Assessment of simplified methods for quantification of (18)F-FDHT uptake in patients with metastatic castration-resistant prostate cancer Journal Article
| Authors: | Kramer, G. M.; Yaqub, M.; Vargas, H. A.; Schuit, R. C.; Windhorst, A. D.; van den Eertwegh, A. J. M.; van der Veldt, A. A. M.; Bergman, A. M.; Burnazi, E. M.; Lewis, J. S.; Chua, S.; Staton, K. D.; Beattie, B. J.; Humm, J. L.; Davis, I. D.; Weickhardt, A. J.; Scott, A. M.; Morris, M. J.; Hoekstra, O. S.; Lammertsma, A. A. |
| Article Title: | Assessment of simplified methods for quantification of (18)F-FDHT uptake in patients with metastatic castration-resistant prostate cancer |
| Abstract: | F-18-fluorodihydrotestosterone (F-18-FDHT) PET/CT potentially provides a noninvasive method for assessment of androgen receptor expression in patients with metastatic castration-resistant prostate cancer (mCRPC). The objective of this study was to assess simplified methods for quantifying F-18-FDHT uptake in mCRPC patients and to assess effects of tumor perfusion on these F-18-FDHT uptake metrics. Methods: Seventeen mCRPC patients were included in this prospective observational multicenter study. Test and retest 30-min dynamic F-18-FDHT PET/CT scans with venous blood sampling were performed in 14 patients. In addition, arterial blood sampling and dynamic O-15-H2O scans were obtained in a subset of 6 patients. Several simplified methods were assessed: Patlak plots; SUV normalized to body weight (SUVBW), lean body mass (SUVLBM), whole blood (SUVWB), parent plasma activity concentration (SUVPP), area under the parent plasma curve (SUVAUC,PP), and area under the whole-blood input curve (SUVAUC,WB); and SUVBW corrected for sex hormone-binding globulin levels (SUVSHBG). Results were correlated with parameters derived from full pharmacokinetic F-18-FDHT and O-15-H2O. Finally, the repeatability of individual quantitative uptake metrics was assessed. Results: Eighty-seven F-18-FDHT-avid lesions were evaluated. F-18-FDHT uptake was best described by an irreversible 2-tissue-compartment model. Replacing the continuous metabolite-corrected arterial plasma input function with an image-derived input function in combination with venous sample data provided similar K-i results (R-2 = 0.98). Patlak K-i and SUVAUC,PP showed an excellent correlation (R-2 > 0.9). SUVBW showed a moderate correlation to K-i (R-2 = 0.70, presumably due to fast F-18-FDHT metabolism. When calculating SUVSHBG, correlation to K-i improved (R-2 = 0.88). The repeatability of full kinetic modeling parameters was inferior to that of simplified methods (repeatability coefficients. 36% vs., 28%, respectively). F-18-FDHT uptake showed minimal blood flow dependency. Conclusion: F-18-FDHT kinetics in mCRPC patients are best described by an irreversible 2-tissue-compartment model with blood volume parameter. SUVAUC, PP showed a near-perfect correlation with the irreversible 2-tissue-compartment model analysis and can be used for accurate quantification of F-18-FDHT uptake in whole-body PET/CT scans. In addition, SUVSHBG could potentially be used as an even simpler method to quantify F-18-FDHT uptake when less complex scanning protocols and accuracy are required. |
| Keywords: | prostate cancer; pet/ct; quantification; fdht; repeatability; enzalutamide; 16-beta-f-18-fluoro-5-alpha-dihydrotestosterone |
| Journal Title: | Journal of Nuclear Medicine |
| Volume: | 60 |
| Issue: | 9 |
| ISSN: | 0161-5505 |
| Publisher: | Society of Nuclear Medicine |
| Date Published: | 2019-09-01 |
| Start Page: | 1221 |
| End Page: | 1227 |
| Language: | English |
| ACCESSION: | WOS:000484372100013 |
| DOI: | 10.2967/jnumed.118.220111 |
| PROVIDER: | wos |
| PMCID: | PMC6735284 |
| PUBMED: | 30850488 |
| Notes: | Article -- Source: Wos |
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