Semiquantitative Parameters in PSMA-Targeted PET Imaging with [18F]DCFPyL

Impact of Tumor Burden on Normal Organ Uptake

Rudolf A. Werner, Ralph A. Bundschuh, Lena Bundschuh, Constantin Lapa, Yafu Yin, Mehrbod Som Som Javadi, Andreas K. Buck, Takahiro Higuchi, Kenneth Pienta, Martin Gilbert Pomper, Martin Lodge, Michael Gorin, Steven Rowe

Research output: Contribution to journalArticle

Abstract

Purpose: In this study, we aimed to quantitatively investigate the biodistribution of [18F]DCFPyL in patients with prostate cancer (PCa) and to determine whether uptake in normal organs correlates with an increase in tumor burden. Procedures: Fifty patients who had been imaged with [18F]DCFPyL positron emission tomography/computed tomography (PET/CT) were retrospectively included in this study. Forty of 50 (80 %) demonstrated radiotracer uptake on [18F]DCFPyL PET/CT compatible with sites of PCa. Volumes of interests (VOIs) were set on normal organs (lacrimal glands, parotid glands, submandibular glands, liver, spleen, and kidneys) and on tumor lesions. Mean standardized uptake values corrected to lean body mass (SULmean) and mean standardized uptake values corrected to body weight (SUVmean) for normal organs were assessed. For the entire tumor burden, SULmean/max, SUVmean, tumor volume (TV), and the total activity in the VOI were obtained using tumor segmentation. A Spearman’s rank correlation coefficient was used to investigate correlations between normal organ uptake and tumor burden. Results: There was no significant correlation between TV with the vast majority of the investigated organs (lacrimal glands, parotid glands, submandibular glands, spleen, and liver). Only the kidney showed significant correlation: With an isocontour threshold at 50 %, left kidney uptake parameters correlated significantly with TV (SUVmean, ρ = − 0.214 and SULmean, ρ = − 0.176, p < 0.05, respectively). Conclusions: Only a minimal sink effect with high tumor burden in patients imaged with [18F]DCFPyL was observed. Other factors, such as a high intra-patient variability of normal organ uptake, may be a much more important consideration for personalized dosimetry with PSMA-targeted therapeutic agents structurally related to [18F]DCFPyL than the tumor burden.

Original languageEnglish (US)
JournalMolecular Imaging and Biology
DOIs
StatePublished - Jan 1 2019

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Tumor Burden
Lacrimal Apparatus
Submandibular Gland
Parotid Gland
Kidney
Prostatic Neoplasms
Spleen
Ideal Body Weight
2-(3-(1-carboxy-5-((6-fluoropyridine-3-carbonyl)amino)pentyl)ureido)pentanedioic acid
Liver
Nonparametric Statistics
Neoplasms

Keywords

  • Biodistribution
  • Positron emission tomography
  • Prostate-specific membrane antigen
  • PSMA
  • [F]DCFPyL

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Semiquantitative Parameters in PSMA-Targeted PET Imaging with [18F]DCFPyL : Impact of Tumor Burden on Normal Organ Uptake. / Werner, Rudolf A.; Bundschuh, Ralph A.; Bundschuh, Lena; Lapa, Constantin; Yin, Yafu; Javadi, Mehrbod Som Som; Buck, Andreas K.; Higuchi, Takahiro; Pienta, Kenneth; Pomper, Martin Gilbert; Lodge, Martin; Gorin, Michael; Rowe, Steven.

In: Molecular Imaging and Biology, 01.01.2019.

Research output: Contribution to journalArticle

Werner, Rudolf A. ; Bundschuh, Ralph A. ; Bundschuh, Lena ; Lapa, Constantin ; Yin, Yafu ; Javadi, Mehrbod Som Som ; Buck, Andreas K. ; Higuchi, Takahiro ; Pienta, Kenneth ; Pomper, Martin Gilbert ; Lodge, Martin ; Gorin, Michael ; Rowe, Steven. / Semiquantitative Parameters in PSMA-Targeted PET Imaging with [18F]DCFPyL : Impact of Tumor Burden on Normal Organ Uptake. In: Molecular Imaging and Biology. 2019.
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abstract = "Purpose: In this study, we aimed to quantitatively investigate the biodistribution of [18F]DCFPyL in patients with prostate cancer (PCa) and to determine whether uptake in normal organs correlates with an increase in tumor burden. Procedures: Fifty patients who had been imaged with [18F]DCFPyL positron emission tomography/computed tomography (PET/CT) were retrospectively included in this study. Forty of 50 (80 {\%}) demonstrated radiotracer uptake on [18F]DCFPyL PET/CT compatible with sites of PCa. Volumes of interests (VOIs) were set on normal organs (lacrimal glands, parotid glands, submandibular glands, liver, spleen, and kidneys) and on tumor lesions. Mean standardized uptake values corrected to lean body mass (SULmean) and mean standardized uptake values corrected to body weight (SUVmean) for normal organs were assessed. For the entire tumor burden, SULmean/max, SUVmean, tumor volume (TV), and the total activity in the VOI were obtained using tumor segmentation. A Spearman’s rank correlation coefficient was used to investigate correlations between normal organ uptake and tumor burden. Results: There was no significant correlation between TV with the vast majority of the investigated organs (lacrimal glands, parotid glands, submandibular glands, spleen, and liver). Only the kidney showed significant correlation: With an isocontour threshold at 50 {\%}, left kidney uptake parameters correlated significantly with TV (SUVmean, ρ = − 0.214 and SULmean, ρ = − 0.176, p < 0.05, respectively). Conclusions: Only a minimal sink effect with high tumor burden in patients imaged with [18F]DCFPyL was observed. Other factors, such as a high intra-patient variability of normal organ uptake, may be a much more important consideration for personalized dosimetry with PSMA-targeted therapeutic agents structurally related to [18F]DCFPyL than the tumor burden.",
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author = "Werner, {Rudolf A.} and Bundschuh, {Ralph A.} and Lena Bundschuh and Constantin Lapa and Yafu Yin and Javadi, {Mehrbod Som Som} and Buck, {Andreas K.} and Takahiro Higuchi and Kenneth Pienta and Pomper, {Martin Gilbert} and Martin Lodge and Michael Gorin and Steven Rowe",
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T2 - Impact of Tumor Burden on Normal Organ Uptake

