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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.


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 18F-NaF PET/CT and 18F-PSMA-targeted PET/CT within prostate cancer bone metastases. Methods:Prostate cancer patients with known bone metastases underwent PSMA-targeted PET/CT (18F-DCFBC or 18F-DCFPyL) and 18F-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.

SUBMITTER: Harmon SA 

PROVIDER: S-EPMC6340866 | biostudies-other | 2018 Dec

REPOSITORIES: biostudies-other

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

Harmon Stephanie A SA   Mena Esther E   Shih Joanna H JH   Adler Stephen S   McKinney Yolanda Y   Bergvall Ethan E   Mehralivand Sherif S   Sowalsky Adam G AG   Couvillon Anna A   Madan Ravi A RA   Gulley James L JL   Eary Janet J   Mease Ronnie C RC   Pomper Martin G MG   Dahut William L WL   Turkbey Baris B   Lindenberg Liza L   Choyke Peter L PL  

Oncotarget 20181228 102


<h4>Purpose</h4>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 <sup>18</sup>F-NaF PET/CT and <sup>18</sup>F-PSMA-targeted PET/CT within prostate cancer bone metastases.<h4>Methods</h4>Prostate cancer patients with known bone metastases underwent PSMA-targeted PET/CT (<sup>18</sup>F-DCFBC or <sup>18</sup>F-DCFPyL) and <sup>18</sup>F-NaF PET/  ...[more]

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