18F-DCFBC Prostate-Specific Membrane Antigen-Targeted PET/CT Imaging in Localized Prostate Cancer: Correlation with Multiparametric MRI and Histopathology

Baris Turkbey, Esther Mena, Liza Lindenberg, Stephen Adler, Sandra Bednarova, Rose Berman, Anita T. Ton, Yolanda McKinney, Philip Eclarinal, Craig Hill, George Afari, Sibaprasad Bhattacharyya, Ronnie C. Mease, Maria J. Merino, Paula M. Jacobs, Bradford J. Wood, Peter A. Pinto, Martin G. Pomper, Peter L. Choyke

Research output: Research - peer-reviewArticle

Abstract

Purpose To assess the ability of (N-[N-[(S)-1,3-dicarboxypropyl]carbamoyl]-4-18F-fluorobenzyl-l-cysteine) (18F-DCFBC), a prostate-specific membrane antigen-Targeted PET agent, to detect localized prostate cancer lesions in correlation with multiparametric MRI (mpMRI) and histopathology. Methods This Health Insurance Portability and Accountability Act of 1996-compliant, prospective, institutional review board-Approved study included 13 evaluable patients with localized prostate cancer (median age, 62.8 years [range, 51-74 years]; median prostate-specific antigen, 37.5 ng/dL [range, 3.26-216 ng/dL]). Patients underwent mpMRI and 18F-DCFBC PET/CT within a 3 months' window. Lesions seen on mpMRI were biopsied under transrectal ultrasound/MRI fusion-guided biopsy, or a radical prostatectomy was performed. 18F-DCFBC PET/CT and mpMRI were evaluated blinded and separately for tumor detection on a lesion basis. For PET image analysis, MRI and 18F-DCFBC PET images were fused by using software registration; imaging findings were correlated with histology, and uptake of 18F-DCFBC in tumors was compared with uptake in benign prostatic hyperplasia nodules and normal peripheral zone tissue using the 80% threshold SUVmax. Results A total of 25 tumor foci (mean size, 1.8 cm; median size, 1.5 cm; range, 0.6-4.7 cm) were histopathologically identified in 13 patients. Sensitivity rates of 18F-DCFBC PET/CT and mpMRI were 36% and 96%, respectively, for all tumors. For index lesions, the largest tumor with highest Gleason score, sensitivity rates of 18F-DCFBC PET/CT and mpMRI were 61.5% and 92%, respectively. The average SUVmax for primary prostate cancer was higher (5.8 ± 4.4) than that of benign prostatic hyperplasia nodules (2.1 ± 0.3) or that of normal prostate tissue (2.1 ± 0.4) at 1 hour postinjection (P = 0.0033). Conclusions The majority of index prostate cancers are detected with 18F-DCFBC PET/CT, and this may be a prognostic indicator based on uptake and staging. However, for detecting prostate cancer with high sensitivity, it is important to combine prostate-specific membrane antigen PET/CT with mpMRI.

LanguageEnglish (US)
Pages735-740
Number of pages6
JournalClinical Nuclear Medicine
Volume42
Issue number10
DOIs
StatePublished - Oct 1 2017

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Prostatic Neoplasms
Neoplasms
human glutamate carboxypeptidase II
Prostatic Hyperplasia
Health Insurance Portability and Accountability Act
Neoplasm Grading
Research Ethics Committees
Prostate-Specific Antigen
Prostatectomy
Cysteine
Prostate
Histology
Software
Biopsy

Keywords

  • F-DCFBC PET/CT
  • multiparametric prostate MRI
  • prostate cancer
  • PSMA

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

18F-DCFBC Prostate-Specific Membrane Antigen-Targeted PET/CT Imaging in Localized Prostate Cancer : Correlation with Multiparametric MRI and Histopathology. / Turkbey, Baris; Mena, Esther; Lindenberg, Liza; Adler, Stephen; Bednarova, Sandra; Berman, Rose; Ton, Anita T.; McKinney, Yolanda; Eclarinal, Philip; Hill, Craig; Afari, George; Bhattacharyya, Sibaprasad; Mease, Ronnie C.; Merino, Maria J.; Jacobs, Paula M.; Wood, Bradford J.; Pinto, Peter A.; Pomper, Martin G.; Choyke, Peter L.

In: Clinical Nuclear Medicine, Vol. 42, No. 10, 01.10.2017, p. 735-740.

