Semiquantitative parameters in PSMA-Targeted PET imaging with 18F-DCFPyL: Variability in normal-organ uptake

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Abstract

18F-DCFPyL is a small-molecule inhibitor of the prostate-specific membrane antigen that has shown promise for evaluation of primary and metastatic prostate cancer using PET. Measuring the variability in normal-organ uptake of 18F-DCFPyL is necessary to understand its biodistribution, aid image interpretation, judge the reliability of scan quantification, and provide a basis for therapeutic monitoring. Methods: Sixty-five consecutive 18F-DCFPyL PET/CT scans from 64 patients with a history of prostate cancer were analyzed. Volumes of interest were defined for the lacrimal glands, major salivary glands, liver, spleen, and both kidneys. The mean SUV normalized to body mass or to lean body mass (SUL) was calculated for each volume of interest. The average SUV across all scans, the SD, and the coefficient of variation (COV) for each organ were calculated. The same parameters were also derived for a 3-cm sphere drawn in the center of the right lobe of the liver. Results: The average SUVmean for all selected organs measured was 6.6 6 1.8 for the right lacrimal gland, 6.4 6 1.8 for the left lacrimal gland, 9.16 2.0 for the right parotid gland, 9.0 6 2.1 for the left parotid gland, 9.6 6 2.3 for the right submandibular gland, 9.4 6 2.2 for the left submandibular gland, 5.0 6 0.7 for the whole liver, 5.1 6 0.7 for a 3-cmsphere in the liver, 4.0 6 1.5 for the spleen, 20.1 6 4.6 for the right kidney, and 19.4 6 4.5 for the left kidney. SULmean was lower overall, although demonstrating similar trends. The COV of SUVmean and SULmean was lower in the liver (13.8% and 14.5%, respectively) than in any other organ and was less than the comparable COV for 18F-FDG PET. The COV of SUVmean and SULmean in the 3-cm sphere in the liver was also low and similar to the variability in the whole liver (14.2% and 14.7%, respectively). Conclusion: 18F-DCFPyL uptake in normal liver demonstrates less variability than in other 18F-DCFPyL-avid organs, and its variability is less than the reported variability of 18F-FDG in liver. Variability was slightly less for SUVmean than for SULmean, suggesting that SUVmean may be the preferable parameter for quantification of images obtained with 18F-DCFPyL.

Original languageEnglish (US)
Pages (from-to)942-946
Number of pages5
JournalJournal of Nuclear Medicine
Volume58
Issue number6
DOIs
StatePublished - Jun 1 2017

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Liver
Lacrimal Apparatus
Submandibular Gland
Parotid Gland
Fluorodeoxyglucose F18
Kidney
Prostatic Neoplasms
Spleen
2-(3-(1-carboxy-5-((6-fluoropyridine-3-carbonyl)amino)pentyl)ureido)pentanedioic acid
Salivary Glands
Therapeutics

Keywords

  • Molecular imaging
  • Positron emission tomography
  • Prostate cancer
  • Prostate-specific membrane antigen
  • SUV

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{1e7cc304a2a1428aa2ac087a7b454779,
title = "Semiquantitative parameters in PSMA-Targeted PET imaging with 18F-DCFPyL: Variability in normal-organ uptake",
abstract = "18F-DCFPyL is a small-molecule inhibitor of the prostate-specific membrane antigen that has shown promise for evaluation of primary and metastatic prostate cancer using PET. Measuring the variability in normal-organ uptake of 18F-DCFPyL is necessary to understand its biodistribution, aid image interpretation, judge the reliability of scan quantification, and provide a basis for therapeutic monitoring. Methods: Sixty-five consecutive 18F-DCFPyL PET/CT scans from 64 patients with a history of prostate cancer were analyzed. Volumes of interest were defined for the lacrimal glands, major salivary glands, liver, spleen, and both kidneys. The mean SUV normalized to body mass or to lean body mass (SUL) was calculated for each volume of interest. The average SUV across all scans, the SD, and the coefficient of variation (COV) for each organ were calculated. The same parameters were also derived for a 3-cm sphere drawn in the center of the right lobe of the liver. Results: The average SUVmean for all selected organs measured was 6.6 6 1.8 for the right lacrimal gland, 6.4 6 1.8 for the left lacrimal gland, 9.16 2.0 for the right parotid gland, 9.0 6 2.1 for the left parotid gland, 9.6 6 2.3 for the right submandibular gland, 9.4 6 2.2 for the left submandibular gland, 5.0 6 0.7 for the whole liver, 5.1 6 0.7 for a 3-cmsphere in the liver, 4.0 6 1.5 for the spleen, 20.1 6 4.6 for the right kidney, and 19.4 6 4.5 for the left kidney. SULmean was lower overall, although demonstrating similar trends. The COV of SUVmean and SULmean was lower in the liver (13.8{\%} and 14.5{\%}, respectively) than in any other organ and was less than the comparable COV for 18F-FDG PET. The COV of SUVmean and SULmean in the 3-cm sphere in the liver was also low and similar to the variability in the whole liver (14.2{\%} and 14.7{\%}, respectively). Conclusion: 18F-DCFPyL uptake in normal liver demonstrates less variability than in other 18F-DCFPyL-avid organs, and its variability is less than the reported variability of 18F-FDG in liver. Variability was slightly less for SUVmean than for SULmean, suggesting that SUVmean may be the preferable parameter for quantification of images obtained with 18F-DCFPyL.",
keywords = "Molecular imaging, Positron emission tomography, Prostate cancer, Prostate-specific membrane antigen, SUV",
author = "Xin Li and Steven Rowe and Leal, {Jeffrey Pettit} and Michael Gorin and Allaf, {Mohamad E} and Ross, {Ashley E.} and Kenneth Pienta and Martin Lodge and Pomper, {Martin Gilbert}",
year = "2017",
month = "6",
day = "1",
doi = "10.2967/jnumed.116.179739",
language = "English (US)",
volume = "58",
pages = "942--946",
journal = "Journal of Nuclear Medicine",
issn = "0161-5505",
publisher = "Society of Nuclear Medicine Inc.",
number = "6",

}

TY - JOUR

T1 - Semiquantitative parameters in PSMA-Targeted PET imaging with 18F-DCFPyL

T2 - Variability in normal-organ uptake

AU - Li, Xin

AU - Rowe, Steven

AU - Leal, Jeffrey Pettit

AU - Gorin, Michael

AU - Allaf, Mohamad E

AU - Ross, Ashley E.

