skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: MO-AB-BRA-05: [18F]NaF PET/CT Imaging Biomarkers in Metastatic Prostate Cancer

Abstract

Purpose: Clinical use of {sup 18}F-Sodium Fluoride (NaF) PET/CT in metastatic settings often lacks technology to quantitatively measure full disease dynamics due to high tumor burden. This study assesses radiomics-based extraction of NaF PET/CT measures, including global metrics of overall burden and local metrics of disease heterogeneity, in metastatic prostate cancer for correlation to clinical outcomes. Methods: Fifty-six metastatic Castrate-Resistant Prostate Cancer (mCRPC) patients had NaF PET/CT scans performed at baseline and three cycles into chemotherapy (N=16) or androgen-receptor (AR) inhibitors (N=39). A novel technology, Quantitative Total Bone Imaging (QTBI), was used for analysis. Employing hybrid PET/CT segmentation and articulated skeletal-registration, QTBI allows for response assessment of individual lesions. Various SUV metrics were extracted from each lesion (iSUV). Global metrics were extracted from composite lesion-level statistics for each patient (pSUV). Proportion of detected lesions and those with significant response (%-increase or %-decrease) was calculated for each patient based on test-retest limits for iSUV metrics. Cox proportional hazard regression analyses were conducted between imaging metrics and progression-free survival (PFS). Results: Functional burden (pSUV{sub total}) assessed mid-treatment was the strongest univariate predictor of PFS (HR=2.03; p<0.0001). Various global metrics outperformed baseline clinical markers, including fraction of skeletal burden, mean uptake (pSUV{sub mean}),more » and heterogeneity of average lesion uptake (pSUV{sub hetero}). Of 43 patients with paired baseline/mid-treatment imaging, 40 showed heterogeneity in lesion-level response, containing populations of lesions with both increasing/decreasing metrics. Proportion of lesions with significantly increasing iSUV{sub mean} was highly predictive of clinical PFS (HR=2.0; p=0.0002). Patients exhibiting higher proportion of lesions with decreasing iSUV{sub total} saw prolonged radiographic PFS (HR=0.51; p=0.02). Conclusion: Technology presented here provides comprehensive disease quantification on NaF PET/CT imaging, showing strong correlation to clinical outcomes. Total functional burden as well as proportions of similarly responding lesions was predictive of PFS. This supports ongoing development of NaF PET/CT based imaging biomarkers in mCRPC. Prostate Cancer Foundation.« less

Authors:
; ; ; ; ; ;  [1]; ; ;  [2]; ; ;  [3]
  1. University of Wisconsin Madison, Madison, WI (United States)
  2. National Cancer Institute at the National Institutes of Health, Bethesda, MD (United States)
  3. Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
Publication Date:
OSTI Identifier:
22649494
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; 61 RADIATION PROTECTION AND DOSIMETRY; BIOLOGICAL MARKERS; BIOMEDICAL RADIOGRAPHY; EXTRACTION; FLUORINE 18; METASTASES; METRICS; NEOPLASMS; PATIENTS; POSITRON COMPUTED TOMOGRAPHY; PROSTATE; REGRESSION ANALYSIS

Citation Formats

Harmon, S, Perk, T, Lin, C, Eickhoff, J, Perlman, S, Liu, G, Jeraj, R, Choyke, P, Dahut, W, Apolo, A, Humm, J, Larson, S, and Morris, MJ. MO-AB-BRA-05: [18F]NaF PET/CT Imaging Biomarkers in Metastatic Prostate Cancer. United States: N. p., 2016. Web. doi:10.1118/1.4957157.
Harmon, S, Perk, T, Lin, C, Eickhoff, J, Perlman, S, Liu, G, Jeraj, R, Choyke, P, Dahut, W, Apolo, A, Humm, J, Larson, S, & Morris, MJ. MO-AB-BRA-05: [18F]NaF PET/CT Imaging Biomarkers in Metastatic Prostate Cancer. United States. doi:10.1118/1.4957157.
Harmon, S, Perk, T, Lin, C, Eickhoff, J, Perlman, S, Liu, G, Jeraj, R, Choyke, P, Dahut, W, Apolo, A, Humm, J, Larson, S, and Morris, MJ. Wed . "MO-AB-BRA-05: [18F]NaF PET/CT Imaging Biomarkers in Metastatic Prostate Cancer". United States. doi:10.1118/1.4957157.
@article{osti_22649494,
title = {MO-AB-BRA-05: [18F]NaF PET/CT Imaging Biomarkers in Metastatic Prostate Cancer},
author = {Harmon, S and Perk, T and Lin, C and Eickhoff, J and Perlman, S and Liu, G and Jeraj, R and Choyke, P and Dahut, W and Apolo, A and Humm, J and Larson, S and Morris, MJ},
abstractNote = {Purpose: Clinical use of {sup 18}F-Sodium Fluoride (NaF) PET/CT in metastatic settings often lacks technology to quantitatively measure full disease dynamics due to high tumor burden. This study assesses radiomics-based extraction of NaF PET/CT measures, including global metrics of overall burden and local metrics of disease heterogeneity, in metastatic prostate cancer for correlation to clinical outcomes. Methods: Fifty-six metastatic Castrate-Resistant Prostate Cancer (mCRPC) patients had NaF PET/CT scans performed at baseline and three cycles into chemotherapy (N=16) or androgen-receptor (AR) inhibitors (N=39). A novel technology, Quantitative Total Bone Imaging (QTBI), was used for analysis. Employing hybrid PET/CT segmentation and articulated skeletal-registration, QTBI allows for response assessment of individual lesions. Various SUV metrics were extracted from each lesion (iSUV). Global metrics were extracted from composite lesion-level statistics for each patient (pSUV). Proportion of detected lesions and those with significant response (%-increase or %-decrease) was calculated for each patient based on test-retest limits for iSUV metrics. Cox proportional hazard regression analyses were conducted between imaging metrics and progression-free survival (PFS). Results: Functional burden (pSUV{sub total}) assessed mid-treatment was the strongest univariate predictor of PFS (HR=2.03; p<0.0001). Various global metrics outperformed baseline clinical markers, including fraction of skeletal burden, mean uptake (pSUV{sub mean}), and heterogeneity of average lesion uptake (pSUV{sub hetero}). Of 43 patients with paired baseline/mid-treatment imaging, 40 showed heterogeneity in lesion-level response, containing populations of lesions with both increasing/decreasing metrics. Proportion of lesions with significantly increasing iSUV{sub mean} was highly predictive of clinical PFS (HR=2.0; p=0.0002). Patients exhibiting higher proportion of lesions with decreasing iSUV{sub total} saw prolonged radiographic PFS (HR=0.51; p=0.02). Conclusion: Technology presented here provides comprehensive disease quantification on NaF PET/CT imaging, showing strong correlation to clinical outcomes. Total functional burden as well as proportions of similarly responding lesions was predictive of PFS. This supports ongoing development of NaF PET/CT based imaging biomarkers in mCRPC. Prostate Cancer Foundation.},
doi = {10.1118/1.4957157},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = {Wed Jun 15 00:00:00 EDT 2016},
month = {Wed Jun 15 00:00:00 EDT 2016}
}