Skip NavigationSkip to Content
Return Return to Search Results

Evaluating Biochemically Recurrent Prostate Cancer: Histologic Validation of 18F-DCFPyL PET/CT with Comparison to Multiparametric MRI

  1. Author:
    Lindenberg, Liza [ORCID]
    Mena, Esther
    Turkbey, Baris [ORCID]
    Shih, Joanna H [ORCID]
    Reese, Sarah E [ORCID]
    Harmon,Stephanie [ORCID]
    Lim, Ilhan
    Lin, Frank
    Ton, Anita
    McKinney, Yolanda L
    Eclarinal, Philip [ORCID]
    Citrin, Deborah E [ORCID]
    Dahut, William [ORCID]
    Madan, Ravi [ORCID]
    Wood, Bradford J [ORCID]
    Krishnasamy, Venkatesh [ORCID]
    Chang, Richard
    Levy, Elliot
    Pinto, Peter
    Eary, Janet F [ORCID]
    Choyke, Peter L [ORCID]

  2. Author Address

    From the Molecular Imaging Program, National Cancer Institute, Building 10, Room B3B47A, Bethesda, MD 20892 (L.L., E.M., B.T., I.L., F.L., A.T., Y.L.M., P.E., P.L.C.); Division of Cancer Treatment and Diagnosis: Biometric Research Program, National Cancer Institute, National Institutes of Health, Bethesda, Md (J.H.S.); National Cancer Institute Biometrics Research Program Contract, General Dynamics Information Technology, Falls Church, Va (S.E.R.); Clinical Research Directorate, Frederick National Laboratory for Cancer Research Sponsored by the National Cancer Institute, Bethesda, Md (S.A.H.); Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Md (D.E.C.); Genitourinary Malignancies Branch, National Cancer Institute, National Institutes of Health, Bethesda, Md (W.D., R.M.); Center of Interventional Oncology, National Cancer Institute, National Institutes of Health, Bethesda, Md (B.J.W., V.K., R.C., E.L.); Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Md (P.P.); and Cancer Imaging Program, National Cancer Institute, Bethesda, Md (J.F.E.).,
    1. Year: 2020
    2. Date: SEP
    3. Epub Date: 2020 07 07
  2. Journal: Radiology
    1. 296
    2. 3
    3. Pages: 564-572
  4. Type of Article: Article
  5. Article Number: 192018
  6. ISSN: 0033-8419
  1. Abstract:

    Background Prostate cancer recurrence is found in up to 40% of men with prior definitive (total prostatectomy or whole-prostate radiation) treatment. Prostate-specific membrane antigen PET agents such as 2-(3-{1-carboxy-5-[(6-[18F]fluoro-pyridine 3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid (18F-DCFPyL) may improve detection of recurrence compared with multiparametric MRI; however, histopathologic validation is lacking. Purpose To determine the sensitivity, specificity, and positive predictive value (PPV) of 18F-DCFPyL PET/CT based on histologic analysis and to compare with pelvic multiparametric MRI in men with biochemically recurrent prostate cancer. Materials and Methods Men were prospectively recruited after prostatectomy and/or radiation therapy with rising prostate-specific antigen level (median, 2.27 ng/mL; range, 0.2-27.45 ng/mL) and a negative result at conventional imaging (bone scan and/or CT). Participants underwent 18F-DCFPyL PET/CT imaging and 3.0-T pelvic multiparametric MRI. Statistical analysis included Wald and modified ?2 tests. Results A total of 323 lesions were visualized in 77 men by using 18F-DCFPyL or multiparametric MRI, with imaging detection concordance of 25% (82 of 323) when including all lesions in the MRI field of view and 53% (52 of 99) when only assessing prostate bed lesions. 18F-DCFPyL depicted more pelvic lymph nodes than did MRI (128 vs 23 nodes). Histologic validation was obtained in 80 locations with sensitivity, specificity, and PPV of 69% (25 of 36; 95% confidence interval [CI]: 51%, 88%), 91% (40 of 44; 95% CI: 74%, 98%), and 86% (25 of 29; 95% CI: 73%, 97%) for 18F-DCFPyL and 69% (24 of 35; 95% CI: 50%, 86%), 74% (31 of 42; 95% CI: 42%, 89%), and 69% (24 of 35; 95% CI: 50%, 88%) for multiparametric MRI (P = .95, P = .14, and P = .07, respectively). In the prostate bed, sensitivity, specificity, and PPV were 57% (13 of 23; 95% CI: 32%, 81%), 86% (18 of 21; 95% CI: 73%, 100%), and 81% (13 of 16; 95% CI: 59%, 100%) for 18F-DCFPyL and 83% (19 of 23; 95% CI: 59%, 100%), 52% (11 of 21; 95% CI: 29%, 74%), and 66% (19 of 29; 95% CI: 44%, 86%) for multiparametric MRI (P = .19, P = .02, and P = .17, respectively). The addition of 18F-DCFPyL to multiparametric MRI improved PPV by 38% overall (P = .02) and by 30% (P = .09) in the prostate bed. Conclusion Findings with 2-(3-{1-carboxy-5-[(6-[18F]fluoro-pyridine 3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid (18F-DCFPyL) were histologically validated and demonstrated high specificity and positive predictive value. In the pelvis, 18F-DCFPyL depicted more lymph nodes and improved positive predictive value and specificity when added to multiparametric MRI. 169; RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Zukotynski and Rowe in this issue.

    See More

  1. Keywords:

External Sources

  1. View Full Text
  2. DOI: 10.1148/radiol.2020192018
  3. PMID: 32633674
  4. View record in Web of Science®
  5. WOS: 000561055300028

Library Notes

  1. Fiscal Year: FY2019-2020
NCI at Frederick

You are leaving a government website.

This external link provides additional information that is consistent with the intended purpose of this site. The government cannot attest to the accuracy of a non-federal site.

Linking to a non-federal site does not constitute an endorsement by this institution or any of its employees of the sponsors or the information and products presented on the site. You will be subject to the destination site's privacy policy when you follow the link.

ContinueCancel