AU - Pienta, Kenneth

AU - Lodge, Martin

AU - Pomper, Martin Gilbert

PY - 2017/6/1

Y1 - 2017/6/1

N2 - 18F-DCFPyL is a small-molecule inhibitor of the prostate-specific membrane antigen that has shown promise for evaluation of primary and metastatic prostate cancer using PET. Measuring the variability in normal-organ uptake of 18F-DCFPyL is necessary to understand its biodistribution, aid image interpretation, judge the reliability of scan quantification, and provide a basis for therapeutic monitoring. Methods: Sixty-five consecutive 18F-DCFPyL PET/CT scans from 64 patients with a history of prostate cancer were analyzed. Volumes of interest were defined for the lacrimal glands, major salivary glands, liver, spleen, and both kidneys. The mean SUV normalized to body mass or to lean body mass (SUL) was calculated for each volume of interest. The average SUV across all scans, the SD, and the coefficient of variation (COV) for each organ were calculated. The same parameters were also derived for a 3-cm sphere drawn in the center of the right lobe of the liver. Results: The average SUVmean for all selected organs measured was 6.6 6 1.8 for the right lacrimal gland, 6.4 6 1.8 for the left lacrimal gland, 9.16 2.0 for the right parotid gland, 9.0 6 2.1 for the left parotid gland, 9.6 6 2.3 for the right submandibular gland, 9.4 6 2.2 for the left submandibular gland, 5.0 6 0.7 for the whole liver, 5.1 6 0.7 for a 3-cmsphere in the liver, 4.0 6 1.5 for the spleen, 20.1 6 4.6 for the right kidney, and 19.4 6 4.5 for the left kidney. SULmean was lower overall, although demonstrating similar trends. The COV of SUVmean and SULmean was lower in the liver (13.8% and 14.5%, respectively) than in any other organ and was less than the comparable COV for 18F-FDG PET. The COV of SUVmean and SULmean in the 3-cm sphere in the liver was also low and similar to the variability in the whole liver (14.2% and 14.7%, respectively). Conclusion: 18F-DCFPyL uptake in normal liver demonstrates less variability than in other 18F-DCFPyL-avid organs, and its variability is less than the reported variability of 18F-FDG in liver. Variability was slightly less for SUVmean than for SULmean, suggesting that SUVmean may be the preferable parameter for quantification of images obtained with 18F-DCFPyL.

AB - 18F-DCFPyL is a small-molecule inhibitor of the prostate-specific membrane antigen that has shown promise for evaluation of primary and metastatic prostate cancer using PET. Measuring the variability in normal-organ uptake of 18F-DCFPyL is necessary to understand its biodistribution, aid image interpretation, judge the reliability of scan quantification, and provide a basis for therapeutic monitoring. Methods: Sixty-five consecutive 18F-DCFPyL PET/CT scans from 64 patients with a history of prostate cancer were analyzed. Volumes of interest were defined for the lacrimal glands, major salivary glands, liver, spleen, and both kidneys. The mean SUV normalized to body mass or to lean body mass (SUL) was calculated for each volume of interest. The average SUV across all scans, the SD, and the coefficient of variation (COV) for each organ were calculated. The same parameters were also derived for a 3-cm sphere drawn in the center of the right lobe of the liver. Results: The average SUVmean for all selected organs measured was 6.6 6 1.8 for the right lacrimal gland, 6.4 6 1.8 for the left lacrimal gland, 9.16 2.0 for the right parotid gland, 9.0 6 2.1 for the left parotid gland, 9.6 6 2.3 for the right submandibular gland, 9.4 6 2.2 for the left submandibular gland, 5.0 6 0.7 for the whole liver, 5.1 6 0.7 for a 3-cmsphere in the liver, 4.0 6 1.5 for the spleen, 20.1 6 4.6 for the right kidney, and 19.4 6 4.5 for the left kidney. SULmean was lower overall, although demonstrating similar trends. The COV of SUVmean and SULmean was lower in the liver (13.8% and 14.5%, respectively) than in any other organ and was less than the comparable COV for 18F-FDG PET. The COV of SUVmean and SULmean in the 3-cm sphere in the liver was also low and similar to the variability in the whole liver (14.2% and 14.7%, respectively). Conclusion: 18F-DCFPyL uptake in normal liver demonstrates less variability than in other 18F-DCFPyL-avid organs, and its variability is less than the reported variability of 18F-FDG in liver. Variability was slightly less for SUVmean than for SULmean, suggesting that SUVmean may be the preferable parameter for quantification of images obtained with 18F-DCFPyL.

KW - Molecular imaging

KW - Positron emission tomography

KW - Prostate cancer

KW - Prostate-specific membrane antigen

KW - SUV

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U2 - 10.2967/jnumed.116.179739

DO - 10.2967/jnumed.116.179739

M3 - Article

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VL - 58

SP - 942

EP - 946

JO - Journal of Nuclear Medicine

JF - Journal of Nuclear Medicine

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