Research output: Research - peer-reviewArticle

Turkbey, B, Mena, E, Lindenberg, L, Adler, S, Bednarova, S, Berman, R, Ton, AT, McKinney, Y, Eclarinal, P, Hill, C, Afari, G, Bhattacharyya, S, Mease, RC, Merino, MJ, Jacobs, PM, Wood, BJ, Pinto, PA, Pomper, MG & Choyke, PL 2017, '18F-DCFBC Prostate-Specific Membrane Antigen-Targeted PET/CT Imaging in Localized Prostate Cancer: Correlation with Multiparametric MRI and Histopathology' Clinical Nuclear Medicine, vol 42, no. 10, pp. 735-740. DOI: 10.1097/RLU.0000000000001804
Turkbey, Baris ; Mena, Esther ; Lindenberg, Liza ; Adler, Stephen ; Bednarova, Sandra ; Berman, Rose ; Ton, Anita T. ; McKinney, Yolanda ; Eclarinal, Philip ; Hill, Craig ; Afari, George ; Bhattacharyya, Sibaprasad ; Mease, Ronnie C. ; Merino, Maria J. ; Jacobs, Paula M. ; Wood, Bradford J. ; Pinto, Peter A. ; Pomper, Martin G. ; Choyke, Peter L./ 18F-DCFBC Prostate-Specific Membrane Antigen-Targeted PET/CT Imaging in Localized Prostate Cancer : Correlation with Multiparametric MRI and Histopathology. In: Clinical Nuclear Medicine. 2017 ; Vol. 42, No. 10. pp. 735-740
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abstract = "Purpose To assess the ability of (N-[N-[(S)-1,3-dicarboxypropyl]carbamoyl]-4-18F-fluorobenzyl-l-cysteine) (18F-DCFBC), a prostate-specific membrane antigen-Targeted PET agent, to detect localized prostate cancer lesions in correlation with multiparametric MRI (mpMRI) and histopathology. Methods This Health Insurance Portability and Accountability Act of 1996-compliant, prospective, institutional review board-Approved study included 13 evaluable patients with localized prostate cancer (median age, 62.8 years [range, 51-74 years]; median prostate-specific antigen, 37.5 ng/dL [range, 3.26-216 ng/dL]). Patients underwent mpMRI and 18F-DCFBC PET/CT within a 3 months' window. Lesions seen on mpMRI were biopsied under transrectal ultrasound/MRI fusion-guided biopsy, or a radical prostatectomy was performed. 18F-DCFBC PET/CT and mpMRI were evaluated blinded and separately for tumor detection on a lesion basis. For PET image analysis, MRI and 18F-DCFBC PET images were fused by using software registration; imaging findings were correlated with histology, and uptake of 18F-DCFBC in tumors was compared with uptake in benign prostatic hyperplasia nodules and normal peripheral zone tissue using the 80% threshold SUVmax. Results A total of 25 tumor foci (mean size, 1.8 cm; median size, 1.5 cm; range, 0.6-4.7 cm) were histopathologically identified in 13 patients. Sensitivity rates of 18F-DCFBC PET/CT and mpMRI were 36% and 96%, respectively, for all tumors. For index lesions, the largest tumor with highest Gleason score, sensitivity rates of 18F-DCFBC PET/CT and mpMRI were 61.5% and 92%, respectively. The average SUVmax for primary prostate cancer was higher (5.8 ± 4.4) than that of benign prostatic hyperplasia nodules (2.1 ± 0.3) or that of normal prostate tissue (2.1 ± 0.4) at 1 hour postinjection (P = 0.0033). Conclusions The majority of index prostate cancers are detected with 18F-DCFBC PET/CT, and this may be a prognostic indicator based on uptake and staging. However, for detecting prostate cancer with high sensitivity, it is important to combine prostate-specific membrane antigen PET/CT with mpMRI.",
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TY - JOUR

T1 - 18F-DCFBC Prostate-Specific Membrane Antigen-Targeted PET/CT Imaging in Localized Prostate Cancer

T2 - Clinical Nuclear Medicine

AU - Turkbey,Baris

AU - Mena,Esther

AU - Lindenberg,Liza

AU - Adler,Stephen

AU - Bednarova,Sandra

AU - Berman,Rose

AU - Ton,Anita T.

AU - McKinney,Yolanda

AU - Eclarinal,Philip

AU - Hill,Craig

AU - Afari,George

AU - Bhattacharyya,Sibaprasad

AU - Mease,Ronnie C.

AU - Merino,Maria J.

AU - Jacobs,Paula M.

AU - Wood,Bradford J.

AU - Pinto,Peter A.

AU - Pomper,Martin G.

AU - Choyke,Peter L.

