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Comparison of [(18)F]DCFPyL and [ (68)Ga]Ga-PSMA-HBED-CC for PSMA-PET Imaging in Patients with Relapsed Prostate Cancer.

Dietlein M, Kobe C, Kuhnert G, Stockter S, Fischer T, Schomäcker K, Schmidt M, Dietlein F, Zlatopolskiy BD, Krapf P, Richarz R, Neubauer S, Drzezga A, Neumaier B - Mol Imaging Biol (2015)

Bottom Line: A systematic comparison was carried out between results obtained with both tracers with regard to the number of detected PSMA-positive lesions, the standardized uptake value (SUV)max and the lesion to background ratios.The mean SUVmax in the concordant [(18)F]DCFPyL PSMA-positive lesions was significantly higher as compared to [(68)Ga]Ga-PSMA-HBED-CC (14.5 vs. 12.2, p = 0.028, n = 15).The mean tumor to background ratios (n = 15) were significantly higher for [(18)F]DCFPyL compared to [(68)Ga]Ga-PSMA-HBED-CC using kidney, spleen, or parotid as reference organs (p = 0.006, p = 0.002, p = 0.008), but no significant differences were found using the liver (p = 0.167) or the mediastinum (p = 0.363) as reference organs. [(18)F]DCFPyL PET/CT provided a high image quality and visualized small prostate lesions with excellent sensitivity. [(18)F]DCFPyL represents a highly promising alternative to [(68)Ga]Ga-PSMA-HBED-CC for PSMA-PET/CT imaging in relapsed prostate cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany, markus.dietlein@uk-koeln.de.

ABSTRACT

Purpose: Gallium-68 (Ga-68)-labeled tracers for imaging expression of the prostate-specific membrane antigen (PSMA) such as the [(68)Ga]Ga-PSMA-HBED-CC have already demonstrated high potential for the detection of recurrent prostate cancer. However, compared to Ga-68, a labeling with fluorine-18 (F-18) would offer advantages with respect to availability, production amount, and image resolution. [(18)F]DCFPyL is a promising F-18-labeled candidate for PSMA-positron emission tomography (PET) imaging that has been recently introduced. In the current study, we aimed to compare [(68)Ga]Ga-PSMA-HBED-CC and [(18)F]DCFPyL for clinical use in biochemically relapsed prostate cancer.

Procedures: In 14 selected patients with PSA relapse of prostate cancer, [(18)F]DCFPyL PET/X-ray computed tomography (CT) was performed in addition to [(68)Ga]Ga-PSMA-HBED-CC PET/CT. A systematic comparison was carried out between results obtained with both tracers with regard to the number of detected PSMA-positive lesions, the standardized uptake value (SUV)max and the lesion to background ratios.

Results: All suspicious lesions identified by [(68)Ga]Ga-PSMA-HBED-CC were also detected with [(18)F]DCFPyL. In three patients, additional lesions were observed using [(18)F]DCFPyL PET/CT. The mean SUVmax in the concordant [(18)F]DCFPyL PSMA-positive lesions was significantly higher as compared to [(68)Ga]Ga-PSMA-HBED-CC (14.5 vs. 12.2, p = 0.028, n = 15). The mean tumor to background ratios (n = 15) were significantly higher for [(18)F]DCFPyL compared to [(68)Ga]Ga-PSMA-HBED-CC using kidney, spleen, or parotid as reference organs (p = 0.006, p = 0.002, p = 0.008), but no significant differences were found using the liver (p = 0.167) or the mediastinum (p = 0.363) as reference organs.

Conclusion: [(18)F]DCFPyL PET/CT provided a high image quality and visualized small prostate lesions with excellent sensitivity. [(18)F]DCFPyL represents a highly promising alternative to [(68)Ga]Ga-PSMA-HBED-CC for PSMA-PET/CT imaging in relapsed prostate cancer.

No MeSH data available.


