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CC BY 4.0 · Nuklearmedizin 2022; 61(03): 240-246
DOI: 10.1055/a-1659-0010
Review

[18F]DCFPyL PET/CT for Imaging of Prostate Cancer

[18F]DCFPyL PET/CT zur Prostatakarzinom-Bildgebung
Steven P. Rowe
1   The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, United States
2   Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, United States
3   Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, United States
,
Andreas Buck
4   Nuclear Medicine, Würzburg University Medical Center Clinic for Nuclear Medicine, Würzburg, Germany (Ringgold ID: RIN526288)
,
Ralph A. Bundschuh
5   Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany (Ringgold ID: RIN39062)
,
Constantin Lapa
6   University of Augsburg, Augsburg, Germany (Ringgold ID: RIN26522)
,
Sebastian E. Serfling
4   Nuclear Medicine, Würzburg University Medical Center Clinic for Nuclear Medicine, Würzburg, Germany (Ringgold ID: RIN526288)
,
Thorsten Derlin
7   Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
,
Takahiro Higuchi
4   Nuclear Medicine, Würzburg University Medical Center Clinic for Nuclear Medicine, Würzburg, Germany (Ringgold ID: RIN526288)
8   Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
,
Michael A. Gorin
9   Urology Associates and UPMC Western Maryland, Cumberland, United States
10   Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, United States
,
Martin G. Pomper
1   The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, United States
2   Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, United States
3   Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, United States
,
Rudolf A. Werner
4   Nuclear Medicine, Würzburg University Medical Center Clinic for Nuclear Medicine, Würzburg, Germany (Ringgold ID: RIN526288)
› Author Affiliations
Supported by: “RECTOR” Program at Okayama RECTOR
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Abstract

Prostate-specific membrane antigen (PSMA)-directed positron emission tomography (PET) has gained increasing interest for imaging of men affected by prostate cancer (PC). In recent years, 68Ga-labeled PSMA compounds have been widely utilized, although there is a trend towards increased utilization of 18F-labeled agents. Among others, [18F]DCFPyL (piflufolastat F 18, PYLARIFY) has been tested in multiple major trials, such as OSPREY and CONDOR, which provided robust evidence on the clinical utility of this compound for staging, restaging, and change in management. Recent explorative prospective trials have also utilized [18F]DCFPyL PET/CT for response assessment, e.g., in patients under abiraterone or enzalutamide, rendering this 18F-labeled PSMA radiotracer as an attractive biomarker for image-guided strategies in men with PC. After recent approval by the U.S. Food and Drug Administration, one may expect more widespread use, not only in the U.S., but also in Europe in the long term. In the present review, we will provide an overview of the current clinical utility of [18F]DCFPyL in various clinical settings for men with PC.

Zusammenfassung

Die Positronen-Emissions-Tomografie (PET) mit PSMA (Prostata-spezifisches Membran-Antigen) gerichteten Liganden ist zunehmend in den Fokus der Bildgebung des Prostatakarzinoms (PC) bei Männern gerückt. In den letzten Jahren wurden in großem Umfang 68Ga-markierte PSMA-Tracer verwendet, obwohl ein Trend zum verstärkten Einsatz von 18F-markierten Tracern zu beobachten ist. Unter anderem wurde [18F]DCFPyL (Piflufolastat F 18, PYLARIFY) in mehreren großen Studien wie OSPREY und CONDOR untersucht, die eine belastbare Evidenz für den klinischen Nutzen dieses Tracers hinsichtlich Staging, Restaging und Änderung des Managements zeigten. Neuere prospektive Untersuchungen haben [18F]DCFPyL PET/CT auch zur Beurteilung des Ansprechens eingesetzt, z. B. bei Patienten unter Abirateron oder Enzalutamid, was diesen 18F-markierten PSMA-Radiotracer zu einem attraktiven Biomarker für bildgestützte Strategien bei Männern mit PC macht. Nach der kürzlich erfolgten Zulassung durch die U.S. Food and Drug Administration (FDA) ist nicht nur in den USA, sondern langfristig auch in Europa mit einer breiteren Anwendung zu rechnen. Im vorliegenden Review geben wir einen Überblick über den aktuellen klinischen Nutzen von [18F]DCFPyL bei Männern mit PC in verschiedenen klinischen Situationen.

