(18)F-fluoride positron emission tomographic imaging of penile arteries and erectile dysfunction Journal Article


Authors: Nakahara, T.; Narula, J.; Tijssen, J. G. P.; Agarwal, S.; Chowdhury, M. M.; Coughlin, P. A.; Dweck, M. R.; Rudd, J. H. F.; Jinzaki, M.; Mulhall, J.; Strauss, H. W.
Article Title: (18)F-fluoride positron emission tomographic imaging of penile arteries and erectile dysfunction
Abstract: Background: Fluorine-18 sodium fluoride (NaF), a bone-seeking radiopharmaceutical used to detect osseous metastases, localizes in regions of microcalcification in atherosclerosis. Objectives: To determine if atherosclerosis of penile arteries plays a role in erectile dysfunction (ED), this study analyzed NaF images in prostate cancer patients. Methods: NaF positron emission tomography–computed tomography bone scans were evaluated in 437 prostate cancer patients (age 66.6 ± 8.7 years). Their urologic histories were reviewed for prevalent ED (diagnosed before the scan date) or incident ED (no ED at first scan, but developed during 1-year follow-up); patients with no ED (neither before the scan nor during follow-up) were included as a control group. A semicircular region of interest was set on the dorsal one-half of the penis (to avoid residual excreted activity in the urethra) on 5 contiguous slices at the base of the penis on positron emission tomography–computed tomography coronal reconstructions, and the average standardized uptake value (SUVmax) was described as NaF uptake. Results: Of 437 patients, 336 (76.9%) had prevalent ED, 60 incident ED (13.7%), and 41 had no ED (9.4%). SUVmax in patients with prevalent (median 1.88; interquartile range [IQR]: 1.67 to 2.16) or incident (median 1.86; IQR: 1.72 to 2.08) ED was significantly higher than no ED (median 1.42; IQR: 1.25 to 1.54) patients (p < 0.001). After adjustment for other risk factors, the odds ratio of prevalent or incident ED was 25.2 (95% confidence interval: 9.5 to 67.0) for every 0.5-U increment in SUVmax with receptor operating characteristic area of 0.91 (95% confidence interval: 0.88 to 0.94). Conclusions: NaF uptake in penile vessels suggests that atherosclerosis is associated with ED in prostate cancer patients. The importance of NaF uptake needs to be tested in noncancer subjects and cause-effect relationship needs to be established. © 2019
Keywords: atherosclerosis; erectile dysfunction; calcification; naf; sodium fluoride
Journal Title: Journal of the American College of Cardiology
Volume: 73
Issue: 12
ISSN: 0735-1097
Publisher: Elsevier Science, Inc.  
Date Published: 2019-04-02
Start Page: 1386
End Page: 1394
Language: English
DOI: 10.1016/j.jacc.2018.10.076
PROVIDER: scopus
PUBMED: 30846336
DOI/URL:
Notes: Article -- Export Date: 1 April 2019 -- Source: Scopus
Altmetric
Citation Impact
MSK Authors
  1. John P Mulhall
    552 Mulhall
  2. Harry W Strauss
    162 Strauss