BAY 1075553 PET-CT for Staging and Restaging Prostate Cancer Patients: Comparison with [18F] Fluorocholine PET-CT (Phase I Study).

Abstract

PURPOSE:

(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.

PROCEDURES:

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.

RESULTS:

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.

CONCLUSIONS:

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.

• Authors: Mohsen Beheshti, Thomas Kunit, Silke Haim, Rasoul Zakavi, Christian Schiller, Andrew Stephens, Ludger Dinkelborg, Werner Langsteger, Wolfgang Loidl
• Journal: Molecular imaging and biology (Mol Imaging Biol) Vol. 17 Issue 3 Pg. 424-33 (Jun 2015) ISSN: 1860-2002 [Electronic] United States
• PMID: 25315836 (Publication Type: Clinical Trial, Phase I, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• 2-fluoro-4-phosphonomethylpentanedioic acid
• Glutarates
• Organophosphonates
• Fluorodeoxyglucose F18
• fluorocholine
• Prostate-Specific Antigen
• Choline

Topics

• Aged
• Aged, 80 and over
• Bone Marrow (pathology)
• Choline (analogs & derivatives, chemistry)
• Fluorodeoxyglucose F18 (chemistry)
• Glutarates (chemistry)
• Humans
• Lymphatic Metastasis (pathology)
• Male
• Middle Aged
• Neoplasm Metastasis
• Neoplasm Recurrence, Local
• Neoplasm Staging
• Organophosphonates (chemistry)
• Positron-Emission Tomography
• Prospective Studies
• Prostate-Specific Antigen (metabolism)
• Prostatic Neoplasms (diagnostic imaging)
• Radiometry
• Sensitivity and Specificity
• Tomography, X-Ray Computed