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Research ArticleTheranostics

Repeatability of Quantitative 18F-DCFPyL PET/CT Measurements in Metastatic Prostate Cancer

Bernard H.E. Jansen, Matthijs C.F. Cysouw, André N. Vis, Reindert J.A. van Moorselaar, Jens Voortman, Yves J.L. Bodar, Patrick R. Schober, N. Harry Hendrikse, Otto S. Hoekstra, Ronald Boellaard and D.E. Oprea-Lager
Journal of Nuclear Medicine September 2020, 61 (9) 1320-1325; DOI: https://doi.org/10.2967/jnumed.119.236075
Bernard H.E. Jansen
1Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
2Department of Urology, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
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Matthijs C.F. Cysouw
1Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
3Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
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André N. Vis
2Department of Urology, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
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Reindert J.A. van Moorselaar
2Department of Urology, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
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Jens Voortman
3Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
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Yves J.L. Bodar
1Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
2Department of Urology, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
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Patrick R. Schober
4Department of Anesthesiology, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands; and
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N. Harry Hendrikse
1Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
5Department of Clinical Pharmacology and Pharmacy, Cancer Center Amsterdam, Amsterdam University Medical Center, VU University, Amsterdam, The Netherlands
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Otto S. Hoekstra
1Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
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Ronald Boellaard
1Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
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D.E. Oprea-Lager
1Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
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  • FIGURE 1.
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    FIGURE 1.

    Test–retest variability of SUV and TBR variants. Significant differences have been indicated with asterisk (Holms-Bonferroni–corrected P values). Differences in repeatability between SUVs and between TBRs were not significant.

  • FIGURE 2.
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    FIGURE 2.

    Bland–Altman plots of lesion-level metrics: SUVpeak (A), peak TBR (B), volume (C), and TBR TLU (D). y-axis in C and D were log-scaled for visual interpretation.

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    FIGURE 3.

    Bland–Altman plots of patient-level metrics TTV, SUV TTB, and TBR TTB. y-axes were log-scaled for visual interpretation.

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    TABLE 1

    Patient and Scan Characteristics of Patients Included in Repeatability Analysis (n = 10)

    CharacteristicData
    Age (y)74 (61–79)
    Initial Gleason score8 (6–9)
    PSA at PET/CT (ng/mL)9 (1–2,796)
    Length (cm)178 (168–192)
    Weight (kg)88 (68–94)
    PCa stage
     Primary metastatic2 (20.0%)
     Biochemically recurrent3 (30.0%)
     Castration-resistant5 (50.0%)
    Analyzed lesion type
     Bone21 (58.3%)
     Lymph node12 (33.3%)
     Intraprostatic3* (8.3%)
    Androgen deprivation at PET/CT7 (70.0%)
    Prior docetaxel3 (30.0%)
    Injected activity (MBq)
     Test317 (280–331)
     Retest313 (254–341)
    Uptake time (min)
     Test120 (118–153)
     Retest122 (111–149)
    Test–retest difference†
     Injected activity (MBq)28 (8–63)
     Uptake time (min)3 (0–22)
    • ↵* Differences were not significant (P > 0.05).

    • ↵† 2 intraprostatic foci in 1 patient.

    • Qualitative data are numbers followed by percentages in parentheses; continuous data are median followed by range in parentheses.

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    TABLE 2

    Descriptive Data of Lesion and Patient-Based Uptake Metrics on Test and Retest Scans

    TestRetest
    ParameterMedianIQRMedianIQR
    Lesion level
     Volume4.62.8–8.74.62.5–8.6
     SUVmean16.69.5–24.417.19.7–28.0
     SUVpeak21.710.5–28.321.611.4–32.2
     SUVmax28.116.0–41.029.817.2–51.2
     Mean TBR13.47.1–24.114.68.6–22.7
     Peak TBR17.77.7–28.418.89.8–26.7
     Maximum TBR25.011.7–40.923.614.1–38.8
     SUV TLU85.632.3–192.780.130.1–194.0
     TBR TLU67.624.6–189.466.723.5–152.6
    Patient level
     TTV21.410.6–63.221.810.3–69.7
     SUV TTB317.870.4–1,920.7285.570.6–1,846.4
     TBR TTB236.663.2–1,920.1224.968.2–1,720.0
    • IQR = interquartile range.

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    TABLE 3

    Repeatability of Lesion- and Patient-Based 18F-DCFPyL Uptake Metrics

    ParameterMean test–retest difference (%)RC (%)ICC95% CI
    Lesion level
     Volume−1.128.11.000.99–1.00
     SUVmean1.024.40.990.98–0.99
     SUVpeak1.825.30.990.97–0.99
     SUVmax1.931.00.970.94–0.99
     Mean TBR1.931.80.980.96–0.99
     Peak TBR2.631.70.980.96–0.99
     Maximum TBR2.737.30.970.94–0.98
     SUV TLU−0.132.10.990.98–1.00
     TBR TLU−3.539.30.980.96–0.99
    Patient level
     TTV−2.217.01.000.99–1.00
     SUV TTB−0.223.20.990.97–1.00
     TBR TTB−2.133.40.980.91–0.99
    • ICC = intraclass correlation coefficient; CI = confidence interval.

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Journal of Nuclear Medicine: 61 (9)
Journal of Nuclear Medicine
Vol. 61, Issue 9
September 1, 2020
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Repeatability of Quantitative 18F-DCFPyL PET/CT Measurements in Metastatic Prostate Cancer
Bernard H.E. Jansen, Matthijs C.F. Cysouw, André N. Vis, Reindert J.A. van Moorselaar, Jens Voortman, Yves J.L. Bodar, Patrick R. Schober, N. Harry Hendrikse, Otto S. Hoekstra, Ronald Boellaard, D.E. Oprea-Lager
Journal of Nuclear Medicine Sep 2020, 61 (9) 1320-1325; DOI: 10.2967/jnumed.119.236075

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Repeatability of Quantitative 18F-DCFPyL PET/CT Measurements in Metastatic Prostate Cancer
Bernard H.E. Jansen, Matthijs C.F. Cysouw, André N. Vis, Reindert J.A. van Moorselaar, Jens Voortman, Yves J.L. Bodar, Patrick R. Schober, N. Harry Hendrikse, Otto S. Hoekstra, Ronald Boellaard, D.E. Oprea-Lager
Journal of Nuclear Medicine Sep 2020, 61 (9) 1320-1325; DOI: 10.2967/jnumed.119.236075
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Keywords

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