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.
Format: Article
Language:English
Subjects:
Abnormalities
Antigens
Biology and Life Sciences
Biopsy
Cancer therapies
Computed tomography
Diagnostic systems
Drug dosages
Fluorine isotopes
Irradiation
Lesions
Lymphatic system
Medical diagnosis
Medical imaging
Medicine and Health Sciences
Metastasis
Nuclear medicine
Patients
Positron emission
Prostate cancer
Prostate-specific antigen
Radiation
Radiation therapy
Research and Analysis Methods
Substrates
Tomography
Urology
Verification
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cited_by cdi_FETCH-LOGICAL-c4184-214ed47ab606d9fc568d4b13a3d0b914efe33978220ceae07bd00f557ece033f3
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container_issue 10
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container_title PloS one
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creator 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.
description 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
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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.</creator><contributor>Chuu, Chih-Pin</contributor><creatorcontrib>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. ; Chuu, Chih-Pin</creatorcontrib><description>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&lt;3.5), in patients with a PSA-level ≥2.0 ng/mL (83.7% vs. 65.7% in patients with PSA &lt;2.0ng/mL) and in patients with &gt;2 PET-positive lesions (94.1% vs. 64.2% in patients with 1–2 PET-positive lesions; p&lt;0.001–0.03). Conclusions In this study, the clinical verification of 18F-DCFPyL PET-positive lesions in patients with BCR was performed. Diagnostic certainty of PET-detected lesions increases in the presence of characteristic abnormalities on CT, when SUVpeak is ≥3.5, when PSA-levels exceed 2.0 ng/mL or in patients with more than two PET-positive lesions.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0239414</identifier><identifier>PMID: 33021980</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Abnormalities ; Antigens ; Biology and Life Sciences ; Biopsy ; Cancer therapies ; Computed tomography ; Diagnostic systems ; Drug dosages ; Fluorine isotopes ; Irradiation ; Lesions ; Lymphatic system ; Medical diagnosis ; Medical imaging ; Medicine and Health Sciences ; Metastasis ; Nuclear medicine ; Patients ; Positron emission ; Prostate cancer ; Prostate-specific antigen ; Radiation ; Radiation therapy ; Research and Analysis Methods ; Substrates ; Tomography ; Urology ; Verification</subject><ispartof>PloS one, 2020-10, Vol.15 (10), p.e0239414-e0239414</ispartof><rights>2020 Meijer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Meijer et al 2020 Meijer et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4184-214ed47ab606d9fc568d4b13a3d0b914efe33978220ceae07bd00f557ece033f3</citedby><cites>FETCH-LOGICAL-c4184-214ed47ab606d9fc568d4b13a3d0b914efe33978220ceae07bd00f557ece033f3</cites><orcidid>0000-0002-8298-575X ; 0000-0002-2594-1486</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2448834816/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2448834816?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids></links><search><contributor>Chuu, Chih-Pin</contributor><creatorcontrib>Meijer, Dennie</creatorcontrib><creatorcontrib>Jansen, Bernard H. E.</creatorcontrib><creatorcontrib>Wondergem, Maurits</creatorcontrib><creatorcontrib>Bodar, Yves J. L.</creatorcontrib><creatorcontrib>Srbljin, Sandra</creatorcontrib><creatorcontrib>Vellekoop, Annelies E.</creatorcontrib><creatorcontrib>Keizer, Bram</creatorcontrib><creatorcontrib>van der Zant, Friso M.</creatorcontrib><creatorcontrib>Hoekstra, Otto S.</creatorcontrib><creatorcontrib>Nieuwenhuijzen, Jakko A.</creatorcontrib><creatorcontrib>Dahele, Max</creatorcontrib><creatorcontrib>Vis, André N.</creatorcontrib><creatorcontrib>Oprea-Lager, Daniela E.</creatorcontrib><title>Clinical verification of 18F-DCFPyL PET-detected lesions in patients with biochemically recurrent prostate cancer</title><title>PloS one</title><description>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&lt;3.5), in patients with a PSA-level ≥2.0 ng/mL (83.7% vs. 65.7% in patients with PSA &lt;2.0ng/mL) and in patients with &gt;2 PET-positive lesions (94.1% vs. 64.2% in patients with 1–2 PET-positive lesions; p&lt;0.001–0.03). Conclusions In this study, the clinical verification of 18F-DCFPyL PET-positive lesions in patients with BCR was performed. Diagnostic certainty of PET-detected lesions increases in the presence of characteristic abnormalities on CT, when SUVpeak is ≥3.5, when PSA-levels exceed 2.0 ng/mL or in patients with more than two PET-positive lesions.