Imaging Urothelial Bladder Cancer: A VPAC PET Targeted Approach

Mathew L. Thakur, Sushil K. Tripathi, Leonard G. Gomella, Ebru Salmanoglu, Sung Kim, William K. Kelly, Scott W. Keith, Charles Intenzo, Peter McCue, Jean Hoffman-Censits, Edouard J. Trabulsi

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Accurate staging of urothelial bladder cancer (UBC) with imaging, which guides effective bladder cancer treatment, remains challenging. This investigation is to validate a hypothesis that targeting Vasoactive intestinal and pituitary adenylate cyclase activating peptide (VPAC) receptors using 64Cu-TP3805 can PET image UBC efficiently. Materials and methods: Nineteen patients (44-84 years of age) scheduled for radical cystectomy, underwent VPAC positron emission tomography (PET) imaging prior to surgery. Sixteen had completed neoadjuvant chemotherapy prior to imaging. All 19 received 64Cu- TP3805 (148 % ± 10% MBq) intravenously, and were imaged 60 to 90 minutes later. Standard uptake value (SUV)max for malignant lesions and SUVmean for normal tissues were determined and mean ±SEM recorded. Following radical cystoprostatectomy, pelvic lymphadenectomy and urinary diversion imaging, results were compared with final surgical pathology. Results: 64Cu-TP3805 had no adverse events, negligible urinary excretion and rapid blood clearance. UBC PET images for residual disease were true positive in 11 patients and true negative in four. Of remaining 4, one had false positive and 3 had false negative scans, equating to 79% sensitivity (95%, CI 49%-95%), 80% specificity (95%, CI 28%-100%), 92% positive predictive value (95%, CI 62%-100%) and 57% negative predictive value (95%, CI 18%-90%). Conclusions: These first in man results, in a group, heavily pretreated with neoadjuvant chemotherapy, indicate that VPAC PET imaging can identify UBC effeiciently and suggest, that VPAC PET can diagnose UBC in a treatment naïve cohort for accurate staging, guide biopsy and treatment in patients with suspected metastasis and determine response to therapy. Further investigation of this molecular imaging approach is warranted.

Original languageEnglish (US)
Pages (from-to)10596-10602
Number of pages7
JournalCanadian Journal of Urology
Volume28
Issue number2
StatePublished - Apr 2021

Keywords

  • Cu-TP3805
  • bladder cancer
  • computed tomography
  • positron emission tomography
  • radioisotope diagnostic technique

ASJC Scopus subject areas

  • Medicine(all)

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