Prospective Comparison of PET Imaging with PSMA-Targeted 18F-DCFPyL Versus Na18F for Bone Lesion Detection in Patients with Metastatic Prostate Cancer

• DOI: 10.2967/jnumed.119.227793
• Publication Date: 2019-08-26T23:35:15Z
• Authors: Steven P. Rowe; Xin Li; Bruce J. Trock; Rudolf A. Werner; Sarah Frey; Michael DiGianvit...; J. Keith Bleiler; Diane K. Reyes; Rehab Abdallah; Kenneth J. Pienta; Michael A. Gorin; Martin G. Pomper
• Keywords: Glutamate carboxypeptidase II; PET-CT; Whole body imaging

Bone metastases in prostate cancer (PCa) have important prognostic significance, and imaging modalities used for PCa staging should high sensitivity detecting such lesions. Prostate-specific membrane antigen (PSMA)–targeted PET radiotracers are promising new agents PCa. We undertook a head-to-head comparison of PSMA-targeted 2-(3-{1-carboxy-5-[(6-¹⁸F-fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid (¹⁸F-DCFPyL) to Na¹⁸F determine which modality was more sensitive the detection lesions suggestive bone group patients with metastatic <b>Methods:</b> Patients progressive, were prospectively imaged both ¹⁸F-DCFPyL PET/CT, scans occurring within 24 h each other. A consensus 2-reader central review performed identify all sites involvement on scans, maximized SUVs corrected body weight (SUV_max) lean mass (SUL_max) recorded. Soft-tissue also noted SUV_max, SUL_max, PSMA reporting data system (RADS) version 1.0 scores Data from 2 compared using generalized estimating equation. <b>Results:</b> In total, 16 meeting inclusion criteria enrolled this study, 15 (93.8%) radiotracers. 405 identified at least 1 scan. On 391 (96.5%) definitively positive, 4 (1.0%) equivocally 10 (2.5%) negative. corresponding values 388 (95.8%), (1.0%), 13 (3.2%). Of negative PET, 8 (80.0%) sclerotic (20.0%) infiltrative or marrow-based. Additionally, 12 (92.3%) marrow-based (7.7%) lytic. Also 78 PSMA-RADS-4, 17 PSMA-RADS-5, PSMA-RADS-3C soft-tissue <b>Conclusion:</b> PET/CT had nearly identical sensitivities As would be expected, provides information disease. There may little additional value after scan has already been performed.