burden density moderately correlated with PSA density (r = 0.47, p = 0.01). Five true-positive tumors identified on 18F-DCFPyL PET/CT were not identified on mpMRI. CONCLUSION. In patients with high-risk prostate cancer, 18F-DCFPyL PET/CT is highly sensitive in detecting intraprostatic tumors and can detect tumors missed on mpMRI. Measured uptake is significantly higher in tumor tissue, and PSMA-derived tumor burden is associated with severity of disease.
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28
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Letter to the Editor re: Semiquantitative Parameters in PSMA-Targeted PET Imaging with [ 18F]DCFPyL: Impact of Tumor Burden on Normal Organ Uptake. Mol Imaging Biol 2020; 22:15-17. [PMID: 31624994 DOI: 10.1007/s11307-019-01438-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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29
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Jansen BHE, Cysouw MCF, Vis AN, van Moorselaar RJA, Voortman J, Bodar YJL, Schober PR, Hendrikse NH, Hoekstra OS, Boellaard R, Oprea-Lager DE. Repeatability of Quantitative 18F-DCFPyL PET/CT Measurements in Metastatic Prostate Cancer. J Nucl Med 2020; 61:1320-1325. [PMID: 31924729 DOI: 10.2967/jnumed.119.236075] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 01/08/2020] [Indexed: 12/31/2022] Open
Abstract
Quantitative evaluation of radiolabeled prostate-specific membrane antigen (PSMA) PET scans may be used to monitor treatment response in patients with prostate cancer (PCa). To interpret longitudinal differences in PSMA uptake, the intrinsic variability of tracer uptake in PCa lesions needs to be defined. The aim of this study was to investigate the repeatability of quantitative PET/CT measurements using 18F-DCFPyL ([2-(3-(1-carboxy-5-[(6-18F-fluoro-pyridine-3-carbonyl)-amino]-pentyl)-ureido)-pentanedioic acid], a second-generation 18F-PSMA-ligand) in patients with PCa. Methods: Twelve patients with metastatic PCa were prospectively included, of whom 2 were excluded from final analyses. Patients received 2 whole-body 18F-DCFPyL PET/CT scans (median dose, 317 MBq; uptake time, 120 min) within a median of 4 d (range, 1-11 d). After semiautomatic (isocontour-based) tumor delineation, the following lesion-based metrics were derived: mean, peak, and maximum tumor-to-blood ratio; SUVmean, SUVpeak, and SUVmax normalized to body weight; tumor volume; and total lesion uptake (TLU). Additionally, patient-based total tumor volume (TTV) (sum of PSMA-positive tumor volumes) and total tumor burden (TTB) (sum of all lesion TLUs) were derived. Repeatability was analyzed using repeatability coefficients (RC) and intraclass correlation coefficients. Additionally, the effect of point-spread function (PSF) image reconstruction on the repeatability of uptake metrics was evaluated. Results: In total, 36 18F-DCFPyL PET-positive lesions were analyzed (≤5 lesions per patient). The RCs for mean, peak, and maximum tumor-to-blood ratio were 31.8%, 31.7%, and 37.3%, respectively. For SUVmean, SUVpeak, and SUVmax, the RCs were 24.4%, 25.3%, and 31.0%, respectively. All intraclass correlation coefficients were at least 0.97. Tumor volume delineations were quite repeatable, with an RC of 28.1% for individual lesion volumes and 17.0% for TTV. TTB had an RC of 23.2% and 33.4% when based on SUVmean and mean tumor-to-blood ratio, respectively. Small lesions (<4.2 cm3) had worse repeatability for volume measurements. The repeatability of SUVpeak, TLU, and all patient-level metrics was not affected by PSF reconstruction. Conclusion: 18F-DCFPyL uptake measurements are quite repeatable and can be used for clinical validation in future treatment response assessment studies. Patient-based TTV may be preferred for multicenter studies because its repeatability was both high and robust to different image reconstructions.
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Affiliation(s)
- Bernard H E Jansen
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands .,Department of Urology, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
| | - Matthijs C F Cysouw
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands.,Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
| | - André N Vis
- Department of Urology, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
| | - Reindert J A van Moorselaar
- Department of Urology, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
| | - Jens Voortman
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
| | - Yves J L Bodar
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands.,Department of Urology, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
| | - Patrick R Schober
- Department of Anesthesiology, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands; and
| | - N Harry Hendrikse
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands.,Department of Clinical Pharmacology and Pharmacy, Cancer Center Amsterdam, Amsterdam University Medical Center, VU University, Amsterdam, The Netherlands
| | - Otto S Hoekstra
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
| | - D E Oprea-Lager
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
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Letter to the Editor re: "Semiquantitative Parameters in PSMA-Targeted PET Imaging with [ 18F]DCFPyL: Impact of Tumor Burden on Normal Organ Uptake". Mol Imaging Biol 2019; 22:19-21. [PMID: 31832870 DOI: 10.1007/s11307-019-01452-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Jansen BH, Yaqub M, Cysouw MC, Vis AN, van Moorselaar RJ, Hendrikse NH, Hoekstra OS, Boellaard R, Oprea-Lager DE. Reply: Quantification of 18F-DCFPyL Uptake: TBR Versus Patlak’s Analysis. J Nucl Med 2019; 60:1834-1835. [DOI: 10.2967/jnumed.119.234047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Laffon E, de Clermont H, Marthan R. Quantification of 18F-DCFPyL Uptake: TBR Versus Patlak's Analysis. J Nucl Med 2019; 60:1834. [PMID: 31451485 DOI: 10.2967/jnumed.119.232926] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Eric Laffon
- CHU de Bordeaux - F-33000 Bordeaux, France, Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, F-33000 Bordeaux, France, E-mail:
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