Schlüsselwörter

Prostatakarzinom - Theranostik - 18F-DCFPyL

Keywords

Prostate Cancer - Theranostics - 18F-DCFPyL


Publication History

Received: 12 September 2021

Accepted: 17 September 2021

Article published online:
14 January 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Savir-Baruch B, Werner RA, Rowe SP. et al. PET Imaging for Prostate Cancer. Radiol Clin N Am 2021; 59: 801-811
    CrossrefPubMedSearch in Google Scholar
  • 2 Seifert R, Seitzer K, Herrmann K. et al. Analysis of PSMA expression and outcome in patients with advanced Prostate Cancer receiving (177)Lu-PSMA-617 Radioligand Therapy. Theranostics 2020; 10 (17) 7812-7820
    CrossrefPubMedSearch in Google Scholar
  • 3 Sartor O, de Bono J, Chi KN. et al. Lutetium-177-PSMA-617 for Metastatic Castration-Resistant Prostate Cancer. N Engl J Med 2021; 385 (12) 1091-1103
    Search in Google Scholar
  • 4 Werner RA, Derlin T, Lapa C. et al. (18)F-Labeled, PSMA-Targeted Radiotracers: Leveraging the Advantages of Radiofluorination for Prostate Cancer Molecular Imaging. Theranostics 2020; 10 (01) 1-16
    CrossrefPubMedSearch in Google Scholar
  • 5 Schmuck S, Mamach M, Wilke F. et al. Multiple Time-Point 68Ga-PSMA I&T PET/CT for Characterization of Primary Prostate Cancer: Value of Early Dynamic and Delayed Imaging. Clin Nucl Med 2017; 42 (06) e286-e293
    CrossrefPubMedSearch in Google Scholar
  • 6 Morris MJ, Rowe SP, Gorin MA. et al. Diagnostic Performance of (18)F-DCFPyL-PET/CT in Men with Biochemically Recurrent Prostate Cancer: Results from the CONDOR Phase III, Multicenter Study. Clin Cancer Res 2021; 27 (13) 3674-3682
    CrossrefPubMedSearch in Google Scholar
  • 7 FDA Approves (18)F-DCFPyL PET Agent in Prostate Cancer. J Nucl Med 2021; 62 (08) 11N
    PubMedSearch in Google Scholar
  • 8 Bouvet V, Wuest M, Jans HS. et al. Automated synthesis of [(18)F]DCFPyL via direct radiofluorination and validation in preclinical prostate cancer models. EJNMMI Res 2016; 6 (01) 40
    CrossrefPubMedSearch in Google Scholar
  • 9 Robu S, Schmidt A, Eiber M. et al. Synthesis and preclinical evaluation of novel (18)F-labeled Glu-urea-Glu-based PSMA inhibitors for prostate cancer imaging: a comparison with (18)F-DCFPyl and (18)F-PSMA-1007. EJNMMI Res 2018; 8 (01) 30
    CrossrefPubMedSearch in Google Scholar
  • 10 Szabo Z, Mena E, Rowe SP. et al. Initial Evaluation of [(18)F]DCFPyL for Prostate-Specific Membrane Antigen (PSMA)-Targeted PET Imaging of Prostate Cancer. Mol Imaging Biol 2015; 17 (04) 565-574
    CrossrefPubMedSearch in Google Scholar
  • 11 Jansen BHE, Cysouw MCF, Vis AN. et al. Repeatability of Quantitative (18)F-DCFPyL PET/CT Measurements in Metastatic Prostate Cancer. J Nucl Med 2020; 61 (09) 1320-1325
    CrossrefPubMedSearch in Google Scholar
  • 12 Werner RA, Habacha B, Bundschuh L. et al. Test-Retest Reproducibility of Conventional Quantitative Parameters on PSMA-targeted 18F-DCFPyL PET/CT in Patients with Metastatic Prostate Cancer. J Nucl Med 2021; 62: 1317
