Diagnostic performance of (18)F-DCFPyL positron emission tomography/computed tomography for biochemically recurrent prostate cancer and change-of-management analysis
| Autor: | Maurice Anidjar, Tamim Niazi, Gad Abikhzer, Michelle Stoopler, Jeremy Y. Levett, Stephan Probst, Guillaume Chaussé, Noah Ben-Ezra |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Biochemical recurrence medicine.medical_specialty PET-CT Multivariate analysis medicine.diagnostic_test business.industry Urology medicine.disease Androgen deprivation therapy 03 medical and health sciences Prostate cancer 030104 developmental biology 0302 clinical medicine medicine.anatomical_structure Positron emission tomography Interquartile range 030220 oncology & carcinogenesis medicine Radiology business Lymph node Original Research |
| Zdroj: | Can Urol Assoc J |
| Popis: | 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 range [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%), 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. |
| Databáze: | OpenAIRE |
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