18F-DCFBC PET/CT for PSMA-Based Detection and Characterization of Primary Prostate Cancer

• DOI: 10.2967/jnumed.115.154336
• Publication Date: 2015-06-12T03:07:39Z
• Authors: Steven P. Rowe; Kenneth L. Gage; Sheila F. Faraj; Katarzyna J. Macura; Toby C. Cornish; Nilda Gonzalez-Ro...; Gunes Guner; Enrico Munari; Alan W. Partin; Christian P. Pavl...; Misop Han; H. Ballentine Carter; Trinity J. Bivala...; Amanda Blackford; Daniel Holt; Robert F. Dannals; George J. Netto; Martin A. Lodge; Ronnie C. Mease; Martin G. Pomper; Steve Y. Cho
• Keywords: Glutamate carboxypeptidase II

We previously demonstrated the ability to detect metastatic prostate cancer using <i>N</i>-[<i>N</i>-[(<i>S</i>)-1,3-dicarboxypropyl]carbamoyl]-4-¹⁸F-fluorobenzyl-l-cysteine (¹⁸F-DCFBC), a low-molecular-weight radiotracer that targets prostate-specific membrane antigen (PSMA). PSMA has been shown be associated with higher Gleason grade and more aggressive disease. An imaging biomarker able clinically significant high-grade primary reliably would address an unmet clinical need by allowing for risk-adapted patient management. <b>Methods:</b> enrolled 13 patients who were imaged ¹⁸F-DCFBC PET before scheduled prostatectomy, 12 of these also undergoing pelvic MR imaging. Prostate was correlated histologic immunohistochemical analysis on prostate-segment (12 regions) dominant-lesion basis. There no incidental extraprostatic findings suggestive <b>Results:</b> sensitive than detection per-segment (sensitivities up 0.17 0.39 imaging, respectively) per-dominant-lesion 0.46 0.92 respectively). However, specific (specificities 0.96 0.89 corresponding sensitivity, lesions (Gleason 8 9) greater 1.0 mL in size (4/4 positive PET). uptake tumors positively score (ρ = 0.64; expression, ρ 0.47; antigen, 0.52). significantly lower benign prostatic hypertrophy (median maximum standardized value, 2.2 vs. 3.5; <i>P</i> 0.004). <b>Conclusion:</b> Although sensitivity less larger-volume specificity In particular, there relatively low lesions, compared prostate, which may allow PET. This study demonstrates utility PSMA-based PET, used conjunction identify cancer.