Related in: MedlinePlus

a Ratio of SUVmax in lesions to SUVmean in the kidney and b ratio of SUVmax in lesions to SUVmean in the liver. The blue columns represent [68Ga]Ga-PSMA-HBED-CC PET/CT, and the red columns represent [18F]DCFPyL PET/CT. [18F]DCFPyL showed a higher tumor to background ratio than [68Ga]Ga-PSMA-HBED-CC when the kidney was used as a reference organ (p = 0.006, n = 15). The tumor to background ratio did not differ significantly between [18F]DCFPyL and [68Ga]Ga-PSMA-HBED-CC when the liver was used as a reference organ (p = 0.167, n = 15). LN lymph node metastasis, LR local relapse, BM bone metastasis.
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Fig5: a Ratio of SUVmax in lesions to SUVmean in the kidney and b ratio of SUVmax in lesions to SUVmean in the liver. The blue columns represent [68Ga]Ga-PSMA-HBED-CC PET/CT, and the red columns represent [18F]DCFPyL PET/CT. [18F]DCFPyL showed a higher tumor to background ratio than [68Ga]Ga-PSMA-HBED-CC when the kidney was used as a reference organ (p = 0.006, n = 15). The tumor to background ratio did not differ significantly between [18F]DCFPyL and [68Ga]Ga-PSMA-HBED-CC when the liver was used as a reference organ (p = 0.167, n = 15). LN lymph node metastasis, LR local relapse, BM bone metastasis.

Mentions: To compare the tumor/background contrast between the two tracers, we calculated SUV values in suspicious lesions/background in seven patients with maximum three lesions, detectable with both PET procedures. This resulted in a comparison of altogether 15 tumor/background ratios. Most of the suspected lymph node/bone metastases showed a higher SUV ratio for [18F]DCFPyL using the kidney (Fig. 5a) or the spleen as a reference region, but no significant difference was found when using for the liver (Fig. 5b) or the mediastinum as reference organ. In detail, the mean tumor to background ratios between the SUVmax in the PSMA-avid lesions with [18F]DCFPyL and [68Ga]Ga-PSMA-HBED-CC were 2.9 and 2.3 as compared with the SUVmean in the liver (p = 0.167, n.s.), 4.3 and 2.1 as compared with the SUVmean in the spleen (p = 0.002), 1.0 and 0.4 as compared with the SUVmean in the kidney (p = 0.006), 10.7 and 9.7 as compared with the SUVmean in the mediastinum (p = 0.363, n.s.), and 1.4 and 0.9 as compared with the SUVmean in the parotid (p = 0.008), respectively.Fig. 5


Comparison of [(18)F]DCFPyL and [ (68)Ga]Ga-PSMA-HBED-CC for PSMA-PET Imaging in Patients with Relapsed Prostate Cancer.

Dietlein M, Kobe C, Kuhnert G, Stockter S, Fischer T, Schomäcker K, Schmidt M, Dietlein F, Zlatopolskiy BD, Krapf P, Richarz R, Neubauer S, Drzezga A, Neumaier B - Mol Imaging Biol (2015)

a Ratio of SUVmax in lesions to SUVmean in the kidney and b ratio of SUVmax in lesions to SUVmean in the liver. The blue columns represent [68Ga]Ga-PSMA-HBED-CC PET/CT, and the red columns represent [18F]DCFPyL PET/CT. [18F]DCFPyL showed a higher tumor to background ratio than [68Ga]Ga-PSMA-HBED-CC when the kidney was used as a reference organ (p = 0.006, n = 15). The tumor to background ratio did not differ significantly between [18F]DCFPyL and [68Ga]Ga-PSMA-HBED-CC when the liver was used as a reference organ (p = 0.167, n = 15). LN lymph node metastasis, LR local relapse, BM bone metastasis.
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4493776&req=5

Fig5: a Ratio of SUVmax in lesions to SUVmean in the kidney and b ratio of SUVmax in lesions to SUVmean in the liver. The blue columns represent [68Ga]Ga-PSMA-HBED-CC PET/CT, and the red columns represent [18F]DCFPyL PET/CT. [18F]DCFPyL showed a higher tumor to background ratio than [68Ga]Ga-PSMA-HBED-CC when the kidney was used as a reference organ (p = 0.006, n = 15). The tumor to background ratio did not differ significantly between [18F]DCFPyL and [68Ga]Ga-PSMA-HBED-CC when the liver was used as a reference organ (p = 0.167, n = 15). LN lymph node metastasis, LR local relapse, BM bone metastasis.
Mentions: To compare the tumor/background contrast between the two tracers, we calculated SUV values in suspicious lesions/background in seven patients with maximum three lesions, detectable with both PET procedures. This resulted in a comparison of altogether 15 tumor/background ratios. Most of the suspected lymph node/bone metastases showed a higher SUV ratio for [18F]DCFPyL using the kidney (Fig. 5a) or the spleen as a reference region, but no significant difference was found when using for the liver (Fig. 5b) or the mediastinum as reference organ. In detail, the mean tumor to background ratios between the SUVmax in the PSMA-avid lesions with [18F]DCFPyL and [68Ga]Ga-PSMA-HBED-CC were 2.9 and 2.3 as compared with the SUVmean in the liver (p = 0.167, n.s.), 4.3 and 2.1 as compared with the SUVmean in the spleen (p = 0.002), 1.0 and 0.4 as compared with the SUVmean in the kidney (p = 0.006), 10.7 and 9.7 as compared with the SUVmean in the mediastinum (p = 0.363, n.s.), and 1.4 and 0.9 as compared with the SUVmean in the parotid (p = 0.008), respectively.Fig. 5

