Beheshti Mohsen, Kunit Thomas, Haim Silke, Zakavi Rasoul, Schiller Christian, Stephens Andrew, Dinkelborg Ludger, Langsteger Werner, Loidl Wolfgang
Department of Nuclear Medicine and Endocrinology, PET-CT Center Linz, St. Vincent's Hospital, Seilerstaette 4, Linz, 4020, Austria,
Mol Imaging Biol. 2015 Jun;17(3):424-33. doi: 10.1007/s11307-014-0800-x.
(2RS,4S)-2-[(18)F]Fluoro-4-phosphonomethyl-pentanedioic acid (BAY1075553) shows increased uptake in prostate cancer cells. We compared the diagnostic potential of positron emission tomography (PET)-X-ray computed tomography (CT) imaging using BAY1075553 versus [(18)F]f luorocholine (FCH) PET-CT.
Twelve prostate cancer patients (nine staging, three re-staging) were included. The mean prostate-specific antigen in the primary staging and re-staging groups was 21.5 ± 12 and 73.6 ± 33 ng/ml, respectively. Gleason score ranged from 5-9. In nine patients imaged for pre-operative staging, the median Gleason score was 8 (range, 7-9). PET acquisition started with dynamic PET images in the pelvic region followed by static whole-body acquisition. The patients were monitored for 5-8 days afterward for adverse events.
There were no relevant changes in laboratory values or physical examination. Urinary bladder wall received the largest dose equivalent 0.12 mSv/MBq. The whole-body mean effective dose was 0.015 mSv/MBq. There was a significant correlation between detected prostatic lesions by the two imaging modalities (Kappa = 0.356, P < 0.001) and no significant difference in sensitivity (P = 0.16) and specificity (P = 0.41). The sensitivity and specificity of PET imaging using BAY1075553 for lymph node (LN) staging was 42.9 % and 100 %, while it was 81.2 % and 50 % using FCH. The two modalities were closely correlated regarding detection of LNs and bone metastases, although BAY1075553 failed to detect a bone marrow metastasis. Degenerative bone lesions often displayed intense uptake of BAY1075553.
BAY1075553 PET-CT produced no adverse effects, was well tolerated, and detected primary and metastatic prostate cancer. FCH PET-CT results were superior, however, with respect to detecting LN and bone marrow metastases.
（2RS，4S）-2-[(18)F]氟-4-膦酰甲基-戊二酸（BAY1075553）在前列腺癌细胞中的摄取增加。我们比较了使用BAY1075553的正电子发射断层扫描（PET）-X射线计算机断层扫描（CT）成像与[(18)F]氟胆碱（FCH）PET-CT的诊断潜力。
纳入12例前列腺癌患者（9例分期，3例重新分期）。初次分期和重新分期组的平均前列腺特异性抗原分别为21.5±12和73.6±33 ng/ml。 Gleason评分范围为5-9。在9例进行术前分期成像的患者中，Gleason评分中位数为8（范围7-9）。PET采集开始于盆腔区域的动态PET图像，随后是全身静态采集。之后对患者进行5-8天的不良事件监测。
实验室值或体格检查无相关变化。膀胱壁接受的最大剂量当量为0.12 mSv/MBq。全身平均有效剂量为0.015 mSv/MBq。两种成像方式检测到的前列腺病变之间存在显著相关性（Kappa = 0.356，P <0.001），敏感性（P = 0.16）和特异性（P = 0.41）无显著差异。使用BAY1075553进行PET成像对淋巴结（LN）分期的敏感性和特异性分别为42.9%和100%，而使用FCH时分别为81.2%和50%。尽管BAY1075553未能检测到骨髓转移，但两种方式在检测LN和骨转移方面密切相关。退行性骨病变常显示BAY1075553摄取强烈。
BAY1075553 PET-CT未产生不良反应，耐受性良好，并能检测原发性和转移性前列腺癌。然而，FCH PET-CT在检测LN和骨髓转移方面结果更优。
