RT Journal Article
SR Electronic
T1 A comparison of 18F-DCFPyL, 18F-NaF and 18F-FDG PET/CT in a prospective cohort of men with metastatic prostate cancer
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP jnumed.121.262371
DO 10.2967/jnumed.121.262371
A1 Aloÿse Fourquet
A1 Adrian Rosenberg
A1 Esther Mena
A1 Joanna J. Shih
A1 Baris Turkbey
A1 Maxime Blain
A1 Ethan Bergvall
A1 Frank I Lin
A1 Stephen Adler
A1 Ilhan Lim
A1 Ravi A Madan
A1 Fatima Karzai
A1 James L. Gulley
A1 William L. Dahut
A1 Bradford J. Wood
A1 Richard Chang
A1 Elliot Levy
A1 Peter L. Choyke
A1 Liza Lindenberg
YR 2021
UL http://jnm.snmjournals.org/content/early/2021/09/02/jnumed.121.262371.abstract
AB Introduction: 18F-DCFPyL, 18F-NaF and 18F-FDG PET/CT were compared in a prospective cohort of men with metastatic prostate cancer (PCa). Materials and Methods: 67 men (Group 1) with documented metastatic PCa underwent 18F-DCFPyL and 18F-NaF PET/CT and a subgroup of 30 men (Group 2) underwent additional imaging with 18F-FDG PET/CT. The tracers were compared for their detection rates, imaging concordance, associations with Prostate Specific Antigen (PSA), treatment at the time of imaging and castration status. Results: Overall, 61 men had metastatic disease detected on one or more scans, while 6 men were negative. In Group 1, 18F-NaF detected significantly more metastatic lesions than 18F-DCFPyL (median of 3 lesions versus 2, P = 0.001) even after eliminating benign causes of 18F-NaF uptake. This difference was particularly clear for men receiving treatment (P = 0.005) or who were castrate resistant (P = 0.014). The median percentage of bone lesions that were concordant on 18F-DCFPyL and 18F-NaF was 50%. In Group 2, 18F-DCFPyL detected more lesions than 18F-FDG (median of 5 lesions versus 2, P = 0.0003), regardless of PSA level, castration status or treatment. The median percentage of lesions that were concordant on 18F-DCFPyL and 18F-FDG was 22.2%. This percentage was slightly higher for castrate-resistant than castrate-sensitive men (P = 0.048). Conclusion: 18F-DCFPyL PET/CT is the most versatile of the three PET agents for metastatic PCa however, 18F-NaF detects more bone metastases. Imaging reveals substantial tumor heterogeneity with only 50% concordance between 18F-DCFPyL and 18F-NaF and 22% concordance for 18F-DCFPyL and 18F-FDG. This indicates considerable phenotypic differences among metastatic lesions.