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Research ArticleClinical Investigations

Biodistribution, Tumor Detection, and Radiation Dosimetry of 18F-DCFBC, a Low-Molecular-Weight Inhibitor of Prostate-Specific Membrane Antigen, in Patients with Metastatic Prostate Cancer

Steve Y. Cho, Kenneth L. Gage, Ronnie C. Mease, Srinivasan Senthamizhchelvan, Daniel P. Holt, Akimosa Jeffrey-Kwanisai, Christopher J. Endres, Robert F. Dannals, George Sgouros, Martin Lodge, Mario A. Eisenberger, Ronald Rodriguez, Michael A. Carducci, Camilo Rojas, Barbara S. Slusher, Alan P. Kozikowski and Martin G. Pomper
Journal of Nuclear Medicine December 2012, 53 (12) 1883-1891; DOI: https://doi.org/10.2967/jnumed.112.104661
Steve Y. Cho
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
2Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
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Kenneth L. Gage
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
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Ronnie C. Mease
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
2Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
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Srinivasan Senthamizhchelvan
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
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Daniel P. Holt
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
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Akimosa Jeffrey-Kwanisai
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
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Christopher J. Endres
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
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Robert F. Dannals
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
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George Sgouros
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
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Martin Lodge
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
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Mario A. Eisenberger
2Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
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Ronald Rodriguez
2Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
3Brady Urological Institute, Johns Hopkins University, Baltimore, Maryland
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Michael A. Carducci
3Brady Urological Institute, Johns Hopkins University, Baltimore, Maryland
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Camilo Rojas
4Brain Sciences Institute of Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, Maryland; and
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Barbara S. Slusher
4Brain Sciences Institute of Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, Maryland; and
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Alan P. Kozikowski
5Department of Medicinal Chemistry and Pharmacognosy, University of Illinois at Chicago College of Pharmacy, Chicago, Illinois
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Martin G. Pomper
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
2Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
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  • FIGURE 1.
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    FIGURE 1.

    Mean biodistribution curves plotted for decay-corrected percentage injected dose per gram of organ mass vs. time. Time axis represents average time over all patients for each PET scan because some patients (i.e., tall patients) required more bed positions. (A) Organs with higher uptake. (B) Organs with lower uptake. (C) Increasing urinary bladder activity. LLI = lower large intestine; SI = small intestine; ULI = upper large intestine. %ID/g = percentage injected dose per gram of organ mass.

  • FIGURE 2.
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    FIGURE 2.

    18F-DCFBC PET anterior projection maximal-intensity-projection images at 2 h after injection in patient 1, with several bone metastases (arrow) (A), and patient 5, with LN metastases (arrow) (B), as confirmed by correlation to CT portion of PET/CT exam.

  • FIGURE 3.
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    FIGURE 3.

    Examples of concordant findings on 18F-DCFBC PET and CIM: (A) T12 bone metastasis (arrows) seen on bone scan (far right) and (B) retroperitoneal right external iliac LN (arrow) seen on CT (arrow).

  • FIGURE 4.
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    FIGURE 4.

    (A and B) Focal 18F-DCFBC PET uptake at aortic bifurcation (arrow, A) with correlative small LN seen on concurrent contrast-enhanced CT (arrow, B), not considered to be nodal metastasis by CT but positive by PET. (C) Retrospective review of prior contrast-enhanced CT scan obtained 1 y previously demonstrates LN in this region (arrow).

  • FIGURE 5.
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    FIGURE 5.

    Focal 18F-DCFBC PET uptake in L4 vertebral body on PET and fused PET/CT (thick arrows, A) with no correlative abnormality on CT (thin arrow, A) or bone scan (arrow, B).

  • FIGURE 6.
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    FIGURE 6.

    (A) New sclerotic lesion in right posterior iliac bone seen on CT (thin white arrow) but not on 18F-DCFBC PET (black arrow) or PET/CT (thick white arrow). (B) Corresponding asymmetric uptake on bone scan (arrow).