AU - Werner, Rudolf A.

AU - Bundschuh, Ralph A.

AU - Bundschuh, Lena

AU - Lapa, Constantin

AU - Yin, Yafu

AU - Javadi, Mehrbod Som Som

AU - Buck, Andreas K.

AU - Higuchi, Takahiro

AU - Pienta, Kenneth

AU - Pomper, Martin Gilbert

AU - Lodge, Martin

AU - Gorin, Michael

AU - Rowe, Steven

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose: In this study, we aimed to quantitatively investigate the biodistribution of [18F]DCFPyL in patients with prostate cancer (PCa) and to determine whether uptake in normal organs correlates with an increase in tumor burden. Procedures: Fifty patients who had been imaged with [18F]DCFPyL positron emission tomography/computed tomography (PET/CT) were retrospectively included in this study. Forty of 50 (80 %) demonstrated radiotracer uptake on [18F]DCFPyL PET/CT compatible with sites of PCa. Volumes of interests (VOIs) were set on normal organs (lacrimal glands, parotid glands, submandibular glands, liver, spleen, and kidneys) and on tumor lesions. Mean standardized uptake values corrected to lean body mass (SULmean) and mean standardized uptake values corrected to body weight (SUVmean) for normal organs were assessed. For the entire tumor burden, SULmean/max, SUVmean, tumor volume (TV), and the total activity in the VOI were obtained using tumor segmentation. A Spearman’s rank correlation coefficient was used to investigate correlations between normal organ uptake and tumor burden. Results: There was no significant correlation between TV with the vast majority of the investigated organs (lacrimal glands, parotid glands, submandibular glands, spleen, and liver). Only the kidney showed significant correlation: With an isocontour threshold at 50 %, left kidney uptake parameters correlated significantly with TV (SUVmean, ρ = − 0.214 and SULmean, ρ = − 0.176, p < 0.05, respectively). Conclusions: Only a minimal sink effect with high tumor burden in patients imaged with [18F]DCFPyL was observed. Other factors, such as a high intra-patient variability of normal organ uptake, may be a much more important consideration for personalized dosimetry with PSMA-targeted therapeutic agents structurally related to [18F]DCFPyL than the tumor burden.

AB - Purpose: In this study, we aimed to quantitatively investigate the biodistribution of [18F]DCFPyL in patients with prostate cancer (PCa) and to determine whether uptake in normal organs correlates with an increase in tumor burden. Procedures: Fifty patients who had been imaged with [18F]DCFPyL positron emission tomography/computed tomography (PET/CT) were retrospectively included in this study. Forty of 50 (80 %) demonstrated radiotracer uptake on [18F]DCFPyL PET/CT compatible with sites of PCa. Volumes of interests (VOIs) were set on normal organs (lacrimal glands, parotid glands, submandibular glands, liver, spleen, and kidneys) and on tumor lesions. Mean standardized uptake values corrected to lean body mass (SULmean) and mean standardized uptake values corrected to body weight (SUVmean) for normal organs were assessed. For the entire tumor burden, SULmean/max, SUVmean, tumor volume (TV), and the total activity in the VOI were obtained using tumor segmentation. A Spearman’s rank correlation coefficient was used to investigate correlations between normal organ uptake and tumor burden. Results: There was no significant correlation between TV with the vast majority of the investigated organs (lacrimal glands, parotid glands, submandibular glands, spleen, and liver). Only the kidney showed significant correlation: With an isocontour threshold at 50 %, left kidney uptake parameters correlated significantly with TV (SUVmean, ρ = − 0.214 and SULmean, ρ = − 0.176, p < 0.05, respectively). Conclusions: Only a minimal sink effect with high tumor burden in patients imaged with [18F]DCFPyL was observed. Other factors, such as a high intra-patient variability of normal organ uptake, may be a much more important consideration for personalized dosimetry with PSMA-targeted therapeutic agents structurally related to [18F]DCFPyL than the tumor burden.

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KW - Positron emission tomography

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KW - PSMA

KW - [F]DCFPyL

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