Steven Patrick Rowe MD, PhD , Presenter: Nothing to Disclose

Katarzyna J. Macura MD, PhD, Abstract Co-Author: Nothing to Disclose

Anthony Ciarallo MD, MSc, Abstract Co-Author: Nothing to Disclose

Esther Mena, Abstract Co-Author: Nothing to Disclose

Amanda Blackford MSc, Abstract Co-Author: Nothing to Disclose

Daniel Holt PhD, Abstract Co-Author: Nothing to Disclose

Ronnie Mease PhD, Abstract Co-Author: Nothing to Disclose

Robert F. Dannals PhD, Abstract Co-Author: Nothing to Disclose

Martin Gilbert Pomper MD, PhD, Abstract Co-Author: Grant, Eisai Co, Ltd Grant, Eli Lilly and Company Founder, Cancer Targeting Systems, Inc Board of Directors, Cancer Targeting Systems, Inc Founder, Theraly Pharmaceuticals Inc

Steve Cho MD, Abstract Co-Author: Nothing to Disclose

Improved methods of imaging metastatic prostate cancer (PCa) are needed given limitations in the conventional imaging modalities (CIM) of bone scan and CT. [18F]DCFBC is a positron-emitting, urea-based small molecule inhibitor of prostate-specific membrane antigen (PSMA) that has been demonstrated to target PCa specifically and can be imaged with PET.

14 patients with recurrent (PCa) and imaging findings diagnostic of and/or indeterminate for radiographic recurrence were imaged with [18F]DCFBC PET/CT and CIM. Central review was performed with lesion-by-lesion analysis of the PET and CIM. Lesions were scored as positive, equivocal, or negative on each modality. GEE intercept-only regression models that accounted for intra-patient correlation of multiple lesions were used to estimate proportion of agreement in lesion detection between [18F]DCFBC PET/CT and CIM.

673 lesions were identified on at least one modality. Of those lesions that were positive with PET, 45% (95% CI, 28-65%) were negative or equivocal with CIM. This includes 89% (71-96%) of identified lymph node lesions, 24% (13-39%) of bone lesions, and 39% (14-71%) of visceral lesions (though only 24 such lesions were identified). Of those lesions that were positive on CIM, only 6% (2-14%) were negative or equivocal on PET. This includes 8% (1-42%) of lymph node lesions, 8% (3-17%) of bone lesions, and no identified visceral lesions.

[18F]DCFBC PET/CT identified more potential sites of metastatic PCa than CIM. The majority of lymph node lesions with PET uptake were negative or equivocal with CIM, often due to size <1 cm and hence not deemed definitely pathologic by CT size criteria. Some bone lesions with PET uptake were also not identified on CIM, apparently as a result of lack of significant associated sclerosis. Planned analyses will include clinical and imaging follow-up to diagnose all sites of true PCa metastases definitively in these patients to further assess the utility of this new PET radiotracer.

[18F]DCFBC is a novel PET imaging agent that promises to be more sensitive than CIM for detection of metastatic disease in patients with prostate cancer. 

Rowe, S, Macura, K, Ciarallo, A, Mena, E, Blackford, A, Holt, D, Mease, R, Dannals, R, Pomper, M, Cho, S, Comparison of [18F]DCFBC PET/CT to Conventional Imaging Modalities in the Detection of Metastatic Prostate Cancer.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14013509.html