High SUVs Have More Robust Repeatability in Patients with Metastatic Prostate Cancer: Results from a Prospective Test-Retest Cohort Imaged with 18F-DCFPyL
Objectives. In patients with prostate cancer (PC) receiving prostate-specific membrane antigen- (PSMA-) targeted radioligand therapy (RLT), higher baseline standardized uptake values (SUVs) are linked to improved outcome. Thus, readers deciding on RLT must have certainty on the repeatability of PSMA...
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SAGE Publishing
2022-01-01
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| Series: | Molecular Imaging |
| Online Access: | http://dx.doi.org/10.1155/2022/7056983 |
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| author | Rudolf A. Werner Bilêl Habacha Susanne Lütje Lena Bundschuh Takahiro Higuchi Philipp Hartrampf Sebastian E. Serfling Thorsten Derlin Constantin Lapa Andreas K. Buck Markus Essler Kenneth J. Pienta Mario A. Eisenberger Mark C. Markowski Laura Shinehouse Rehab AbdAllah Ali Salavati Martin A. Lodge Martin G. Pomper Michael A. Gorin Ralph A. Bundschuh Steven P. Rowe |
| author_facet | Rudolf A. Werner Bilêl Habacha Susanne Lütje Lena Bundschuh Takahiro Higuchi Philipp Hartrampf Sebastian E. Serfling Thorsten Derlin Constantin Lapa Andreas K. Buck Markus Essler Kenneth J. Pienta Mario A. Eisenberger Mark C. Markowski Laura Shinehouse Rehab AbdAllah Ali Salavati Martin A. Lodge Martin G. Pomper Michael A. Gorin Ralph A. Bundschuh Steven P. Rowe |
| author_sort | Rudolf A. Werner |
| collection | DOAJ |
| description | Objectives. In patients with prostate cancer (PC) receiving prostate-specific membrane antigen- (PSMA-) targeted radioligand therapy (RLT), higher baseline standardized uptake values (SUVs) are linked to improved outcome. Thus, readers deciding on RLT must have certainty on the repeatability of PSMA uptake metrics. As such, we aimed to evaluate the test-retest repeatability of lesion uptake in a large cohort of patients imaged with 18F-DCFPyL. Methods. In this prospective, IRB-approved trial (NCT03793543), 21 patients with history of histologically proven PC underwent two 18F-DCFPyL PET/CTs within 7 days (mean 3.7, range 1 to 7 days). Lesions in the bone, lymph nodes (LN), and other organs were manually segmented on both scans, and uptake parameters were assessed (maximum (SUVmax) and mean (SUVmean) SUVs), PSMA-tumor volume (PSMA-TV), and total lesion PSMA (TL-PSMA, defined as PSMA−TV×SUVmean)). Repeatability was determined using Pearson’s correlations, within-subject coefficient of variation (wCOV), and Bland-Altman analysis. Results. In total, 230 pairs of lesions (177 bone, 38 LN, and 15 other) were delineated, demonstrating a wide range of SUVmax (1.5–80.5) and SUVmean (1.4–24.8). Including all sites of suspected disease, SUVs had a strong interscan correlation (R2≥0.99), with high repeatability for SUVmean and SUVmax (wCOV, 7.3% and 12.1%, respectively). High SUVs showed significantly improved wCOV relative to lower SUVs (P<0.0001), indicating that high SUVs are more repeatable, relative to the magnitude of the underlying SUV. Repeatability for PSMA-TV and TL-PSMA, however, was low (wCOV≥23.5%). Across all metrics for LN and bone lesions, interscan correlation was again strong (R2≥0.98). Moreover, LN-based SUVmean also achieved the best wCOV (3.8%), which was significantly reduced when compared to osseous lesions (7.8%, P<0.0001). This was also noted for SUVmax (wCOV, LN 8.8% vs. bone 12.0%, P<0.03). On a compartment-based level, wCOVs for volumetric features were ≥22.8%, demonstrating no significant differences between LN and bone lesions (PSMA-TV, P =0.63; TL-PSMA, P =0.9). Findings on an entire tumor burden level were also corroborated in a hottest lesion analysis investigating the SUVmax of the most intense lesion per patient (R2, 0.99; wCOV, 11.2%). Conclusion. In this prospective test-retest setting, SUV parameters demonstrated high repeatability, in particular in LNs, while volumetric parameters demonstrated low repeatability. Further, the large number of lesions and wide distribution of SUVs included in this analysis allowed for the demonstration of a dependence of repeatability on SUV, with higher SUVs having more robust repeatability. |
| format | Article |
| id | doaj-art-5bfc1256bc1347abb2e5c98b1daffdae |
| institution | Kabale University |
| issn | 1536-0121 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Molecular Imaging |
| spelling | doaj-art-5bfc1256bc1347abb2e5c98b1daffdae2025-02-03T10:08:03ZengSAGE PublishingMolecular Imaging1536-01212022-01-01202210.1155/2022/7056983High SUVs Have More Robust Repeatability in Patients with Metastatic Prostate Cancer: Results from a Prospective Test-Retest Cohort Imaged with 18F-DCFPyLRudolf A. Werner0Bilêl Habacha1Susanne Lütje2Lena Bundschuh3Takahiro Higuchi4Philipp Hartrampf5Sebastian E. Serfling6Thorsten Derlin7Constantin Lapa8Andreas K. Buck9Markus Essler10Kenneth J. Pienta11Mario A. Eisenberger12Mark C. Markowski13Laura Shinehouse14Rehab AbdAllah15Ali Salavati16Martin A. Lodge17Martin G. Pomper18Michael A. Gorin19Ralph A. Bundschuh20Steven P. Rowe21Department of Nuclear MedicineDepartment of Nuclear MedicineDepartment of Nuclear MedicineDepartment of Nuclear