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    TABLE 1

    Average TIACs (Bq-h/Bq)

    OrganAverageSDPercentage coefficient of variation
    Adrenals9.26E−042.35E−0425.43
    Brain1.20E−021.30E−0310.78
    Gallbladder contents2.50E−036.87E−0427.47
    Lower large intestine contents1.40E−023.96E−0328.29
    Small intestine contents4.93E−025.35E−0310.85
    Stomach1.96E−023.06E−0315.55
    Upper large intestine contents1.52E−022.55E−0316.76
    Heart contents4.78E−027.26E−0315.20
    Heart wall2.10E−022.58E−0312.31
    Kidneys3.50E−025.84E−0316.68
    Liver1.59E−013.29E−0220.62
    Lungs1.09E−011.87E−0217.13
    Pancreas5.34E−038.93E−0416.73
    Spleen1.01E−028.92E−048.80
    Testes2.42E−031.00E−0341.50
    Thyroid8.00E−048.23E−0510.29
    Bladder contents1.26E−014.94E−0239.13
    Red marrow (femoral head)1.08E−011.06E−029.86
    Red marrow (spine)6.92E−027.70E−0311.12
    Total body2.37E+009.09E−023.83
    Remainder of body1.72E+001.01E−015.86
    • View popup
    TABLE 2

    Average Organ-Absorbed Dose (mGy/MBq) and Estimated Effective Dose (mSv/MBq)

    OrganAverageSDPercentage coefficient of variation
    Adrenals1.85E−022.83E−0315.32
    Brain4.21E−032.83E−046.73
    Breasts8.51E−033.22E−043.78
    Gallbladder wall1.79E−021.95E−0310.90
    Lower large intestine wall2.47E−023.69E−0314.92
    Small intestine wall2.36E−021.72E−037.31
    Stomach wall3.02E−023.24E−0310.72
    Upper large intestine wall2.34E−022.20E−039.39
    Heart wall2.92E−023.24E−0311.12
    Kidneys2.84E−023.81E−0313.45
    Liver2.46E−024.16E−0316.88
    Lungs2.45E−022.99E−0312.22
    Muscle9.69E−033.97E−044.10
    Ovaries1.32E−025.26E−043.99
    Pancreas1.92E−022.15E−0311.19
    Red marrow1.70E−029.81E−045.79
    Osteogenic cells1.82E−028.92E−044.90
    Skin7.30E−033.50E−044.79
    Spleen1.72E−021.05E−036.08
    Testes1.54E−024.19E−0327.23
    Thymus1.10E−024.53E−044.12
    Thyroid1.17E−026.87E−045.88
    Bladder wall3.24E−027.24E−0322.35
    Uterus1.34E−022.95E−042.20
    Total body1.09E−024.28E−043.91
    Effective dose1.99E−021.34E−036.73

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Journal of Nuclear Medicine: 53 (12)
Journal of Nuclear Medicine
Vol. 53, Issue 12
December 1, 2012
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Biodistribution, Tumor Detection, and Radiation Dosimetry of 18F-DCFBC, a Low-Molecular-Weight Inhibitor of Prostate-Specific Membrane Antigen, in Patients with Metastatic Prostate Cancer
Steve Y. Cho, Kenneth L. Gage, Ronnie C. Mease, Srinivasan Senthamizhchelvan, Daniel P. Holt, Akimosa Jeffrey-Kwanisai, Christopher J. Endres, Robert F. Dannals, George Sgouros, Martin Lodge, Mario A. Eisenberger, Ronald Rodriguez, Michael A. Carducci, Camilo Rojas, Barbara S. Slusher, Alan P. Kozikowski, Martin G. Pomper
Journal of Nuclear Medicine Dec 2012, 53 (12) 1883-1891; DOI: 10.2967/jnumed.112.104661

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Biodistribution, Tumor Detection, and Radiation Dosimetry of 18F-DCFBC, a Low-Molecular-Weight Inhibitor of Prostate-Specific Membrane Antigen, in Patients with Metastatic Prostate Cancer
Steve Y. Cho, Kenneth L. Gage, Ronnie C. Mease, Srinivasan Senthamizhchelvan, Daniel P. Holt, Akimosa Jeffrey-Kwanisai, Christopher J. Endres, Robert F. Dannals, George Sgouros, Martin Lodge, Mario A. Eisenberger, Ronald Rodriguez, Michael A. Carducci, Camilo Rojas, Barbara S. Slusher, Alan P. Kozikowski, Martin G. Pomper
Journal of Nuclear Medicine Dec 2012, 53 (12) 1883-1891; DOI: 10.2967/jnumed.112.104661
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