    Search in Google Scholar
  • 13 Li X, Rowe SP, Leal JP. et al. Semiquantitative Parameters in PSMA-Targeted PET Imaging with (18)F-DCFPyL: Variability in Normal-Organ Uptake. J Nucl Med 2017; 58 (06) 942-6
    CrossrefPubMedSearch in Google Scholar
  • 14 Viner M, Mercier G, Hao F. et al. Liver SULmean at FDG PET/CT: interreader agreement and impact of placement of volume of interest. Radiology 2013; 267 (02) 596-601
    CrossrefPubMedSearch in Google Scholar
  • 15 Werner RA, Bundschuh RA, Bundschuh L. et al. Semiquantitative Parameters in PSMA-Targeted PET Imaging with [(18)F]DCFPyL: Impact of Tumor Burden on Normal Organ Uptake. Mol Imaging Biol 2020; 22 (01) 190-197
    CrossrefPubMedSearch in Google Scholar
  • 16 Sahakyan K, Li X, Lodge MA. et al. Semiquantitative Parameters in PSMA-Targeted PET Imaging with [(18)F]DCFPyL: Intrapatient and Interpatient Variability of Normal Organ Uptake. Mol Imaging Biol 2020; 22 (01) 181-189
    CrossrefPubMedSearch in Google Scholar
  • 17 Rowe SP, Macura KJ, Mena E. et al. PSMA-Based [(18)F]DCFPyL PET/CT Is Superior to Conventional Imaging for Lesion Detection in Patients with Metastatic Prostate Cancer. Mol Imaging Biol 2016; 18 (03) 411-419
    CrossrefPubMedSearch in Google Scholar
  • 18 Dietlein M, Kobe C, Kuhnert G. et al. Comparison of [(18)F]DCFPyL and [ (68)Ga]Ga-PSMA-HBED-CC for PSMA-PET Imaging in Patients with Relapsed Prostate Cancer. Mol Imaging Biol 2015; 17 (04) 575-584
    CrossrefPubMedSearch in Google Scholar
  • 19 Giesel FL, Will L, Lawal I. et al. Intraindividual Comparison of (18)F-PSMA-1007 and (18)F-DCFPyL PET/CT in the Prospective Evaluation of Patients with Newly Diagnosed Prostate Carcinoma: A Pilot Study. J Nucl Med 2018; 59 (07) 1076-1080
    CrossrefPubMedSearch in Google Scholar
  • 20 Wondergem M, van der Zant FM, Broos WA. et al. Matched-pair comparison of (18)F-DCFPyL PET/CT and (18)F-PSMA-1007 PET/CT in 240 prostate cancer patients; inter-reader agreement and lesion detection rate of suspected lesions. J Nucl Med 2021; 62 (10) 1422-1429
    CrossrefPubMedSearch in Google Scholar
  • 21 Rowe SP, Li X, Trock BJ. et al. Prospective Comparison of PET Imaging with PSMA-Targeted (18)F-DCFPyL Versus Na(18)F for Bone Lesion Detection in Patients with Metastatic Prostate Cancer. J Nucl Med 2020; 61 (02) 183-188
    CrossrefPubMedSearch in Google Scholar
  • 22 Fendler WP, Eiber M, Beheshti M. et al. (68)Ga-PSMA PET/CT: Joint EANM and SNMMI procedure guideline for prostate cancer imaging: version 1.0. Eur J Nucl Med Mol Imaging 2017; 44 (06) 1014-1024
    CrossrefPubMedSearch in Google Scholar
  • 23 Wondergem M, van der Zant FM, Rafimanesh-Sadr L. et al. Effect of forced diuresis during 18F-DCFPyL PET/CT in patients with prostate cancer: activity in ureters, kidneys and bladder and occurrence of halo artefacts around kidneys and bladder. Nucl Med Commun 2019; 40 (06) 652-656
