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. 2021 Jun;15(6):173-178.
doi: 10.5489/cuaj.6817.

Diagnostic performance of 18F-DCFPyL positron emission tomography/computed tomography for biochemically recurrent prostate cancer and change-of-management analysis

Guillaume Chaussé  1 , Noah Ben-Ezra  1 , Michelle Stoopler  1 , Jeremy Y Levett  1 , Tamim Niazi  2 , Maurice Anidjar  3 , Gad Abikhzer  1 , Stephan Probst  1
Affiliations

Diagnostic performance of 18F-DCFPyL positron emission tomography/computed tomography for biochemically recurrent prostate cancer and change-of-management analysis

Guillaume Chaussé et al. Can Urol Assoc J. 2021 Jun.

Abstract

Introduction: Conventional imaging (CI) performs poorly to identify sites of disease in biochemically recurrent prostate cancer. 68Ga-PSMA-11 positron emission tomography/computed tomography (PET/CT) is most studied but has a very short half-life. This study reports the diagnostic performance of the novel prostate-specific membrane antigen (PSMA) radiotracer 18F-DCFPyL using real-life data and tumor board simulation to estimate the impact of 18F-DCFPyL PET on patient management.

Methods: Ninety-three 18F-DCFPyL PET/CT scans performed for patients previously treated for prostate cancer with a rising prostate-specific antigen (PSA) were retrospectively compared to contemporary CI and clinical imaging and PSA followups. A chart review was performed to document prior imaging, pathology results, serial serum PSA measurements, and other pertinent clinical data. Clinical utility of 18F-DCFPyL PET was measured using a simulated tumor board formed by three physicians with extensive prostate cancer experience deciding on management with and without knowledge of PET/CT results.

Results: At median PSA 2.27 (interquartile rage [IQR] 5.27], 82% of 18F-DCFPyL PET/CT demonstrated at least one site of disease: non-regional lymph nodes (37% of scans), regional lymph node metastases (28%), local recurrence (27%), and bone metastases (20%), with higher PET positivity at higher PSA. Compared to 18F-DCFPyL PET/CT, CI showed overall poor performance, with accuracy below 20% for all extent of disease. PET/CT changed management in 44% of cases. The most frequent scenario was a radical change from initiating androgen deprivation therapy (ADT) to stereotactic body radiotherapy (SBRT) of oligo-lesional disease. In univariate and multivariate analysis, no patient characteristic could predict change of management by PET/CT results.

Conclusions: 18F-DCFPyL significantly outperforms CI in recurring prostate cancer and is likely to impact management.

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Conflict of interest statement

Competing interests: Dr. Probst declares in-kind research support from Progenics Inc. The remaining authors report no competing personal or financial interests related to this work.

Figures

Fig. 1
Fig. 1
18F-DCFPyL positivity per prostate-specific antigen (PSA) level.
See this image and copyright information in PMC

References

    1. Fradet Y, Klotz L, Trachtenberg J, et al. The burden of prostate cancer in Canada. Can Urol Assoc J. 2009;3:S92–S100. doi: 10.5489/cuaj.1113. - DOI - PMC - PubMed
    1. Lerner SP, Seale-Hawkins C, Carlton CE, Jr, et al. The risk of dying of prostate cancer in patients with clinically localized disease. J Urol. 1991;146:1040–5. doi: 10.1016/S0022-5347(17)37997-1. - DOI - PubMed
    1. Hövels AM, Heesakkers RA, Adang EM, et al. The diagnostic accuracy of CT and MRI in the staging of pelvic lymph nodes in patients with prostate cancer: a meta-analysis. Clin Radiol. 2008;63:387–95. doi: 10.1016/j.crad.2007.05.022. - DOI - PubMed
    1. Eissa A, Elsherbiny A, Coelho RF, et al. The role of 68Ga-PSMA PET/CT scan in biochemical recurrence after primary treatment for prostate cancer: A systematic review of the literature. Minerva Urol Nefrol. 2018;70:462–78. doi: 10.23736/S0393-2249.18.03081-3. - DOI - PubMed
    1. Sathianathen NJ, Butaney M, Konety BR. The utility of PET-based imaging for prostate cancer biochemical recurrence: A systematic review and meta-analysis. World J Urol. 2019;37:1239–49. doi: 10.1007/s00345-018-2403-7. - DOI - PubMed