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Metastatic prostate adenocarcinoma with neuroendocrine differentiation on 18F-FDG PET/CT, 68Ga-PSMA PET/CT and 68Ga-DOTA TATE PET/CT with injected ultra-low-activity. MÉDECINE NUCLÉAIRE 2022. [DOI: 10.1016/j.mednuc.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Vargas Ahumada J, González Rueda SD, Sinisterra Solís FA, Pitalúa Cortés Q, Torres Agredo LP, Miguel JR, Scavuzzo A, Soldevilla-Gallardo I, Álvarez Avitia MA, Sobrevilla N, García Pérez FO. Multitarget Molecular Imaging in Metastatic Castration Resistant Adenocarcinoma Prostate Cancer with Therapy Induced Neuroendocrine Differentiation. Diagnostics (Basel) 2022; 12:diagnostics12061387. [PMID: 35741197 PMCID: PMC9221809 DOI: 10.3390/diagnostics12061387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 11/16/2022] Open
Abstract
Neuroendocrine differentiation of prostate cancer (NEDPC) includes de novo presentation and secondary to epigenetic changes, referred as therapy-induced neuroendocrine prostate cancer (t-NEPC). Molecular imaging with prostate-specific membrane antigen (PSMA) and somatostatin analogues positron emission tomography (PET/CT) in NEDPC have not been validated. 18F-FDG (fluorodeoxyglucose) PET/CT has numerous limitations in prostate cancer (PCa) and the utility in NEDPC has only been reported in a few series of cases. The objective of this study is to compare the lesions detection rate of the three radiotracers in metastatic t-NEPC patients. (1) Material and Methods: Retrospective evaluation of patients with prostate adenocarcinoma treated with androgen deprivation therapy, chemotherapy, a novel androgen receptor pathway inhibitor or a combination of them and a second tumour biopsy confirming t-NEPC was made. All patients underwent 18F PSMA-1007, 18F AlF-NOTA-Octreotide, and 18F-FDG PET/CT. Evaluation of positive lesions was determined and SUVmax of each radiotracer was estimated and correlated with computer tomography (CT) findings. (2) Results: A total of eight patients were included. The mean time from diagnosis of prostate adenocarcinoma to t-NEPC was 28.2 months, with a mean serum specific prostate antigen (PSA) of 16.6 ng/dl at the time of NEPC diagnosis. All patients were treated with antiandrogen therapy and 87.5% with chemotherapy. A total of 273 lesions were identified by CT from which 182 were detected by 18F-FDG PET/CT, 174 lesions by 18F PSMA-1007, and 59 by 18F AlF-NOTA-Octreotide. An interpatient analysis of the lesions was performed and dual tracer 18F-FDG PET/CT and 18F PSMA-1007 PET/CT detected a total of 270/273 lesions (98.9%). (3) Conclusions: NEDPC patients demonstrated wide inter and intrapatient molecular imaging heterogeneity within the three radiotracers. 18F-FDG detected most lesions in t-NEPC among all radiotracers, especially in visceral sites; 18F PSMA-1007 detected more bone lesions. 18F AlF-NOTA-Octreotide showed no significant utility.
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Affiliation(s)
- Joel Vargas Ahumada
- Nuclear Medicine and Molecular Imaging Department, National Cancer Institute, Tlalpan, Mexico City 14080, Mexico; (J.V.A.); (S.D.G.R.); (F.A.S.S.); (Q.P.C.); (I.S.-G.)
| | - Sofía D. González Rueda
- Nuclear Medicine and Molecular Imaging Department, National Cancer Institute, Tlalpan, Mexico City 14080, Mexico; (J.V.A.); (S.D.G.R.); (F.A.S.S.); (Q.P.C.); (I.S.-G.)
| | - Fabio A. Sinisterra Solís
- Nuclear Medicine and Molecular Imaging Department, National Cancer Institute, Tlalpan, Mexico City 14080, Mexico; (J.V.A.); (S.D.G.R.); (F.A.S.S.); (Q.P.C.); (I.S.-G.)
| | - Quetzali Pitalúa Cortés
- Nuclear Medicine and Molecular Imaging Department, National Cancer Institute, Tlalpan, Mexico City 14080, Mexico; (J.V.A.); (S.D.G.R.); (F.A.S.S.); (Q.P.C.); (I.S.-G.)
| | | | - Jimenez Ríos Miguel
- Urological Oncology Department, National Cancer Institute, Tlalpan, Mexico City 14080, Mexico; (J.R.M.); (A.S.)
| | - Anna Scavuzzo
- Urological Oncology Department, National Cancer Institute, Tlalpan, Mexico City 14080, Mexico; (J.R.M.); (A.S.)
| | - Irma Soldevilla-Gallardo
- Nuclear Medicine and Molecular Imaging Department, National Cancer Institute, Tlalpan, Mexico City 14080, Mexico; (J.V.A.); (S.D.G.R.); (F.A.S.S.); (Q.P.C.); (I.S.-G.)
| | - Miguel A. Álvarez Avitia
- Medical Oncology Department, National Cancer Institute, Tlalpan, Mexico City 14080, Mexico; (M.A.Á.A.); (N.S.)
| | - Nora Sobrevilla
- Medical Oncology Department, National Cancer Institute, Tlalpan, Mexico City 14080, Mexico; (M.A.Á.A.); (N.S.)
| | - Francisco Osvaldo García Pérez
- Nuclear Medicine and Molecular Imaging Department, National Cancer Institute, Tlalpan, Mexico City 14080, Mexico; (J.V.A.); (S.D.G.R.); (F.A.S.S.); (Q.P.C.); (I.S.-G.)
- Correspondence:
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Validation of SV2A-Targeted PET Imaging for Noninvasive Assessment of Neuroendocrine Differentiation in Prostate Cancer. Int J Mol Sci 2021; 22:ijms222313085. [PMID: 34884893 PMCID: PMC8657802 DOI: 10.3390/ijms222313085] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 12/03/2022] Open
Abstract
Neuroendocrine prostate cancer (NEPC) is an aggressive and lethal variant of prostate cancer (PCa), and it remains a diagnostic challenge. Herein we report our findings of using synaptic vesicle glycoprotein 2 isoform A (SV2A) as a promising marker for positron emission tomography (PET) imaging of neuroendocrine differentiation (NED). The bioinformatic analyses revealed an amplified SV2A gene expression in clinical samples of NEPC versus castration-resistant PCa with adenocarcinoma characteristics (CRPC-Adeno). Importantly, significantly upregulated SV2A protein levels were found in both NEPC cell lines and tumor tissues. PET imaging studies were carried out in NEPC xenograft models with 18F-SynVesT-1. Although 18F-SynVesT-1 is not a cancer imaging agent, it showed a significant uptake level in the SV2A+ tumor (NCI-H660: 0.70 ± 0.14 %ID/g at 50–60 min p.i.). The SV2A blockade resulted in a significant reduction of tumor uptake (0.25 ± 0.03 %ID/g, p = 0.025), indicating the desired SV2A imaging specificity. Moreover, the comparative PET imaging study showed that the DU145 tumors could be clearly visualized by 18F-SynVesT-1 but not 68Ga-PSMA-11 nor 68Ga-DOTATATE, further validating the role of SV2A-targeted imaging for noninvasive assessment of NED in PCa. In conclusion, we demonstrated that SV2A, highly expressed in NEPC, can serve as a promising target for noninvasive imaging evaluation of NED.
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