MedicineDepartment of Nuclear MedicineDepartment of Nuclear MedicineDepartment of Nuclear MedicineMedical School HannoverNuclear MedicineDepartment of Nuclear MedicineDepartment of Nuclear MedicineThe James Buchanan Brady Urological Institute and Department of UrologySidney Kimmel Comprehensive Cancer CenterSidney Kimmel Comprehensive Cancer CenterThe Russell H. Morgan Department of Radiology and Radiological ScienceThe Russell H. Morgan Department of Radiology and Radiological ScienceThe Russell H. Morgan Department of Radiology and Radiological ScienceThe Russell H. Morgan Department of Radiology and Radiological ScienceThe James Buchanan Brady Urological Institute and Department of UrologyUrology Associates and UPMC Western MarylandDepartment of Nuclear MedicineThe James Buchanan Brady Urological Institute and Department of UrologyObjectives. In patients with prostate cancer (PC) receiving prostate-specific membrane antigen- (PSMA-) targeted radioligand therapy (RLT), higher baseline standardized uptake values (SUVs) are linked to improved outcome. Thus, readers deciding on RLT must have certainty on the repeatability of PSMA uptake metrics. As such, we aimed to evaluate the test-retest repeatability of lesion uptake in a large cohort of patients imaged with 18F-DCFPyL. Methods. In this prospective, IRB-approved trial (NCT03793543), 21 patients with history of histologically proven PC underwent two 18F-DCFPyL PET/CTs within 7 days (mean 3.7, range 1 to 7 days). Lesions in the bone, lymph nodes (LN), and other organs were manually segmented on both scans, and uptake parameters were assessed (maximum (SUVmax) and mean (SUVmean) SUVs), PSMA-tumor volume (PSMA-TV), and total lesion PSMA (TL-PSMA, defined as PSMA−TV×SUVmean)). Repeatability was determined using Pearson’s correlations, within-subject coefficient of variation (wCOV), and Bland-Altman analysis. Results. In total, 230 pairs of lesions (177 bone, 38 LN, and 15 other) were delineated, demonstrating a wide range of SUVmax (1.5–80.5) and SUVmean (1.4–24.8). Including all sites of suspected disease, SUVs had a strong interscan correlation (R2≥0.99), with high repeatability for SUVmean and SUVmax (wCOV, 7.3% and 12.1%, respectively). High SUVs showed significantly improved wCOV relative to lower SUVs (P<0.0001), indicating that high SUVs are more repeatable, relative to the magnitude of the underlying SUV. Repeatability for PSMA-TV and TL-PSMA, however, was low (wCOV≥23.5%). Across all metrics for LN and bone lesions, interscan correlation was again strong (R2≥0.98). Moreover, LN-based SUVmean also achieved the best wCOV (3.8%), which was significantly reduced when compared to osseous lesions (7.8%, P<0.0001). This was also noted for SUVmax (wCOV, LN 8.8% vs. bone 12.0%, P<0.03). On a compartment-based level, wCOVs for volumetric features were ≥22.8%, demonstrating no significant differences between LN and bone lesions (PSMA-TV, P =0.63; TL-PSMA, P =0.9). Findings on an entire tumor burden level were also corroborated in a hottest lesion analysis investigating the SUVmax of the most intense lesion per patient (R2, 0.99; wCOV, 11.2%). Conclusion. In this prospective test-retest setting, SUV parameters demonstrated high repeatability, in particular in LNs, while volumetric parameters demonstrated low repeatability. Further, the large number of lesions and wide distribution of SUVs included in this analysis allowed for the demonstration of a dependence of repeatability on SUV, with higher SUVs having more robust repeatability.http://dx.doi.org/10.1155/2022/7056983 |
| spellingShingle | Rudolf A. Werner Bilêl Habacha Susanne Lütje Lena Bundschuh Takahiro Higuchi Philipp Hartrampf Sebastian E. Serfling Thorsten Derlin Constantin Lapa Andreas K. Buck Markus Essler Kenneth J. Pienta Mario A. Eisenberger Mark C. Markowski Laura Shinehouse Rehab AbdAllah Ali Salavati Martin A. Lodge Martin G. Pomper Michael A. Gorin Ralph A. Bundschuh Steven P. Rowe High SUVs Have More Robust Repeatability in Patients with Metastatic Prostate Cancer: Results from a Prospective Test-Retest Cohort Imaged with 18F-DCFPyL Molecular Imaging |
| title | High SUVs Have More Robust Repeatability in Patients with Metastatic Prostate Cancer: Results from a Prospective Test-Retest Cohort Imaged with 18F-DCFPyL |
| title_full | High SUVs Have More Robust Repeatability in Patients with Metastatic Prostate Cancer: Results from a Prospective Test-Retest Cohort Imaged with 18F-DCFPyL |
| title_fullStr | High SUVs Have More Robust Repeatability in Patients with Metastatic Prostate Cancer: Results from a Prospective Test-Retest Cohort Imaged with 18F-DCFPyL |
| title_full_unstemmed | High SUVs Have More Robust Repeatability in Patients with Metastatic Prostate Cancer: Results from a Prospective Test-Retest Cohort Imaged with 18F-DCFPyL |
| title_short | High SUVs Have More Robust Repeatability in Patients with Metastatic Prostate Cancer: Results from a Prospective Test-Retest Cohort Imaged with 18F-DCFPyL |
| title_sort | high suvs have more robust repeatability in patients with metastatic prostate cancer results from a prospective test retest cohort imaged with 18f dcfpyl |
| url | http://dx.doi.org/10.1155/2022/7056983 |
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