Bottom Line: A systematic comparison was carried out between results obtained with both tracers with regard to the number of detected PSMA-positive lesions, the standardized uptake value (SUV)max and the lesion to background ratios.The mean SUVmax in the concordant [(18)F]DCFPyL PSMA-positive lesions was significantly higher as compared to [(68)Ga]Ga-PSMA-HBED-CC (14.5 vs. 12.2, p = 0.028, n = 15).The mean tumor to background ratios (n = 15) were significantly higher for [(18)F]DCFPyL compared to [(68)Ga]Ga-PSMA-HBED-CC using kidney, spleen, or parotid as reference organs (p = 0.006, p = 0.002, p = 0.008), but no significant differences were found using the liver (p = 0.167) or the mediastinum (p = 0.363) as reference organs. [(18)F]DCFPyL PET/CT provided a high image quality and visualized small prostate lesions with excellent sensitivity. [(18)F]DCFPyL represents a highly promising alternative to [(68)Ga]Ga-PSMA-HBED-CC for PSMA-PET/CT imaging in relapsed prostate cancer.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany, markus.dietlein@uk-koeln.de.

ABSTRACT

Purpose: Gallium-68 (Ga-68)-labeled tracers for imaging expression of the prostate-specific membrane antigen (PSMA) such as the [(68)Ga]Ga-PSMA-HBED-CC have already demonstrated high potential for the detection of recurrent prostate cancer. However, compared to Ga-68, a labeling with fluorine-18 (F-18) would offer advantages with respect to availability, production amount, and image resolution. [(18)F]DCFPyL is a promising F-18-labeled candidate for PSMA-positron emission tomography (PET) imaging that has been recently introduced. In the current study, we aimed to compare [(68)Ga]Ga-PSMA-HBED-CC and [(18)F]DCFPyL for clinical use in biochemically relapsed prostate cancer.

Procedures: In 14 selected patients with PSA relapse of prostate cancer, [(18)F]DCFPyL PET/X-ray computed tomography (CT) was performed in addition to [(68)Ga]Ga-PSMA-HBED-CC PET/CT. A systematic comparison was carried out between results obtained with both tracers with regard to the number of detected PSMA-positive lesions, the standardized uptake value (SUV)max and the lesion to background ratios.

Results: All suspicious lesions identified by [(68)Ga]Ga-PSMA-HBED-CC were also detected with [(18)F]DCFPyL. In three patients, additional lesions were observed using [(18)F]DCFPyL PET/CT. The mean SUVmax in the concordant [(18)F]DCFPyL PSMA-positive lesions was significantly higher as compared to [(68)Ga]Ga-PSMA-HBED-CC (14.5 vs. 12.2, p = 0.028, n = 15). The mean tumor to background ratios (n = 15) were significantly higher for [(18)F]DCFPyL compared to [(68)Ga]Ga-PSMA-HBED-CC using kidney, spleen, or parotid as reference organs (p = 0.006, p = 0.002, p = 0.008), but no significant differences were found using the liver (p = 0.167) or the mediastinum (p = 0.363) as reference organs.

Conclusion: [(18)F]DCFPyL PET/CT provided a high image quality and visualized small prostate lesions with excellent sensitivity. [(18)F]DCFPyL represents a highly promising alternative to [(68)Ga]Ga-PSMA-HBED-CC for PSMA-PET/CT imaging in relapsed prostate cancer.

No MeSH data available.


Related in: MedlinePlus