Management impact of 18F-DCFPyL PET/CT in hormone-sensitive prostate cancer patients with biochemical recurrence after definitive treatment: a multicenter retrospective study

• Published in: European journal of nuclear medicine and molecular imaging Vol. 48; no. 9; pp. 2960 - 2969
• Main Authors: Meijer, Dennie, van Leeuwen, Pim J., Oosterholt, Pepijn M. J., Bodar, Yves J. L., van der Poel, Henk G., Hendrikse, N. Harry, Donswijk, Maarten L., Wondergem, Maurits, Vellekoop, Annelies E., van Moorselaar, R. Jeroen A., Nieuwenhuijzen, Jakko A., Oprea-Lager, Daniela E., Vis, André N.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2021; Springer Nature B.V
• Subjects: Biochemistry; Cancer surgery; Cancer therapies; Cardiology; Computed tomography; Disease management; Fluorine isotopes; Imaging; Lymph nodes; Lymphatic system; Medicine; Medicine & Public Health; Nuclear Medicine; Oncology; Oncology – Genitourinary; Original; Original Article; Orthopedics; Patients; Positron emission; Prostate cancer; Prostatectomy; Radiation therapy; Radiology; Robotic surgery; Tomography; Urological surgery; Change of management; PSMA; Biochemical recurrence; F-DCFPyL PET/CT; Prostate cancer
• ISSN: 1619-7070; 1619-7089; 1619-7089
• DOI: 10.1007/s00259-021-05222-5

Purpose The aim of this study was to investigate whether an early, accurate identification of disease using 18 F-DCFPyL PET/CT imaging resulted in a change of decision on treatment management, for individual patients with biochemically recurrent (BCR), hormone-sensitive prostate cancer. Methods In this retrospective study, a total of 253 patients with BCR who underwent restaging 18 F-DCFPyL PET/CT were assessed. Two urologists specialized in uro-oncology were asked to formulate a preferred treatment for each patient before and after knowing the results of the 18 F-DCFPyL PET/CT. Results Out of 253 patients, 191 (75%) underwent robot-assisted radical prostatectomy (RARP) as primary therapy, and 62 (25%) external beam radiation therapy (EBRT). In 103/253 cases (40.7%), a preferred treatment change based on the 18 F-DCFPyL PET/CT findings was reported. In patients post-RARP, a positive 18 F-DCFPyL PET/CT (OR 6.21; 95%CI 2.78–13.8; p  < 0.001) and positive pathological lymph node status (pN1) (OR 2.96; 95%CI 1.15–7.60; p  = 0.024) were significant predictors for an intended change of management, whereas a positive surgical margin (OR 0.42; 95%CI 0.20–0.88; p  = 0.022) was inversely associated with an intended change of management. Conclusion In this study, we found a significant impact of 18 F-DCFPyL PET/CT on the intended management of patients with biochemically recurrent hormone-sensitive prostate cancer. A positive 18 F-DCFPyL PET/CT scan, positive pathological lymph node status, and a negative surgical margin status were significantly associated with increased odds of having a change of management based on 18 F-DCFPyL PET/CT findings.