    CrossrefPubMedSearch in Google Scholar
  • 24 Wondergem M, van der Zant FM, Knol RJJ. et al. (18)F-DCFPyL PET/CT in the Detection of Prostate Cancer at 60 and 120 Minutes: Detection Rate, Image Quality, Activity Kinetics, and Biodistribution. J Nucl Med 2017; 58 (11) 1797-1804
    CrossrefPubMedSearch in Google Scholar
  • 25 Sheikhbahaei S, Werner RA, Solnes LB. et al. Prostate-Specific Membrane Antigen (PSMA)-Targeted PET Imaging of Prostate Cancer: An Update on Important Pitfalls. Semin Nucl Med 2019; 49 (04) 255-270
    CrossrefPubMedSearch in Google Scholar
  • 26 Salas Fragomeni RA, Pienta KJ, Pomper MG. et al. Uptake of Prostate-Specific Membrane Antigen-Targeted 18F-DCFPyL in Cerebral Radionecrosis: Implications for Diagnostic Imaging of High-Grade Gliomas. Clin Nucl Med 2018; 43 (11) e419-e421
    CrossrefPubMedSearch in Google Scholar
  • 27 Werner RA, Sheikhbahaei S, Jones KM. et al. Patterns of uptake of prostate-specific membrane antigen (PSMA)-targeted (18)F-DCFPyL in peripheral ganglia. Ann Nucl Med 2017; 31 (09) 696-702
    CrossrefPubMedSearch in Google Scholar
  • 28 Werner RA, Bundschuh RA, Bundschuh L. et al. Novel Structured Reporting Systems for Theranostic Radiotracers. J Nucl Med 2019; 60 (05) 577-584
    CrossrefPubMedSearch in Google Scholar
  • 29 Eiber M, Herrmann K, Calais J. et al. Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE): Proposed miTNM Classification for the Interpretation of PSMA-Ligand PET/CT. J Nucl Med 2018; 59 (03) 469-478
    Search in Google Scholar
  • 30 Fendler WP, Calais J, Eiber M. et al. Assessment of 68Ga-PSMA-11 PET Accuracy in Localizing Recurrent Prostate Cancer: A Prospective Single-Arm Clinical Trial. JAMA Oncol 2019; 5 (06) 856-863
    CrossrefPubMedSearch in Google Scholar
  • 31 Spak DA, Plaxco JS, Santiago L. et al. BI-RADS((R)) fifth edition: A summary of changes. Diagn Interv Imaging 2017; 98 (03) 179-190
    CrossrefPubMedSearch in Google Scholar
  • 32 Rowe SP, Pienta KJ, Pomper MG. et al. PSMA-RADS Version 1.0: A Step Towards Standardizing the Interpretation and Reporting of PSMA-targeted PET Imaging Studies. Eur Urol 2018; 73 (04) 485-487
    CrossrefPubMedSearch in Google Scholar
  • 33 Werner RA, Bundschuh RA, Bundschuh L. et al. Interobserver Agreement for the Standardized Reporting System PSMA-RADS 1.0 on (18)F-DCFPyL PET/CT Imaging. J Nucl Med 2018; 59 (12) 1857-64
    CrossrefPubMedSearch in Google Scholar
  • 34 Ashrafinia M, Sadaghiani MS, Dalaie P. et al. Characterization of Segmented 18F-DCFPyL PET/CT Lesions in the Context of PSMA-RADS Structured Reporting. J Nucl Med 2019; 60: 1565
    Search in Google Scholar
  • 35 Ceci F, Oprea-Lager DE, Emmett L. et al. E-PSMA: the EANM standardized reporting guidelines v1.0 for PSMA-PET. Eur J Nucl Med Mol Imaging 2021; 48 (05) 1626-1638
