PSA-Stratified Performance of [<sup>18</sup>F]DCFPyL PET/CT in Biochemically Recurrent Prostate Cancer Patients under Androgen Deprivation Therapy
Based on in vitro studies, it is known that androgen deprivation therapy (ADT) increases prostate-specific membrane antigen (PSMA) expression on prostate cancer (PCa) cells. However, ADT also has cytoreductive effects which can decrease lesion size. The present evaluation was conducted to further an...
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MDPI AG
2022-09-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/9/2212 |
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| author | Sara Harsini Don Wilson François Bénard |
| author_facet | Sara Harsini Don Wilson François Bénard |
| author_sort | Sara Harsini |
| collection | DOAJ |
| description | Based on in vitro studies, it is known that androgen deprivation therapy (ADT) increases prostate-specific membrane antigen (PSMA) expression on prostate cancer (PCa) cells. However, ADT also has cytoreductive effects which can decrease lesion size. The present evaluation was conducted to further analyze the influence of ongoing ADT on [<sup>18</sup>F]DCFPyL positron emission tomography/computed tomography (PET/CT) performance in the setting of biochemically recurrent PCa. We retrospectively evaluated two groups of PCa patients, previously treated with radical intent, who had undergone [<sup>18</sup>F]DCFPyL PET/CT because of biochemical relapse with a minimum PSA level of 0.4 ng/mL. One group consisted of 95 patients under ADT at the time of the PET examination, and the other consisted of 445 patients not receiving ADT at the time of PET/CT. The uptake characteristics of the cardiac blood pool, liver, parotid glands, and five most active lesions were measured and compared between these two groups. The overall detection rate of [<sup>18</sup>F]DCFPyL PET/CT in patients under ADT at the time of imaging was significantly higher than patients not under ADT (91.6% vs. 80.4%, <i>p</i>-value = 0.007). However, the PSA-stratified differences in detection rates between patients with and without ADT did not reach statistical significance. Except for the maximal standardized uptake values corrected for lean body mass (SULmax) in the PSA range of 1 to <2 ng/mL, the intensity and volume of [<sup>18</sup>F]DCFPyL accumulation were higher in patients with ADT compared to the patients without. Statistical significance was attained for the SULmax in PSA range of 0.5 to <1 ng/mL (<i>p</i>-value = 0.0004) and metabolic tumor volume (MTV) in all PSA ranges (<i>p</i>-values of 0.0005 to 0.03). No significant difference was observed for radiotracer uptake in normal organs between the two groups with and without ADT. In this study population with biochemical recurrence of PCa and measurable PSA, ongoing ADT at the time of [<sup>18</sup>F]DCFPyL PET/CT imaging was associated with higher radiotracer uptake and overall lesion detection rate. This could be due in part to the more aggressive disease phenotype in patients with ongoing ADT. |
| first_indexed | 2024-03-10T00:15:44Z |
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| id | doaj.art-281d7d069c8244679cc6454196a49a1d |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T00:15:44Z |
| publishDate | 2022-09-01 |
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| spelling | doaj.art-281d7d069c8244679cc6454196a49a1d2023-11-23T15:50:32ZengMDPI AGDiagnostics2075-44182022-09-01129221210.3390/diagnostics12092212PSA-Stratified Performance of [<sup>18</sup>F]DCFPyL PET/CT in Biochemically Recurrent Prostate Cancer Patients under Androgen Deprivation TherapySara Harsini0Don Wilson1François Bénard2BC Cancer Research Institute, 675 West 10th Ave, Vancouver, BC V5Z 1L3, CanadaBC Cancer Research Institute, 675 West 10th Ave, Vancouver, BC V5Z 1L3, CanadaBC Cancer Research Institute, 675 West 10th Ave, Vancouver, BC V5Z 