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

• Published in: Molecular imaging and biology Vol. 13; no. 6; pp. 1272 - 1277
• Main Authors: Savir-Baruch, Bital, Schuster, David M, Jarkas, Nashwa, Master, Viraj A, Nieh, Peter T, Halkar, Raghuveer K, Nye, Jonathon A, Lewis, Melinda M, Crowe, Ronald J, Voll, Ronald J, Camp, Vernon M, Bellamy, Leah M, Roberts, David L, Goodman, Mark M
• Format: Journal Article
• Language: English
• Published: 01.12.2011
• Subjects: Amino acids; Blood; Leucine; Nodes; Pelvis; Positron emission tomography; Prostate cancer; prostate carcinoma; Tumor cell lines; Urinary bladder
• ISSN: 1536-1632; 1860-2002
• DOI: 10.1007/s11307-010-0445-3

Purpose: Anti-1-amino-2-[ super(18)F]flu orocyclopentane-1-carboxylic acid (anti-2-[ super(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-[ super(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-[ super(18)F]FACPC. Uptake was compared against PET scans in the same patients with the leucine analog, anti-1-amino-3-[ super(18)F]flu orocyclobutane-1-carboxylic acid (anti-[ super(18)F]FACBC), at similar time points and validated via pathology, clinical, and imaging follow-up. Results: At 5 min, average ( plus or minus SD) SUVmax of malignant lesions is 4.1( plus or minus 1.3) for anti-2-[ super(18)F] FACPC and 4.3( plus or minus 1.1) for anti-[ super(18)F]FACBC. Yet, blood pool activity at 5 min is significantly higher for anti-2-[ super(18)F]FACPC with average ( plus or minus SD) lesion/blood pool SUVmax/SUVmean ratio of 1.4 ( plus or minus 0.5) vs. 3.0 ( plus or minus 0.9) for anti-[ super(18)F]FACBC. At 20 min, average ( plus or minus SD) SUVmax of malignant lesions is 2.6 ( plus or minus 1.0) for anti-2-[ super(18)F]FACPC and 3.4 ( plus or minus 0.8) for anti-[ super(18)F]FACBC. Yet, bladder activity at 20 min is significantly more intense for anti-2-[ super(18)F] FACPC with average ( plus or minus SD) lesion/bladder SUVmax/SUVmean ratio of 0.3 ( plus or minus 0.8) vs. 2.3 ( plus or minus 1.4) for anti-[ super(18)F]FACBC. Conclusions: While prostate bed lesions are visible on early imaging with anti-2-[ super(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-[ super(18)F]FACBC, imaging characteristics for anti-2-[ super(18)F]FACPC are unfavorable for pelvic recurrent prostate carcinoma detection.