Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/21542
Title: Reproducibility and Repeatability of Semiquantitative 18F-Fluorodihydrotestosterone Uptake Metrics in Castration-Resistant Prostate Cancer Metastases: A Prospective Multicenter Study.
Austin Authors: Vargas, Hebert Alberto;Kramer, Gem M;Scott, Andrew M ;Weickhardt, Andrew;Meier, Andreas A;Parada, Nicole;Beattie, Bradley J;Humm, John L;Staton, Kevin D;Zanzonico, Pat B;Lyashchenko, Serge K;Lewis, Jason S;Yaqub, Maqsood;Sosa, Ramon E;van den Eertwegh, Alfons J;Davis, Ian D;Ackermann, Uwe ;Pathmaraj, Kunthi ;Schuit, Robert C;Windhorst, Albert D;Chua, Sue;Weber, Wolfgang A;Larson, Steven M;Scher, Howard I;Lammertsma, Adriaan A;Hoekstra, Otto S;Morris, Michael J
Affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
Department of Nuclear Medicine, Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Department of Radiology, Weill Cornell Medicine, New York, New York, USA
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Department of Medicine, Weill Cornell Medicine, New York, New York, USA
Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Department of Medical Oncology, VU University Medical Centre, Amsterdam, The Netherlands
Monash University and Eastern Health, Eastern Health Clinical School, Box Hill, Australia
Department of Nuclear Medicine and Centre for PET, Austin Health, Heidelberg, Victoria, Australia
Department of Radiology and Nuclear Medicine, VU University Medical Centre, Amsterdam, The Netherlands
Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia
La Trobe University, Heidelberg, Victoria, Australia
Department of Molecular Imaging and Therapy, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Medical Oncology, Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
Issue Date: Oct-2018
Date: 2018-04-06
Publication information: Journal of Nuclear Medicine 2018; 59(10): 1516-1523
Abstract: 18F-fluorodihydrotestosterone (18F-FDHT) is a radiolabeled analog of the androgen receptor's primary ligand that is currently being credentialed as a biomarker for prognosis, response, and pharmacodynamic effects of new therapeutics. As part of the biomarker qualification process, we prospectively assessed its reproducibility and repeatability in men with metastatic castration-resistant prostate cancer. Methods: We conducted a prospective multiinstitutional study of metastatic castration-resistant prostate cancer patients undergoing 2 (test/retest) 18F-FDHT PET/CT scans on 2 consecutive days. Two independent readers evaluated all examinations and recorded SUVs, androgen receptor-positive tumor volumes, and total lesion uptake for the most avid lesion detected in each of 32 predefined anatomic regions. The relative absolute difference and reproducibility coefficient (RC) of each metric were calculated between the test and retest scans. Linear regression analyses, intraclass correlation coefficients (ICCs), and Bland-Altman plots were used to evaluate repeatability of 18F-FDHT metrics. The coefficient of variation and ICC were used to assess interobserver reproducibility. Results: Twenty-seven patients with 140 18F-FDHT-avid regions were included. The best repeatability among 18F-FDHT uptake metrics was found for SUV metrics (SUVmax, SUVmean, and SUVpeak), with no significant differences in repeatability among them. Correlations between the test and retest scans were strong for all SUV metrics (R2 ≥ 0.92; ICC ≥ 0.97). The RCs of the SUV metrics ranged from 21.3% (SUVpeak) to 24.6% (SUVmax). The test and retest androgen receptor-positive tumor volumes and TLU, respectively, were highly correlated (R2 and ICC ≥ 0.97), although variability was significantly higher than that for SUV (RCs > 46.4%). The prostate-specific antigen levels, Gleason score, weight, and age did not affect repeatability, nor did total injected activity, uptake measurement time, or differences in uptake time between the 2 scans. Including the most avid lesion per patient, the 5 most avid lesions per patient, only lesions 4.2 mL or more, only lesions with an SUV of 4 g/mL or more, or normalizing of SUV to area under the parent plasma activity concentration-time curve did not significantly affect repeatability. All metrics showed high interobserver reproducibility (ICC > 0.98; coefficient of variation < 0.2%-10.8%). Conclusion: Uptake metrics derived from 18F-FDHT PET/CT show high repeatability and interobserver reproducibility.
URI: https://ahro.austin.org.au/austinjspui/handle/1/21542
DOI: 10.2967/jnumed.117.206490
ORCID: 0000-0002-6656-295X
Journal: Journal of Nuclear Medicine
PubMed URL: 29626121
Type: Journal Article
Subjects: FDHT
PET
Prostate cancer
repeatability
reproducibility
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