Work

A comparison of prostate cancer bone metastases on 18F-Sodium Fluoride and Prostate Specific Membrane Antigen (18F-PSMA) PET/CT: Discordant uptake in the same lesion

Year: 2018

Type: article

Abstract: // Stephanie A. Harmon 1, 2 , Esther Mena 2 , Joanna H. Shih 3 , Stephen Adler 1, 2 , Yolanda McKinney 2 , Ethan Bergvall 2 , Sherif Mehralivand 2 , Adam G. Sowalsky 4 , Anna Couvillon 5 , Ravi A. Madan 5 , James L. Gulley 5 , Janet Eary 6 , Ronnie C. Mease 7 , Martin G. Pomper 7 , William L. Dahut 5 , Baris Turkbey 2 , Liza Lindenberg 2 and Peter L. Choyke 2 1 Clinical Research Directorate, Frederick National Laboratory for Cancer Research sponsored by the National Cancer Institute, Frederick, MD, USA 2 Molecular Imaging Program, National Cancer Institute, NIH, Bethesda, MD, USA 3 Biometric Research Branch, National Cancer Institute, NIH, Bethesda, MD, USA 4 Laboratory of Genitourinary Cancer Pathogenesis, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, MD, USA 5 Genitourinary Malignancies Branch, National Cancer Institute, NIH, Bethesda, MD, USA 6 Cancer Imaging Program, National Cancer Institute, NIH, Rockville, MD, USA 7 Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA Correspondence to: Stephanie A. Harmon, email: [email protected] Keywords: prostate cancer; bone metastases; sodium fluoride; prostate specific membrane antigen; spatial analysis Received: October 01, 2018 Accepted: December 04, 2018 Published: December 28, 2018 ABSTRACT Purpose: Prostate-Specific Membrane Antigen (PSMA) PET/CT has been introduced as a sensitive method for characterizing metastatic prostate cancer. The purpose of this study is to compare the spatial concordance of 18 F-NaF PET/CT and 18 F-PSMA-targeted PET/CT within prostate cancer bone metastases. Methods: Prostate cancer patients with known bone metastases underwent PSMA-targeted PET/CT ( 18 F-DCFBC or 18 F-DCFPyL) and 18 F-NaF PET/CT. In pelvic and spinal lesions detected by both radiotracers, regions-of-interest (ROIs) derived by various thresholds of uptake intensity were compared for spatial colocalization. Overlap volume was correlated with uptake characteristics and disease status. Results: The study included 149 lesions in 19 patients. Qualitatively, lesions exhibited a heterogeneous range of spatial concordance between PSMA and NaF uptake from completely matched to completely discordant. Quantitatively, overlap volume decreased as a function of tracer intensity. and disease status, where lesions from patients with castration-sensitive disease showed higher spatial concordance while lesions from patients with castration-resistant disease demonstrated more frequent spatial discordance. Conclusion: As metastatic prostate cancer progresses from castration-sensitive to castration-resistant, greater discordance is observed between NaF PET and PSMA PET uptake. This may indicate a possible phenotypic shift to tumor growth that is more independent of bone remodeling via osteoblastic formation.

Source: Oncotarget

DOI: 10.18632/oncotarget.26481