1L3, CanadaBased on in vitro studies, it is known that androgen deprivation therapy (ADT) increases prostate-specific membrane antigen (PSMA) expression on prostate cancer (PCa) cells. However, ADT also has cytoreductive effects which can decrease lesion size. The present evaluation was conducted to further analyze the influence of ongoing ADT on [<sup>18</sup>F]DCFPyL positron emission tomography/computed tomography (PET/CT) performance in the setting of biochemically recurrent PCa. We retrospectively evaluated two groups of PCa patients, previously treated with radical intent, who had undergone [<sup>18</sup>F]DCFPyL PET/CT because of biochemical relapse with a minimum PSA level of 0.4 ng/mL. One group consisted of 95 patients under ADT at the time of the PET examination, and the other consisted of 445 patients not receiving ADT at the time of PET/CT. The uptake characteristics of the cardiac blood pool, liver, parotid glands, and five most active lesions were measured and compared between these two groups. The overall detection rate of [<sup>18</sup>F]DCFPyL PET/CT in patients under ADT at the time of imaging was significantly higher than patients not under ADT (91.6% vs. 80.4%, <i>p</i>-value = 0.007). However, the PSA-stratified differences in detection rates between patients with and without ADT did not reach statistical significance. Except for the maximal standardized uptake values corrected for lean body mass (SULmax) in the PSA range of 1 to <2 ng/mL, the intensity and volume of [<sup>18</sup>F]DCFPyL accumulation were higher in patients with ADT compared to the patients without. Statistical significance was attained for the SULmax in PSA range of 0.5 to <1 ng/mL (<i>p</i>-value = 0.0004) and metabolic tumor volume (MTV) in all PSA ranges (<i>p</i>-values of 0.0005 to 0.03). No significant difference was observed for radiotracer uptake in normal organs between the two groups with and without ADT. In this study population with biochemical recurrence of PCa and measurable PSA, ongoing ADT at the time of [<sup>18</sup>F]DCFPyL PET/CT imaging was associated with higher radiotracer uptake and overall lesion detection rate. This could be due in part to the more aggressive disease phenotype in patients with ongoing ADT.https://www.mdpi.com/2075-4418/12/9/2212prostate cancerbiochemical recurrenceprostate-specific membrane antigenandrogen deprivation therapy |
| spellingShingle | Sara Harsini Don Wilson François Bénard PSA-Stratified Performance of [<sup>18</sup>F]DCFPyL PET/CT in Biochemically Recurrent Prostate Cancer Patients under Androgen Deprivation Therapy Diagnostics prostate cancer biochemical recurrence prostate-specific membrane antigen androgen deprivation therapy |
| title | PSA-Stratified Performance of [<sup>18</sup>F]DCFPyL PET/CT in Biochemically Recurrent Prostate Cancer Patients under Androgen Deprivation Therapy |
| title_full | PSA-Stratified Performance of [<sup>18</sup>F]DCFPyL PET/CT in Biochemically Recurrent Prostate Cancer Patients under Androgen Deprivation Therapy |
| title_fullStr | PSA-Stratified Performance of [<sup>18</sup>F]DCFPyL PET/CT in Biochemically Recurrent Prostate Cancer Patients under Androgen Deprivation Therapy |
| title_full_unstemmed | PSA-Stratified Performance of [<sup>18</sup>F]DCFPyL PET/CT in Biochemically Recurrent Prostate Cancer Patients under Androgen Deprivation Therapy |
| title_short | PSA-Stratified Performance of [<sup>18</sup>F]DCFPyL PET/CT in Biochemically Recurrent Prostate Cancer Patients under Androgen Deprivation Therapy |
| title_sort | psa stratified performance of sup 18 sup f dcfpyl pet ct in biochemically recurrent prostate cancer patients under androgen deprivation therapy |
| topic | prostate cancer biochemical recurrence prostate-specific membrane antigen androgen deprivation therapy |
| url | https://www.mdpi.com/2075-4418/12/9/2212 |
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