A Teaching Tool on How to Reduce All-Cause Mortality in Biochemical Recurrence and Role of 18F-DCFPyL PSMA PET-CT

Saturday, April 13, 2024

10:00 AM - 10:00 PM ET

Location: Foyer Kiosk

First Author(s)

BB

Bryson Brister, BS

Medical Student
University of Mississippi Medical Center
University of Mississippi Medical Center
Brandon, Mississippi, United States

Co-Author(s)

JY

Johnny Yang, BS, BA

Medical Student
University of Mississippi Medical Center
University of Mississippi Medical Center, United States
JT

John Hollis Tackett, BS

Student
University of Mississippi Medical Center
University of Mississippi Medical Center
Flowood, Mississippi, United States
ML

Marjorie Lam, BA

Medical Student
University of Mississippi Medical Center, United States
ES

Easton Sheffield, BS

Medical Student
University of Mississippi Medical Center
University of Mississippi Medical Center
Flowood, Mississippi, United States
CC

Chanukya Cherukuri, BS

Medical Student
University of Mississippi Medical Center
University of Mississippi Medical Center, United States
LR

Logan Ryals, BS

Medical Student
University of Mississippi Medical Center, United States
BH

Bradley Hathaway, BA

Medical Student
University of Mississippi Medical Center
University of Mississippi Medical Center, United States
JS

John D. Salvemini, MS

Medical Student
University of Mississippi Medical Center
University of Mississippi Medical Center, United States
VV

Vani Vijayakumar, MD

Professor
University of Mississippi Medical Center, United States

Purpose: To examine radical prostatectomy surveillance and PSA levels for biochemical recurrence (BCR), compare PET/CT radiotracers, discuss imaging-driven changes in BCR management, and review 18F-DCFPyL PET/CT updates for improved outcomes.

Methods/Materials: An extensive literature review was conducted to evaluate the impact of 18F-DCFPyL PET/CT on the management of BCR in prostate cancer. The review focused on various studies encompassing detection rates, management changes, and outcomes associated with 18F-DCFPyL PET/CT. Additionally, patient cases utilizing 18F-DCFPyL were systematically gathered and examined to serve as examples, offering tangible instances of the clinical utility. MEDLINE, PubMed, and Google Scholar were employed with search criteria including combinations of “18FDCFPyL” and “biochemical.” Relevant cases from an academic and tertiary care hospital were also included.

Results: Investigations into various studies on 18F-DCFPyL PET/CT in managing BCR in prostate cancer consistently highlighted a variety of changes in management, affirming its heightened sensitivity compared to other radiotracers. The advantageous detection rate of 18F-DCFPyL, especially below the clinically relevant PSA threshold for 18F-fluoromethylcholine (4 ng/mL), was a recurrent pattern. Additionally, studies indicated a significant elevation in median SUVmax in cases of BCR, suggesting potential prognostic utility. Independent American and Australian studies reported improved outcomes, emphasizing the promising role of 18F-DCFPyL PET/CT in patient management.

Relevant cases from our institution also support the findings from literature. Metastatic tissue was identified using 18F-DCFPyL in a prostate adenocarcinoma patient exhibiting increased PSA and SUVmax and in a metastatic prostate carcinoma patient despite low PSA and variable SUVmax.

Conclusions: 18F-DCFPyL PSMA PET-CT serves a valuable role for improving outcomes in patients with biochemical recurrence of prostate cancer. Its demonstrated impact on management changes and heightened sensitivity compared to other radiotracers underscore its pivotal significance in optimizing patient care.