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Purpose To assess the ability of (N-[N-[(S)-1,3-dicarboxypropyl]carbamoyl]-4-18F-fluorobenzyl-l-cysteine) (18F-DCFBC), a prostate-specific membrane antigen-Targeted PET agent, to detect localized prostate cancer lesions in correlation with multiparametric MRI (mpMRI) and histopathology. Methods This Health Insurance Portability and Accountability Act of 1996-compliant, prospective, institutional review board-Approved study included 13 evaluable patients with localized prostate cancer (median age, 62.8 years [range, 51-74 years]; median prostate-specific antigen, 37.5 ng/dL [range, 3.26-216 ng/dL]). Patients underwent mpMRI and 18F-DCFBC PET/CT within a 3 months' window. Lesions seen on mpMRI were biopsied under transrectal ultrasound/MRI fusion-guided biopsy, or a radical prostatectomy was performed. 18F-DCFBC PET/CT and mpMRI were evaluated blinded and separately for tumor detection on a lesion basis. For PET image analysis, MRI and 18F-DCFBC PET images were fused by using software registration; imaging findings were correlated with histology, and uptake of 18F-DCFBC in tumors was compared with uptake in benign prostatic hyperplasia nodules and normal peripheral zone tissue using the 80% threshold SUVmax. Results A total of 25 tumor foci (mean size, 1.8 cm; median size, 1.5 cm; range, 0.6-4.7 cm) were histopathologically identified in 13 patients. Sensitivity rates of 18F-DCFBC PET/CT and mpMRI were 36% and 96%, respectively, for all tumors. For index lesions, the largest tumor with highest Gleason score, sensitivity rates of 18F-DCFBC PET/CT and mpMRI were 61.5% and 92%, respectively. The average SUVmax for primary prostate cancer was higher (5.8 ± 4.4) than that of benign prostatic hyperplasia nodules (2.1 ± 0.3) or that of normal prostate tissue (2.1 ± 0.4) at 1 hour postinjection (P = 0.0033). Conclusions The majority of index prostate cancers are detected with 18F-DCFBC PET/CT, and this may be a prognostic indicator based on uptake and staging. However, for detecting prostate cancer with high sensitivity, it is important to combine prostate-specific membrane antigen PET/CT with mpMRI.

AB - Purpose To assess the ability of (N-[N-[(S)-1,3-dicarboxypropyl]carbamoyl]-4-18F-fluorobenzyl-l-cysteine) (18F-DCFBC), a prostate-specific membrane antigen-Targeted PET agent, to detect localized prostate cancer lesions in correlation with multiparametric MRI (mpMRI) and histopathology. Methods This Health Insurance Portability and Accountability Act of 1996-compliant, prospective, institutional review board-Approved study included 13 evaluable patients with localized prostate cancer (median age, 62.8 years [range, 51-74 years]; median prostate-specific antigen, 37.5 ng/dL [range, 3.26-216 ng/dL]). Patients underwent mpMRI and 18F-DCFBC PET/CT within a 3 months' window. Lesions seen on mpMRI were biopsied under transrectal ultrasound/MRI fusion-guided biopsy, or a radical prostatectomy was performed. 18F-DCFBC PET/CT and mpMRI were evaluated blinded and separately for tumor detection on a lesion basis. For PET image analysis, MRI and 18F-DCFBC PET images were fused by using software registration; imaging findings were correlated with histology, and uptake of 18F-DCFBC in tumors was compared with uptake in benign prostatic hyperplasia nodules and normal peripheral zone tissue using the 80% threshold SUVmax. Results A total of 25 tumor foci (mean size, 1.8 cm; median size, 1.5 cm; range, 0.6-4.7 cm) were histopathologically identified in 13 patients. Sensitivity rates of 18F-DCFBC PET/CT and mpMRI were 36% and 96%, respectively, for all tumors. For index lesions, the largest tumor with highest Gleason score, sensitivity rates of 18F-DCFBC PET/CT and mpMRI were 61.5% and 92%, respectively. The average SUVmax for primary prostate cancer was higher (5.8 ± 4.4) than that of benign prostatic hyperplasia nodules (2.1 ± 0.3) or that of normal prostate tissue (2.1 ± 0.4) at 1 hour postinjection (P = 0.0033). Conclusions The majority of index prostate cancers are detected with 18F-DCFBC PET/CT, and this may be a prognostic indicator based on uptake and staging. However, for detecting prostate cancer with high sensitivity, it is important to combine prostate-specific membrane antigen PET/CT with mpMRI.

KW - F-DCFBC PET/CT

KW - multiparametric prostate MRI

KW - prostate cancer

KW - PSMA

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