Pilot Evaluation of Anti-1-amino-2-[18F] fluorocyclopentane-1-carboxylic acid (anti-2-[18F] FACPC) PET-CT in Recurrent Prostate Carcinoma

• Type of Material: Article
• Authors: Bital Savir Baruch, Emory University; David M. Schuster, Emory University; Nashwa Jarkas, Emory University; Viraj Master, Emory University; Peter T Nieh, Emory University; Raghuveer Halkar, Emory University; Jonathon A Nye, Emory University; Melinda M Lewis, Emory University; Ronald Crowe, Emory University; Ronald Voll, Emory University; Vernon M. Camp, Emory University; Leah M. Bellamy, Emory University; David L Roberts, Emory University; Mark Goodman, Emory University
• Language: English
• Date: 2011-12
• Publisher: Springer Verlag (Germany)
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © Academy of Molecular Imaging and Society for Molecular Imaging, 2010
• Final Published Version (URL): http://link.springer.com/article/10.1007%2Fs11307-010-0445-3
• Title of Journal or Parent Work: Molecular Imaging and Biology
• ISSN: 1536-1632
• Volume: 13
• Issue: 6
• Start Page: 1272
• End Page: 1277
• Grant/Funding Information: This research was sponsored by the Georgia Cancer Coalition, the Georgia Research Alliance and the NIH (R01CA129356).
• Keywords: PET; FACBC; Prostate; FACPC
• Research Categories: Biology, Radiation

Abstract

Purpose Anti-1-amino-2-[18F]fluorocyclopentane-1-carboxylic acid (anti-2-[18F]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-[18F]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-[18F]FACPC. Uptake was compared against PET scans in the same patients with the leucine analog, anti-1-amino-3-[18F]fluorocyclobutane-1-carboxylic acid (anti-[18F]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-[18F] FACPC and 4.3(±1.1) for anti-[18F]FACBC. Yet, blood pool activity at 5 min is significantly higher for anti-2-[18F]FACPC with average (±SD) lesion/blood pool SUVmax/SUVmean ratio of 1.4 (±0.5) vs. 3.0 (±0.9) for anti-[18F]FACBC. At 20 min, average (±SD) SUVmax of malignant lesions is 2.6 (±1.0) for anti-2-[18F]FACPC and 3.4 (±0.8) for anti-[18F]FACBC. Yet, bladder activity at 20 min is significantly more intense for anti-2-[18F] FACPC with average (±SD) lesion/bladder SUVmax/SUVmean ratio of 0.3 (±0.8) vs. 2.3 (±1.4) for anti-[18F]FACBC. Conclusions While prostate bed lesions are visible on early imaging with anti-2-[18F]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-[18F]FACBC, imaging characteristics for anti-2-[18F]FACPC are unfavorable for pelvic recurrent prostate carcinoma detection.