Joseph R Osborne1, David A Green2, Daniel E Spratt3, Serge Lyashchenko4, Shoaib B Fareedy1, Brian D Robinson5, Bradley J Beattie6, Manu Jain2, Jason S Lewis4, Paul Christos7, Steven M Larson1, Neil H Bander2, Douglas S Scherr8. 1. Molecular Imaging and Therapy Service, Memorial Sloan-Kettering Cancer Center, New York, New York. 2. Department of Urology, Weill Medical College of Cornell University, New York, New York. 3. Department of Radiology, Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York. 4. Radiochemistry and Imaging Sciences Service, Memorial Sloan-Kettering Cancer Center, New York, New York. 5. Department of Urology, Weill Medical College of Cornell University, New York, New York; Department of Pathology, Weill Medical College of Cornell University, New York, New York. 6. Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York. 7. Division of Biostatistics and Epidemiology, Department of Public Health, Weill Medical College of Cornell University, New York, New York. 8. Department of Urology, Weill Medical College of Cornell University, New York, New York. Electronic address: dss2001@med.cornell.edu.
Abstract
PURPOSE: In this pilot study we explored the feasibility of (89)Zr labeled J591 monoclonal antibody positron emission tomography of localized prostate cancer. MATERIALS AND METHODS: Before scheduled radical prostatectomy 11 patients were injected intravenously with (89)Zr-J591, followed 6 days later by whole body positron emission tomography. Patients underwent surgery the day after imaging. Specimens were imaged by ex vivo micro positron emission tomography and a custom 3 Tesla magnetic resonance scanner coil. Positron emission tomography images and histopathology were correlated. RESULTS: Median patient age was 61 years (range 47 to 68), median prostate specific antigen was 5.2 ng/ml (range 3.5 to 12.0) and median biopsy Gleason score of the 11 index lesions was 7 (range 7 to 9). On histopathology 22 lesions were identified. Median lesion size was 5.5 mm (range 2 to 21) and median Gleason score after radical prostatectomy was 7 (range 6 to 9). Eight of 11 index lesions (72.7%) were identified by in vivo positron emission tomography. Lesion identification improved with increasing lesion size for in vivo and ex vivo positron emission tomography (each p <0.0001), and increasing Gleason score (p = 0.14 and 0.01, respectively). Standardized uptake values appeared to correlate with increased Gleason score but not significantly (p = 0.19). CONCLUSIONS: To our knowledge this is the first report of (89)Zr-J591/prostate specific membrane antigen positron emission tomography in localized prostate cancer cases. In this setting (89)Zr-J591 bound to tumor foci in situ and positron emission tomography identified primarily Gleason score 7 or greater and larger tumors, likely corresponding to clinically significant disease warranting definitive therapy. A future, larger clinical validation trial is planned to better define the usefulness of (89)Zr-J591 positron emission tomography for localized prostate cancer.
PURPOSE: In this pilot study we explored the feasibility of (89)Zr labeled J591 monoclonal antibody positron emission tomography of localized prostate cancer. MATERIALS AND METHODS: Before scheduled radical prostatectomy 11 patients were injected intravenously with (89)Zr-J591, followed 6 days later by whole body positron emission tomography. Patients underwent surgery the day after imaging. Specimens were imaged by ex vivo micro positron emission tomography and a custom 3 Tesla magnetic resonance scanner coil. Positron emission tomography images and histopathology were correlated. RESULTS: Median patient age was 61 years (range 47 to 68), median prostate specific antigen was 5.2 ng/ml (range 3.5 to 12.0) and median biopsy Gleason score of the 11 index lesions was 7 (range 7 to 9). On histopathology 22 lesions were identified. Median lesion size was 5.5 mm (range 2 to 21) and median Gleason score after radical prostatectomy was 7 (range 6 to 9). Eight of 11 index lesions (72.7%) were identified by in vivo positron emission tomography. Lesion identification improved with increasing lesion size for in vivo and ex vivo positron emission tomography (each p <0.0001), and increasing Gleason score (p = 0.14 and 0.01, respectively). Standardized uptake values appeared to correlate with increased Gleason score but not significantly (p = 0.19). CONCLUSIONS: To our knowledge this is the first report of (89)Zr-J591/prostate specific membrane antigen positron emission tomography in localized prostate cancer cases. In this setting (89)Zr-J591 bound to tumor foci in situ and positron emission tomography identified primarily Gleason score 7 or greater and larger tumors, likely corresponding to clinically significant disease warranting definitive therapy. A future, larger clinical validation trial is planned to better define the usefulness of (89)Zr-J591 positron emission tomography for localized prostate cancer.
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