Molecular Imaging Branch, National Cancer Institute, NIH, Bethesda, MD, USA.
Clinical Research Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA.
Mol Imaging Biol. 2022 Jun;24(3):444-452. doi: 10.1007/s11307-021-01670-5. Epub 2021 Nov 1.
The primary aim of this study was to investigate the pharmacokinetics of F-DCFPyL, an F-labeled PSMA-based ligand, and to explore the utility of early time point positron emission tomography (PET) imaging extracted from PET data to distinguish malignant primary prostate from benign prostate tissue.
Ten consecutive patients with biopsy-proven high-risk prostate cancer underwent a dynamic F-DCFPyL PET/CT scan of the pelvis for the first 45 min post-injection (p.i.) followed by a static PET/CT at 2 h p.i. F-DCFPyL uptake values and kinetics were compared between benign prostate tissue and prostate cancer, including quantitative pharmacokinetic PET parameters extracted from F-DCFPyL time activity curves generated from dynamic data using a two-tissue compartment model and Patlak plots.
F-DCFPyL uptake values were significantly higher in primary prostate tumors than those in benign prostatic hyperplasia (BPH) and normal prostate tissue at 5 min, 30 min, and 120 min p.i. (P = 0.0002), when examining both SUV and SUV values. The two-tissue compartment model found an overall influx value (K) of 0.063 in primary prostate cancer, demonstrating a K over 15-fold higher in malignant prostate tissue compared with BPH (K = 0.004) and normal prostate tissue (K = 0.005) (P = 0.0001).
High-risk primary prostate cancer is readily identified on dynamic and static, delayed, F-DCFPyL PET images. The tumor-to-background ratio increases over time, with optimal F-DCFPyL PET/CT imaging at 120 min p.i. for evaluation of prostate cancer, but not necessarily ideal for clinical application. Primary prostate cancer demonstrates different uptake kinetics in comparison to BPH and normal prostate tissue. The 15-fold difference in K between prostate cancer and non-cancer (BPH and normal) tissues translates to an ability to distinguish prostate cancer from normal tissue at time points as early as 5 to 10 min p.i.
本研究的主要目的是研究 F-DCFPyL 的药代动力学，F-DCFPyL 是一种基于 PSMA 的配体，并探索从 PET 数据中提取的早期时间点正电子发射断层扫描（PET）成像在区分恶性原发性前列腺与良性前列腺组织中的应用。
连续 10 例经活检证实的高危前列腺癌患者接受了盆腔 F-DCFPyL 动态 PET/CT 扫描，注射后 45 分钟内（p.i.）进行，2 小时后进行静态 PET/CT。比较良性前列腺组织和前列腺癌之间的 F-DCFPyL 摄取值和动力学，包括使用双组织室模型和 Patlak 图从动态数据生成的 F-DCFPyL 时间活性曲线中提取的定量药代动力学 PET 参数。
F-DCFPyL 在原发性前列腺肿瘤中的摄取值在 5 分钟、30 分钟和 120 分钟时明显高于良性前列腺增生（BPH）和正常前列腺组织（p.i.）（P = 0.0002），当同时检查 SUV 和 SUV 值时。双组织室模型发现原发性前列腺癌的总体内流值（K）为 0.063，表明恶性前列腺组织中的 K 比 BPH（K = 0.004）和正常前列腺组织（K = 0.005）高 15 倍以上（P = 0.0001）。
高危原发性前列腺癌在动态和静态、延迟 F-DCFPyL PET 图像上很容易识别。肿瘤与背景的比值随时间增加，在注射后 120 分钟时进行最佳的 F-DCFPyL PET/CT 成像，以评估前列腺癌，但不一定适用于临床应用。原发性前列腺癌与 BPH 和正常前列腺组织相比，摄取动力学不同。K 在前列腺癌和非癌（BPH 和正常）组织之间的 15 倍差异转化为在注射后 5 至 10 分钟即可区分前列腺癌与正常组织的能力。
