2877. 18F-DCFPyL PET/CT Scan for the Evaluation of Prostate Cancer: Do Findings Correlate With Prostate Multiparametric MRI and Gleason Score?
Authors* Denotes Presenting Author
Soheil Kooraki *;
University of California, Los Angeles
Nandakumar Menon;
University of California, Los Angeles
Nicholas Nickols;
University of California, Los Angeles
Matthew Rettig;
Greater Los Angeles VA Healthcare System; University of California, Los Angeles
William Aronson;
Greater Los Angeles VA Healthcare System; University of California, Los Angeles
Yuxin Li;
Greater Los Angeles VA Healthcare System; University of California, Los Angeles
Gholam Reza Berenji;
Greater Los Angeles VA Healthcare System; University of California, Los Angeles
Objective:
18F-DCFPyL PET/CT is a second-generation, FDA-approved molecular agent for targeting prostate-specific membrane antigen (PSMA). This study aimed to assess the correlation of 18F-DCFPyL PET/CT with multiparametric MRI (mpMRI) and histologic Gleason Score (GS) in individuals with clinically significant prostate cancer (PCa).
Materials and Methods:
This IRB-approved, HIPAA-compliant, single-center, prospective study was part of a clinical trial that aimed to assess the impact of 18F-DCFPyL PET/CT in veterans with PCa. We reviewed data of 150 patients who had undergone 18F-DCFPyL PET/CT scan and found 41 patients (mean age 69, ranged 55-92 years, mean serum PSA 18.6 ng/mL at the time of performing scan) who had completed a diagnostic mpMRI no more than three months before acquisition of 18F-DCFPyL PET/CT scan. PET/CT scans and mpMRIs were interpreted independently and findings were compared later. Maximum standardized uptake value (SUVmax) of the prostate lesions were measured and then was normalized relative to the mean SUVs of liver, right parotid gland and blood pool. All lesions on mpMRI were scored using Prostate Imaging Reporting and Data System (PI-RADS). Gleason scores were extracted from patients’ histopathology data.
Results:
Multiparametric MRI and 18F-DCFPyL PET/CT scans were concordant for localization of prostate lesions in 78% (32/41) of the study cohort. 18F-DCFPyL PET/CT outperformed mpMRI for the detection of positive pelvic lymph nodes (13/41, p < .001). The detection of extracapsular extension was better with mpMRI compared to PET/CT (12/41 vs. 8/41, p < .001). There was no correlation between absolute and normalized SUVmax values of the prostate lesions with Gleason scores (p > .05). We did not find any correlation between SUVmax values and PI-RADS scores (p > .05).
Conclusion:
This study did not show any association between SUV values with PI-RADS scores or Gleason scores. 18F-DCFPyL PET/CT is more sensitive to detect regional lymph nodes, whereas mpMRI is more accurate for the visualization of extracapsular extension. Therefore, mpMRI and 18F-DCFPyL PET/CT are complementary and concurrent acquisition of 18F-DCFPyL PET/CT and mpMRI can be beneficial for patient care in the diagnostic path of PCa.
