Dae-Myoung Yang1,2,3, Fiona Li1,2,3, Glenn Bauman3,4, Joseph Chin3,4, Stephen Pautler3,4, Madeleine Moussa5, Irina Rachinsky3, John Valliant6, Ting-Yim Lee7,8,9,10. 1. Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond St, London, ON, N6A 3K7, Canada. 2. Robarts Research Institute, University of Western Ontario, 1151 Richmond St, London, ON, N6A 5B7, Canada. 3. Lawson Health Research Institute, 268 Grosvenor St, London, ON, N6A 4V2, Canada. 4. Department of Oncology, Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond St, London, ON, N6A 3K7, Canada. 5. Pathology and Laboratory Medicine, London Health Sciences Centre, 800 Commissioners Rd E, London, ON, N6A 5W9, Canada. 6. Centre for Probe Development and Commercialization, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada. 7. Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond St, London, ON, N6A 3K7, Canada. tlee@imaging.robarts.ca. 8. Robarts Research Institute, University of Western Ontario, 1151 Richmond St, London, ON, N6A 5B7, Canada. tlee@imaging.robarts.ca. 9. Lawson Health Research Institute, 268 Grosvenor St, London, ON, N6A 4V2, Canada. tlee@imaging.robarts.ca. 10. Department of Oncology, Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond St, London, ON, N6A 3K7, Canada. tlee@imaging.robarts.ca.
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).
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).
Authors: Marius R Schmid; Thomas Schertler; Christian W Pfirrmann; Nadja Saupe; Mirjana Manestar; Simon Wildermuth; Dominik Weishaupt Journal: Radiology Date: 2005-12 Impact factor: 11.105
Authors: Johannes Schwenck; Hansjoerg Rempp; Gerald Reischl; Stephan Kruck; Arnulf Stenzl; Konstantin Nikolaou; Christina Pfannenberg; Christian la Fougère Journal: Eur J Nucl Med Mol Imaging Date: 2016-08-24 Impact factor: 9.236
Authors: Hyuna Sung; Rebecca L Siegel; Lindsey A Torre; Jonathan Pearson-Stuttard; Farhad Islami; Stacey A Fedewa; Ann Goding Sauer; Kerem Shuval; Susan M Gapstur; Eric J Jacobs; Edward L Giovannucci; Ahmedin Jemal Journal: CA Cancer J Clin Date: 2018-12-12 Impact factor: 508.702
Authors: Martin Heinisch; Albert Dirisamer; Wolfgang Loidl; Franz Stoiber; Bernhard Gruy; Silke Haim; Werner Langsteger Journal: Mol Imaging Biol Date: 2006 Jan-Feb Impact factor: 3.488
Authors: Axel Häcker; Stefan Jeschke; Karl Leeb; Kurt Prammer; Josef Ziegerhofer; Wolfgang Sega; Werner Langsteger; Guenter Janetschek Journal: J Urol Date: 2006-11 Impact factor: 7.450
Authors: I Igerc; S Kohlfürst; H J Gallowitsch; S Matschnig; E Kresnik; I Gomez-Segovia; P Lind Journal: Eur J Nucl Med Mol Imaging Date: 2008-01-11 Impact factor: 9.236
Authors: Markus Dietlein; Carsten Kobe; Georg Kuhnert; Simone Stockter; Thomas Fischer; Klaus Schomäcker; Matthias Schmidt; Felix Dietlein; Boris D Zlatopolskiy; Philipp Krapf; Raphael Richarz; Stephan Neubauer; Alexander Drzezga; Bernd Neumaier Journal: Mol Imaging Biol Date: 2015-08 Impact factor: 3.488
Authors: Ali Afshar-Oromieh; Eleni Avtzi; Frederik L Giesel; Tim Holland-Letz; Heinz G Linhart; Matthias Eder; Michael Eisenhut; Silvan Boxler; Boris A Hadaschik; Clemens Kratochwil; Wilko Weichert; Klaus Kopka; Jürgen Debus; Uwe Haberkorn Journal: Eur J Nucl Med Mol Imaging Date: 2014-11-20 Impact factor: 9.236