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Evaluating Biochemically Recurrent Prostate Cancer: Histologic Validation of 18F-DCFPyL PET/CT with Comparison to Multiparametric MRI.
Lindenberg, Liza; Mena, Esther; Turkbey, Baris; Shih, Joanna H; Reese, Sarah E; Harmon, Stephanie A; Lim, Ilhan; Lin, Frank; Ton, Anita; McKinney, Yolanda L; Eclarinal, Philip; Citrin, Deborah E; Dahut, William; Madan, Ravi; Wood, Bradford J; Krishnasamy, Venkatesh; Chang, Richard; Levy, Elliot; Pinto, Peter; Eary, Janet F; Choyke, Peter L.
Afiliación
  • Lindenberg L; 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, Be
  • Mena E; 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, Be
  • Turkbey B; 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, Be
  • Shih JH; 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, Be
  • Reese SE; 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, Be
  • Harmon SA; 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, Be
  • Lim I; 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, Be
  • Lin F; 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, Be
  • Ton A; 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, Be
  • McKinney YL; 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, Be
  • Eclarinal P; 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, Be
  • Citrin DE; 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, Be
  • Dahut W; 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, Be
  • Madan R; 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, Be
  • Wood BJ; 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, Be
  • Krishnasamy V; 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, Be
  • Chang R; 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, Be
  • Levy E; 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, Be
  • Pinto P; 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, Be
  • Eary JF; 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, Be
  • Choyke PL; 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, Be
Radiology ; 296(3): 564-572, 2020 09.
Article en En | MEDLINE | ID: mdl-32633674
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 χ2 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. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Zukotynski and Rowe in this issue.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Próstata / Neoplasias de la Próstata / Tomografía Computarizada por Tomografía de Emisión de Positrones / Imágenes de Resonancia Magnética Multiparamétrica Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans / Male / Middle aged Idioma: En Revista: Radiology Año: 2020 Tipo del documento: Article País de afiliación: Bélgica
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Próstata / Neoplasias de la Próstata / Tomografía Computarizada por Tomografía de Emisión de Positrones / Imágenes de Resonancia Magnética Multiparamétrica Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans / Male / Middle aged Idioma: En Revista: Radiology Año: 2020 Tipo del documento: Article País de afiliación: Bélgica