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Journal of Nuclear Medicine

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Research ArticleTheranostics

Detection of Early Progression with 18F-DCFPyL PET/CT in Men with Metastatic Castration-Resistant Prostate Cancer Receiving Bipolar Androgen Therapy

Mark C. Markowski, Pedro Isaacsson Velho, Mario A. Eisenberger, Martin G. Pomper, Kenneth J. Pienta, Michael A. Gorin, Emmanuel S. Antonarakis, Samuel R. Denmeade and Steven P. Rowe
Journal of Nuclear Medicine September 2021, 62 (9) 1270-1273; DOI: https://doi.org/10.2967/jnumed.120.259226
Mark C. Markowski
1Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland;
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Pedro Isaacsson Velho
1Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland;
2Department of Medical Oncology, Hospital Moinhos de Vento, Porto Alegre, Brazil;
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Mario A. Eisenberger
1Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland;
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Martin G. Pomper
1Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland;
3Russel H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland; and
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Kenneth J. Pienta
4James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Michael A. Gorin
4James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Emmanuel S. Antonarakis
1Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland;
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Samuel R. Denmeade
1Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland;
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Steven P. Rowe
1Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland;
3Russel H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland; and
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    FIGURE 1.

    Changes in 18F-DCFPyL PET/CT imaging after 3 mo of BAT. Baseline and follow-up maximum-intensity-projection whole-body images are shown for each patient included in study. For patients 4–6, representative new lesions or sites of progression are demarcated with arrows. Additional new lesions may be hidden by normal uptake or other sites of disease.

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    FIGURE 2.

    Swimmer plot showing radiographic response/progression on BAT. All patients were followed until radiographic progression. 18F-DCFPyL PET/CT imaging was performed before start of BAT and after 3 mo of treatment. Patients 1–3 had no progression noted with 18F-DCFPyL. Patients 4–6 had new 18F-DCFPyL–avid lesions. These data suggest that disease progression on PSMA-targeted PET imaging precedes detection on conventional imaging.

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    TABLE 1

    Best Biochemical, Radiographic, and 18F-DCFPyL Response After 3 Months of BAT

    PatientPSA changeTumor changePSMA result
    193%Not evaluableNo progression
    2−98%−44%No progression
    3−93%−23%No progression
    41%−11%Progression
    5−55%−2%Progression
    6−63%−25%Progression

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Journal of Nuclear Medicine: 62 (9)
Journal of Nuclear Medicine
Vol. 62, Issue 9
September 1, 2021
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Detection of Early Progression with 18F-DCFPyL PET/CT in Men with Metastatic Castration-Resistant Prostate Cancer Receiving Bipolar Androgen Therapy
Mark C. Markowski, Pedro Isaacsson Velho, Mario A. Eisenberger, Martin G. Pomper, Kenneth J. Pienta, Michael A. Gorin, Emmanuel S. Antonarakis, Samuel R. Denmeade, Steven P. Rowe
Journal of Nuclear Medicine Sep 2021, 62 (9) 1270-1273; DOI: 10.2967/jnumed.120.259226

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Detection of Early Progression with 18F-DCFPyL PET/CT in Men with Metastatic Castration-Resistant Prostate Cancer Receiving Bipolar Androgen Therapy
Mark C. Markowski, Pedro Isaacsson Velho, Mario A. Eisenberger, Martin G. Pomper, Kenneth J. Pienta, Michael A. Gorin, Emmanuel S. Antonarakis, Samuel R. Denmeade, Steven P. Rowe
Journal of Nuclear Medicine Sep 2021, 62 (9) 1270-1273; DOI: 10.2967/jnumed.120.259226
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Keywords

  • PSMA
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