    CrossrefPubMedSearch in Google Scholar
  • 36 Wondergem M, van der Zant FM, Roeleveld TA. et al. 18F-DCFPyL PET/CT in primary staging of prostate cancer. European J Hybrid Imaging 2018; 2: 26
    CrossrefPubMedSearch in Google Scholar
  • 37 Gorin MA, Rowe SP, Patel HD. et al. Prostate Specific Membrane Antigen Targeted (18)F-DCFPyL Positron Emission Tomography/Computerized Tomography for the Preoperative Staging of High Risk Prostate Cancer: Results of a Prospective, Phase II, Single Center Study. J Urol 2018; 199 (01) 126-132
    CrossrefPubMedSearch in Google Scholar
  • 38 Pienta KJ, Gorin MA, Rowe SP. et al. A Phase 2/3 Prospective Multicenter Study of the Diagnostic Accuracy of Prostate Specific Membrane Antigen PET/CT with (18)F-DCFPyL in Prostate Cancer Patients (OSPREY). J Urol 2021; 206 (01) 52-61
    CrossrefPubMedSearch in Google Scholar
  • 39 Budaus L, Leyh-Bannurah SR, Salomon G. et al. Initial Experience of (68)Ga-PSMA PET/CT Imaging in High-risk Prostate Cancer Patients Prior to Radical Prostatectomy. Eur Urol 2016; 69 (03) 393-396
    CrossrefPubMedSearch in Google Scholar
  • 40 Meijer D, Jansen BHE, Wondergem M. et al. Clinical verification of 18F-DCFPyL PET-detected lesions in patients with biochemically recurrent prostate cancer. PLoS One 2020; 15 (10) e0239414
    CrossrefPubMedSearch in Google Scholar
  • 41 Dietlein F, Kobe C, Neubauer S. et al. PSA-Stratified Performance of (18)F- and (68)Ga-PSMA PET in Patients with Biochemical Recurrence of Prostate Cancer. J Nucl Med 2017; 58 (06) 947-952
    CrossrefPubMedSearch in Google Scholar
  • 42 Song H, Harrison C, Duan H. et al. Prospective Evaluation of (18)F-DCFPyL PET/CT in Biochemically Recurrent Prostate Cancer in an Academic Center: A Focus on Disease Localization and Changes in Management. J Nucl Med 2020; 61 (04) 546-551
    CrossrefPubMedSearch in Google Scholar
  • 43 Rowe SP, Campbell SP, Mana-Ay M. et al. Prospective Evaluation of PSMA-Targeted (18)F-DCFPyL PET/CT in Men with Biochemical Failure After Radical Prostatectomy for Prostate Cancer. J Nucl Med 2020; 61 (01) 58-61
    CrossrefPubMedSearch in Google Scholar
  • 44 Lindenberg L, Mena E, Turkbey B. et al. Evaluating Biochemically Recurrent Prostate Cancer: Histologic Validation of (18)F-DCFPyL PET/CT with Comparison to Multiparametric MRI. Radiology 2020; 296 (03) 564-572
    CrossrefPubMedSearch in Google Scholar
  • 45 True LD, Chen DL. How Accurately does PSMA Inhibitor 18F-DCFPyL-PET-CT Image Prostate Cancer?. Clin Cancer Res 2021; 27 (13) 3512-4
    CrossrefPubMedSearch in Google Scholar
  • 46 Phillips R, Shi WY, Deek M. et al. Outcomes of Observation vs Stereotactic Ablative Radiation for Oligometastatic Prostate Cancer: The ORIOLE Phase 2 Randomized Clinical Trial. JAMA Oncol 2020; 6 (05) 650-659
    CrossrefPubMedSearch in Google Scholar
