Anti-3-[F-18]FACBC Positron Emission Tomography-Computerized Tomography and In-111-Capromab Pendetide Single Photon Emission Computerized Tomography-Computerized Tomography for Recurrent Prostate Carcinoma: Results of a Prospective Clinical Trial

• Type of Material: Article
• Authors: David Schuster, Emory University; Peter Nieh, Emory University; Ashesh Jani, Emory University; Rianot Amzat, Emory University; F Dubois Bowman, Emory University; Raghuveer Halkar, Emory University; Viraj Master, Emory University; Jonathon Nye, Emory University; Oluwaseun Odewole, Emory University; Adeboye Osunkoya, Emory University; Bital Savir Baruch, Emory University; Pooneh Alaei-Taleghani, Emory University; Mark Goodman, Emory University
• Language: English
• Date: 2014-05-01
• Publisher: Elsevier: Journal of Urology
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2014 by American Urological Association Education and Research, Inc.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.juro.2013.10.065
• Title of Journal or Parent Work: Journal of Urology, The
• ISSN: 0022-5347
• Volume: 191
• Issue: 5
• Start Page: 1446
• End Page: 1453
• Grant/Funding Information: Supported by National Institutes of Health Grant 5R01CA129356 and the Georgia Cancer Coalition.
• Keywords: RISK; CANCER; PET/CT; capromab pendetide; 1-amino-3-fluorocyclobutane-1-carboxylic acid; ANTI-1-AMINO-3-F-18-FLUOROCYCLOBUTANE-1-CARBOXYLIC ACID; MRI; tomography, emission-computed, photon; prostatic neoplasms; positron-emission tomography; Urology & Nephrology; IMPACT; THERAPY; Life Sciences & Biomedicine; BIOCHEMICAL RECURRENCE; Science & Technology; ANTIGEN; RELAPSE
• Research Categories: Health Sciences, Oncology; Health Sciences, Radiology

Abstract

Purpose We prospectively evaluated the amino acid analogue positron emission tomography radiotracer anti-3-[18F]FACBC compared to ProstaScint® (111In-capromab pendetide) single photon emission computerized tomography-computerized tomography to detect recurrent prostate carcinoma. Materials and Methods A total of 93 patients met study inclusion criteria who underwent anti-3-[18F]FACBC positron emission tomography-computerized tomography plus 111In-capromab pendetide single photon emission computerized tomography-computerized tomography for suspected recurrent prostate carcinoma within 90 days. Reference standards were applied by a multidisciplinary board. We calculated diagnostic performance for detecting disease. Results In the 91 of 93 patients with sufficient data for a consensus on the presence or absence of prostate/bed disease anti-3-[ 18F]FACBC had 90.2% sensitivity, 40.0% specificity, 73.6% accuracy, 75.3% positive predictive value and 66.7% negative predictive value compared to 111In-capromab pendetide with 67.2%, 56.7%, 63.7%, 75.9% and 45.9%, respectively. In the 70 of 93 patients with a consensus on the presence or absence of extraprostatic disease anti-3-[18F]FACBC had 55.0% sensitivity, 96.7% specificity, 72.9% accuracy, 95.7% positive predictive value and 61.7% negative predictive value compared to 111In-capromab pendetide with 10.0%, 86.7%, 42.9%, 50.0% and 41.9%, respectively. Of 77 index lesions used to prove positivity histological proof was obtained in 74 (96.1%). Anti-3-[18F]FACBC identified 14 more positive prostate bed recurrences (55 vs 41) and 18 more patients with extraprostatic involvement (22 vs 4). Anti-3-[18F]FACBC positron emission tomography-computerized tomography correctly up-staged 18 of 70 cases (25.7%) in which there was a consensus on the presence or absence of extraprostatic involvement. Conclusions Better diagnostic performance was noted for anti-3-[18F]FACBC positron emission tomography-computerized tomography than for 111In-capromab pendetide single photon emission computerized tomography-computerized tomography for prostate carcinoma recurrence. The former method detected significantly more prostatic and extraprostatic disease.