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Clinical verification of 18F-DCFPyL PET-detected lesions in patients with biochemically recurrent prostate cancer

Purpose Radiolabeled Prostate-Specific Membrane Antigen (PSMA) PET/CT is the current standard-of-care for lesion detection in patients with biochemically recurrent (BCR) prostate cancer (PCa). However, rigorous verification of detected lesions is not always performed in routine clinical practice. To...

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Published in:PloS one 2020-10, Vol.15 (10), p.e0239414-e0239414
Main Authors: Meijer, Dennie, Jansen, Bernard H. E., Wondergem, Maurits, Bodar, Yves J. L., Srbljin, Sandra, Vellekoop, Annelies E., Keizer, Bram, van der Zant, Friso M., Hoekstra, Otto S., Nieuwenhuijzen, Jakko A., Dahele, Max, Vis, André N., Oprea-Lager, Daniela E.
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Language:English
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Summary:Purpose Radiolabeled Prostate-Specific Membrane Antigen (PSMA) PET/CT is the current standard-of-care for lesion detection in patients with biochemically recurrent (BCR) prostate cancer (PCa). However, rigorous verification of detected lesions is not always performed in routine clinical practice. To aid future 18F-radiolabeled PSMA PET/CT interpretation, we aimed to identify clinical/imaging characteristics that increase the likelihood that a PSMA-avid lesion is malignant. Materials and methods 262 patients with BCR, who underwent 18F-DCFPyL PSMA PET/CT, were retrospectively analyzed. The malignant nature of 18F-DCFPyL PET-detected lesions was verified through any of the following metrics: (1) positive histopathological examination; (2) additional positive imaging; (3) a ≥50% decrease in Prostate-Specific Antigen (PSA) following irradiation of the lesion(s). Results In 226/262 PET scans (86.3%) at least one lesion suspicious for recurrent PCa was detected (‘positive scan’). In 84/226 positive scans (37.2%), at least one independent verification metric was available. PSMA PET-detected lesions were most often confirmed to be malignant (PCa) in the presence of a CT-substrate (96.5% vs. 55.6% without CT-substrate), with SUVpeak ≥3.5 (91.4% vs. 60.0% with SUVpeak
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0239414