  • 47 Pan KH, Wang JF, Wang CY. et al. Evaluation of 18F-DCFPyL PSMA PET/CT for Prostate Cancer: A Meta-Analysis. Front Oncol 2020; 10: 597422
    CrossrefPubMedSearch in Google Scholar
  • 48 Zukotynski KA, Emmenegger U, Hotte S. et al. Prospective, Single-Arm Trial Evaluating Changes in Uptake Patterns on Prostate-Specific Membrane Antigen (PSMA)-Targeted (18)F-DCFPyL PET/CT in Patients with Castration-Resistant Prostate Cancer Starting Abiraterone or Enzalutamide. J Nucl Med 2021; 62 (10) 1430-1437
    CrossrefPubMedSearch in Google Scholar
  • 49 Markowski MC, Velho PI, Eisenberger MA. et al. Detection of Early Progression with (18)F-DCFPyL PET/CT in Men with Metastatic Castration-Resistant Prostate Cancer Receiving Bipolar Androgen Therapy. J Nucl Med 2021; 62 (09) 1270-1273
    CrossrefPubMedSearch in Google Scholar
  • 50 Lovrec P, Bradshaw T, Kyriakopoulos C. et al. PSMA-based 18F-DCFPyL PET/MRI for Prediction of Progression and Assessment of Response to Neo-Adjuvant Chemohormonal Therapy in Men with High-Risk Primary Prostate Cancer. J Nucl Med 2021; 2021 (62) 1356
    Search in Google Scholar
  • 51 Leung K, Ashrafinia S, Sadaghiani MS. et al. A fully automated deep-learning based method for lesion segmentation in 18F-DCFPyL PSMA PET images of patients with prostate cancer. J Nucl Med 2019; 60: 399
    Search in Google Scholar
  • 52 Salas Fragomeni RA, Amir T, Sheikhbahaei S. et al. Imaging of Nonprostate Cancers Using PSMA-Targeted Radiotracers: Rationale, Current State of the Field, and a Call to Arms. J Nucl Med 2018; 59 (06) 871-877
    CrossrefPubMedSearch in Google Scholar
  • 53 Rowe SP, Gorin MA, Hammers HJ. et al. Imaging of metastatic clear cell renal cell carcinoma with PSMA-targeted (1)(8)F-DCFPyL PET/CT. Ann Nucl Med 2015; 29 (10) 877-882
    CrossrefPubMedSearch in Google Scholar
  • 54 Meyer AR, Carducci MA, Denmeade SR. et al. Improved identification of patients with oligometastatic clear cell renal cell carcinoma with PSMA-targeted (18)F-DCFPyL PET/CT. Ann Nucl Med 2019; 33 (08) 617-623
    CrossrefPubMedSearch in Google Scholar
  • 55 Roy J, Warner BM, Basuli F. et al. Competitive blocking of salivary gland [(18)F]DCFPyL uptake via localized, retrograde ductal injection of non-radioactive DCFPyL: a preclinical study. EJNMMI Res 2021; 11 (01) 66
    CrossrefPubMedSearch in Google Scholar
  • 56 Widjaja L, Werner RA, Ross TL. et al. PSMA Expression Predicts Early Biochemical Response in Patients with Metastatic Castration-Resistant Prostate Cancer under (177)Lu-PSMA-617 Radioligand Therapy. Cancers (Basel) 2021; 13 (12) 2938
    CrossrefPubMedSearch in Google Scholar
  • 57 Grubmuller B, Senn D, Kramer G. et al. Response assessment using (68)Ga-PSMA ligand PET in patients undergoing (177)Lu-PSMA radioligand therapy for metastatic castration-resistant prostate cancer. Eur J Nucl Med Mol Imaging 2019; 46 (05) 1063-1072
    CrossrefPubMedSearch in Google Scholar