使用F-DCFPyL进行PSMA靶向PET成像的半定量参数:正常器官摄取的变异性

Semiquantitative Parameters in PSMA-Targeted PET Imaging with F-DCFPyL: Variability in Normal-Organ Uptake.

作者信息

Li Xin, Rowe Steven P, Leal Jeffrey P, Gorin Michael A, Allaf Mohamad E, Ross Ashley E, Pienta Kenneth J, Lodge Martin A, Pomper Martin G

机构信息

Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan City, Shandong Province, China.

出版信息

J Nucl Med. 2017 Jun;58(6):942-946. doi: 10.2967/jnumed.116.179739. Epub 2016 Dec 8.

Abstract

F-DCFPyL is a small-molecule inhibitor of the prostate-specific membrane antigen that has shown promise for evaluation of primary and metastatic prostate cancer using PET. Measuring the variability in normal-organ uptake of F-DCFPyL is necessary to understand its biodistribution, aid image interpretation, judge the reliability of scan quantification, and provide a basis for therapeutic monitoring. Sixty-five consecutive F-DCFPyL PET/CT scans from 64 patients with a history of prostate cancer were analyzed. Volumes of interest were defined for the lacrimal glands, major salivary glands, liver, spleen, and both kidneys. The mean SUV normalized to body mass or to lean body mass (SUL) was calculated for each volume of interest. The average SUV across all scans, the SD, and the coefficient of variation (COV) for each organ were calculated. The same parameters were also derived for a 3-cm sphere drawn in the center of the right lobe of the liver. The average SUV for all selected organs measured was 6.6 ± 1.8 for the right lacrimal gland, 6.4 ± 1.8 for the left lacrimal gland, 9.1 ± 2.0 for the right parotid gland, 9.0 ± 2.1 for the left parotid gland, 9.6 ± 2.3 for the right submandibular gland, 9.4 ± 2.2 for the left submandibular gland, 5.0 ± 0.7 for the whole liver, 5.1 ± 0.7 for a 3-cm sphere in the liver, 4.0 ± 1.5 for the spleen, 20.1 ± 4.6 for the right kidney, and 19.4 ± 4.5 for the left kidney. SUL was lower overall, although demonstrating similar trends. The COV of SUV and SUL was lower in the liver (13.8% and 14.5%, respectively) than in any other organ and was less than the comparable COV for F-FDG PET. The COV of SUV and SUL in the 3-cm sphere in the liver was also low and similar to the variability in the whole liver (14.2% and 14.7%, respectively). F-DCFPyL uptake in normal liver demonstrates less variability than in other F-DCFPyL-avid organs, and its variability is less than the reported variability of F-FDG in liver. Variability was slightly less for SUV than for SUL, suggesting that SUV may be the preferable parameter for quantification of images obtained with F-DCFPyL.

摘要

F-DCFPyL是一种前列腺特异性膜抗原的小分子抑制剂,已显示出在使用正电子发射断层扫描(PET)评估原发性和转移性前列腺癌方面的前景。测量F-DCFPyL在正常器官摄取中的变异性对于了解其生物分布、辅助图像解读、判断扫描定量的可靠性以及为治疗监测提供依据是必要的。对64例有前列腺癌病史患者的65次连续F-DCFPyL PET/CT扫描进行了分析。为泪腺、主要唾液腺、肝脏、脾脏和双肾定义了感兴趣区。计算每个感兴趣区归一化到体重或去脂体重(SUL)的平均标准化摄取值(SUV)。计算了每个器官在所有扫描中的平均SUV、标准差(SD)和变异系数(COV)。对于在肝右叶中心绘制的一个3厘米球体,也得出了相同的参数。所有选定测量器官的平均SUV为:右泪腺6.6±1.8,左泪腺6.4±1.8,右腮腺9.1±2.0,左腮腺9.0±2.1,右下颌下腺9.6±2.3,左下颌下腺9.4±2.2,全肝5.0±0.7,肝内3厘米球体5.1±0.7,脾脏4.0±1.5,右肾20.1±4.6,左肾19.4±4.5。总体而言,SUL较低,尽管呈现相似趋势。SUV和SUL的COV在肝脏中较低(分别为13.8%和14.5%),低于任何其他器官,且低于F-FDG PET的可比COV。肝内3厘米球体中SUV和SUL的COV也较低,与全肝的变异性相似(分别为14.2%和14.7%)。F-DCFPyL在正常肝脏中的摄取显示出比在其他F-DCFPyL摄取器官中更小的变异性,并且其变异性小于报道的F-FDG在肝脏中的变异性。SUV的变异性略小于SUL,这表明SUV可能是定量F-DCFPyL获得的图像的更优参数。

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