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Tytuł:
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A Prospective Study of 18F-DCFPyL PSMA PET/CT Restaging in Recurrent Prostate Cancer following Primary External Beam Radiotherapy or Brachytherapy.
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Autorzy:
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Liu W; Division of Radiation Oncology, Department of Oncology, London Health Sciences Centre and Western University, London, Canada.
Zukotynski K; Department of Radiology, Hamilton Health Sciences Centre and McMaster University, Hamilton, Canada.
Emmett L; Department of Nuclear Medicine and Theranostics, St. Vincent's Hospital and University of New South Wales, Sydney, Australia.
Chung HT; Department of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Centre, Toronto, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Canada.
Chung P; Department of Radiation Oncology, University of Toronto, Toronto, Canada; Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada.
Wolfson R; Department of Medical Imaging, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, Canada.
Rachinsky I; Division of Nuclear Medicine, London Health Sciences Centre and Western University, London, Canada.
Kapoor A; Urologic Cancer Centre for Research & Innovation and McMaster University, Hamilton, Ontario.
Metser U; Department of Medical Imaging, Princess Margaret Cancer Centre and University of Toronto, Toronto, Canada.
Loblaw A; Department of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Centre, Toronto, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Canada; University of Toronto, Institute of Health Care Policy and Evaluation, Toronto, Canada.
Morton G; Department of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Centre, Toronto, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Canada.
Sexton T; Division of Radiation Oncology, Department of Oncology, London Health Sciences Centre and Western University, London, Canada.
Lock M; Division of Radiation Oncology, Department of Oncology, London Health Sciences Centre and Western University, London, Canada.
Helou J; Department of Radiation Oncology, University of Toronto, Toronto, Canada; Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada.
Berlin A; Department of Radiation Oncology, University of Toronto, Toronto, Canada; Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada.
Boylan C; Department of Diagnostic Imaging, St. Joseph's Healthcare and McMaster University, Hamilton, Canada.
Archer S; Division of Radiation Oncology, Department of Oncology, London Health Sciences Centre and Western University, London, Canada.
Pond GR; Department of Oncology, McMaster University, Hamilton, Canada.
Bauman G; Division of Radiation Oncology, Department of Oncology, London Health Sciences Centre and Western University, London, Canada. Electronic address: .
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Źródło:
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International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2020 Mar 01; Vol. 106 (3), pp. 546-555. Date of Electronic Publication: 2019 Nov 12.
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Typ publikacji:
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Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: New York, NY : Elsevier, Inc
Original Publication: Elmsford, N. Y., Pergamon Press.
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MeSH Terms:
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Lysine/*analogs & derivatives
Neoplasm Recurrence, Local/*diagnostic imaging
Positron Emission Tomography Computed Tomography/*methods
Prostatic Neoplasms/*diagnostic imaging
Urea/*analogs & derivatives
Aged ; Aged, 80 and over ; Antigens, Surface/blood ; Fluorine Radioisotopes ; Glutamate Carboxypeptidase II/blood ; Humans ; Kallikreins/blood ; Male ; Middle Aged ; Neoplasm Recurrence, Local/blood ; Neoplasm Recurrence, Local/pathology ; Neoplasm Recurrence, Local/radiotherapy ; Prospective Studies ; Prostate-Specific Antigen/blood ; Prostatic Neoplasms/blood ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/radiotherapy
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Substance Nomenclature:
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0 (2-(3-(1-carboxy-5-((6-fluoropyridine-3-carbonyl)amino)pentyl)ureido)pentanedioic acid)
0 (Antigens, Surface)
0 (Fluorine Radioisotopes)
8W8T17847W (Urea)
EC 3.4.17.21 (FOLH1 protein, human)
EC 3.4.17.21 (Glutamate Carboxypeptidase II)
EC 3.4.21.- (KLK3 protein, human)
EC 3.4.21.- (Kallikreins)
EC 3.4.21.77 (Prostate-Specific Antigen)
K3Z4F929H6 (Lysine)
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Entry Date(s):
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Date Created: 20191116 Date Completed: 20200214 Latest Revision: 20211122
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Update Code:
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20240104
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DOI:
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10.1016/j.ijrobp.2019.11.001
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PMID:
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31730876
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Purpose: Radio-recurrent prostate cancer is typically detected by a rising prostate-specific antigen and may reflect local or distant disease. Positron emission tomography (PET) radiotracers targeting prostate-specific membrane antigen, such as 18F-DCFPyL have shown promise in restaging men with recurrent disease postprostatectomy but are less well characterized in the setting of radio-recurrent disease.
Methods and Materials: A prospective, multi-institutional study was conducted to evaluate the effect of 18F-DCFPyL PET/computed tomography (CT) when added to diagnostic imaging (DI; CT abdomen and pelvis, bone scan, multiparametric magnetic resonance imaging pelvis) for men with radio-recurrent prostate cancer. All men were imaged with DI and subsequently underwent 18F-DCFPyL PET/CT with local and central reads. Tie break reads were performed as required. Management questionnaires were completed after DI and again after 18F-DCFPyL PET/CT. Discordance in patterns of disease detected with 18F-DCFPyL PET/CT versus DI and changes in management were characterized.
Results: Seventy-nine men completed the study. Most men had T1 disease (62%) and Gleason score <7 (95%). Median prostate-specific antigen at diagnosis was 7.4 ng/mL and at relapse was 4.8 ng/mL. DI detected isolated intraprostatic recurrence in 38 out of 79 men (48%), regional nodal recurrence in 9 out of 79 (11%), distant disease in 12 out of 79 (15%), and no disease in 26 out of 79 (33%). 18F-DCFPyL PET/CT detected isolated intraprostatic recurrence in 38 out of 79 men (48%), regional nodal recurrence in 21 out of 79 (27%), distant disease in 24 out of 79 (30%), and no disease in 10 out of 79 (13%). DI identified 8 out of 79 (10%) patients to have oligometastatic disease, compared with 21 out of 79 (27%) with 18F-DCFPyL PET/CT. 18F-DCFPyL PET/CT changed proposed management in 34 out of 79 (43%) patients.
Conclusions: 18F-DCFPyL PET/CT identified extraprostatic disease in twice as many men with radio-recurrent prostate cancer compared with DI and detected a site of recurrence in 87% of men compared with 67% with DI. Furthermore, 18F-DCFPyL PET/CT identified potentially actionable disease (prostate only recurrence or oligometastatic disease) in 75% of men and changed proposed management in 43% of men.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
Erratum in: Int J Radiat Oncol Biol Phys. 2020 Jun 1;107(2):390. (PMID: 32386739)
