Pilot evaluation of anti-1-amino-2-[18F] fluorocyclopentane-1-carboxylic acid (anti-2-[18F] FACPC) PET-CT in recurrent prostate carcinoma.

Abstract

PURPOSE:

Anti-1-amino-2-[(18)F]fluorocyclopentane-1-carboxylic acid (anti-2-[(18)F]FACPC) is an unnatural alicyclic amino acid radiotracer with high uptake in the DU-145 prostate cancer cell line in vitro. Our goal was to determine if anti-2-[(18)F]FACPC is useful in the detection of prostate carcinoma.

PROCEDURES:

Five patients with elevated PSA (1.1-20.5 ng/mL) after curative therapy for prostate carcinoma underwent 60 min dynamic positron emission tomography (PET) of the pelvis after IV injection of 193-340 MBq of anti-2-[(18)F]FACPC. Uptake was compared against PET scans in the same patients with the leucine analog, anti-1-amino-3-[(18)F]fluorocyclobutane-1-carboxylic acid (anti-[(18)F]FACBC), at similar time points and validated via pathology, clinical, and imaging follow-up.

RESULTS:

At 5 min, average (±SD) SUVmax of malignant lesions is 4.1(±1.3) for anti-2-[(18)F] FACPC and 4.3(±1.1) for anti-[(18)F]FACBC. Yet, blood pool activity at 5 min is significantly higher for anti-2-[(18)F]FACPC with average (±SD) lesion/blood pool SUVmax/SUVmean ratio of 1.4 (±0.5) vs. 3.0 (±0.9) for anti-[(18)F]FACBC. At 20 min, average (±SD) SUVmax of malignant lesions is 2.6 (±1.0) for anti-2-[(18)F]FACPC and 3.4 (±0.8) for anti-[(18)F]FACBC. Yet, bladder activity at 20 min is significantly more intense for anti-2-[(18)F] FACPC with average (±SD) lesion/bladder SUVmax/SUVmean ratio of 0.3 (±0.8) vs. 2.3 (±1.4) for anti-[(18)F]FACBC.

CONCLUSIONS:

While prostate bed lesions are visible on early imaging with anti-2-[(18)F]FACPC, there is high blood pool activity obscuring nodes. As blood pool fades, nodal uptake decreases and high bladder activity then obscures pelvic structures. Compared with anti-[(18)F]FACBC, imaging characteristics for anti-2-[(18)F]FACPC are unfavorable for pelvic recurrent prostate carcinoma detection.

• Authors: Bital Savir-Baruch, David M Schuster, Nashwa Jarkas, Viraj A Master, Peter T Nieh, Raghuveer K Halkar, Jonathon A Nye, Melinda M Lewis, Ronald J Crowe, Ronald J Voll, Vernon M Camp, Leah M Bellamy, David L Roberts, Mark M Goodman
• Journal: Molecular imaging and biology (Mol Imaging Biol) Vol. 13 Issue 6 Pg. 1272-7 (Dec 2011) ISSN: 1860-2002 [Electronic] United States
• PMID: 20976627 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• 1-amino-2-fluorocyclopentyl-1-carboxylic acid
• Fluorine Radioisotopes
• Cycloleucine

Topics

• Biopsy
• Cycloleucine (analogs & derivatives, pharmacokinetics)
• Evaluation Studies as Topic
• Fluorine Radioisotopes
• Humans
• Male
• Multimodal Imaging
• Pelvis (diagnostic imaging)
• Pilot Projects
• Positron-Emission Tomography
• Prostatic Neoplasms (diagnostic imaging, pathology)
• Recurrence
• Time Factors
• Tomography, X-Ray Computed