</description><subject>Abnormalities</subject><subject>Antigens</subject><subject>Biology and Life Sciences</subject><subject>Biopsy</subject><subject>Cancer therapies</subject><subject>Computed tomography</subject><subject>Diagnostic systems</subject><subject>Drug dosages</subject><subject>Fluorine isotopes</subject><subject>Irradiation</subject><subject>Lesions</subject><subject>Lymphatic system</subject><subject>Medical diagnosis</subject><subject>Medical imaging</subject><subject>Medicine and Health Sciences</subject><subject>Metastasis</subject><subject>Nuclear medicine</subject><subject>Patients</subject><subject>Positron emission</subject><subject>Prostate cancer</subject><subject>Prostate-specific antigen</subject><subject>Radiation</subject><subject>Radiation therapy</subject><subject>Research and Analysis Methods</subject><subject>Substrates</subject><subject>Tomography</subject><subject>Urology</subject><subject>Verification</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptkktvEzEUhUcIRB_wD5CwxIbNBHvsGXs2SCg0pVIkuihry4_rxpEzntqTovx7nGZAFLHylc_n43uvTlW9I3hBKCeftnGfBhUWYxxggRvaM8JeVOekp03dNZi-_Ks-qy5y3mLcUtF1r6szSnFDeoHPq4dl8IM3KqBHSN6VavJxQNEhIlb11-Xq9rBGt1d3tYUJzAQWBciFyMgPaCwwDFNGP_20QdpHs4Hd0SwcUAKzT6moaEwxT2oCZNRgIL2pXjkVMrydz8vqx-rqbvmtXn-_vll-WdeGEcHqhjCwjCvd4c72zrSdsEwTqqjFui-iA0p7LpoGG1CAubYYu7blYABT6uhl9f7kO4aY5bytLBvGhKBMkK4QNyfCRrWVY_I7lQ4yKi-fLmK6lypN3gSQDmyrNfRdazQD3guuOXYdVYwoC1oXr8_zb3u9A2vK4EmFZ6bPlcFv5H18lLylXHBaDD7OBik-7CFPcuezgRDUAHH_1HdPOG9IW9AP_6D_n46dKFP2nxO4P80QLI8J-v1KHhMk5wTRX4RRvGI</recordid><startdate>20201001</startdate><enddate>20201001</enddate><creator>Meijer, Dennie</creator><creator>Jansen, Bernard H. 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E.</au><au>Wondergem, Maurits</au><au>Bodar, Yves J. L.</au><au>Srbljin, Sandra</au><au>Vellekoop, Annelies E.</au><au>Keizer, Bram</au><au>van der Zant, Friso M.</au><au>Hoekstra, Otto S.</au><au>Nieuwenhuijzen, Jakko A.</au><au>Dahele, Max</au><au>Vis, André N.</au><au>Oprea-Lager, Daniela E.</au><au>Chuu, Chih-Pin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical verification of 18F-DCFPyL PET-detected lesions in patients with biochemically recurrent prostate cancer</atitle><jtitle>PloS one</jtitle><date>2020-10-01</date><risdate>2020</risdate><volume>15</volume><issue>10</issue><spage>e0239414</spage><epage>e0239414</epage><pages>e0239414-e0239414</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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&lt;3.5), in patients with a PSA-level ≥2.0 ng/mL (83.7% vs. 65.7% in patients with PSA &lt;2.0ng/mL) and in patients with &gt;2 PET-positive lesions (94.1% vs. 64.2% in patients with 1–2 PET-positive lesions; p&lt;0.001–0.03). Conclusions In this study, the clinical verification of 18F-DCFPyL PET-positive lesions in patients with BCR was performed. Diagnostic certainty of PET-detected lesions increases in the presence of characteristic abnormalities on CT, when SUVpeak is ≥3.5, when PSA-levels exceed 2.0 ng/mL or in patients with more than two PET-positive lesions.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>33021980</pmid><doi>10.1371/journal.pone.0239414</doi><orcidid>https://orcid.org/0000-0002-8298-575X</orcidid><orcidid>https://orcid.org/0000-0002-2594-1486</orcidid><oa>free_for_read</oa></addata></record>
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source PubMed Central (Open Access); Publicly Available Content Database (Proquest) (PQ_SDU_P3)
subjects Abnormalities
Antigens
Biology and Life Sciences
Biopsy
Cancer therapies
Computed tomography
Diagnostic systems
Drug dosages
Fluorine isotopes
Irradiation
Lesions
Lymphatic system
Medical diagnosis
Medical imaging
Medicine and Health Sciences
Metastasis
Nuclear medicine
Patients
Positron emission
Prostate cancer
Prostate-specific antigen
Radiation
Radiation therapy
Research and Analysis Methods
Substrates
Tomography
Urology
Verification
title Clinical verification of 18F-DCFPyL PET-detected lesions in patients with biochemically recurrent prostate cancer
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