MP80-04 89ZR-DF-IAB2M AND 68GA-PSMA-11 IMAGING IN LOCALIZED PRE-PROSTATECTOMY PROSTATE CANCER PATIENTS (2019)

You have accessJournal of UrologyImaging/Radiology: Uroradiology III (MP80)1 Apr 2019MP80-04 89ZR-DF-IAB2M AND 68GA-PSMA-11 IMAGING IN LOCALIZED PRE-PROSTATECTOMY PROSTATE CANCER PATIENTS Muhammad Junaid Niaz*, Yuliya Jhanwar, Thomas Flynn, Shankar Vallabhajosula, Jaspreet Batra, Scott Tagawa, Francesca Khani, Brian Robinson, Neil Bander, and Douglas Scherr Muhammad Junaid Niaz*Muhammad Junaid Niaz* More articles by this author , Yuliya JhanwarYuliya Jhanwar More articles by this author , Thomas FlynnThomas Flynn More articles by this author , Shankar VallabhajosulaShankar Vallabhajosula More articles by this author , Jaspreet BatraJaspreet Batra More articles by this author , Scott TagawaScott Tagawa More articles by this author , Francesca KhaniFrancesca Khani More articles by this author , Brian RobinsonBrian Robinson More articles by this author , Neil BanderNeil Bander More articles by this author , and Douglas ScherrDouglas Scherr More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000557403.86936.3fAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Due to the high expression of Prostate Specific Membrane Antigen (PSMA), it is an excellent target for molecular imaging. IAB2M is an 85kD minibody derived from J591 and PSMA-11 is a PSMA small molecule ligand. METHODS: Patients with clinically significant (defined as ≥ 0.5 cm3 with Gleason pattern ≥ 4) localized prostate cancer(PCa) on conventional imaging modalities who planned to undergo surgery were imaged by PET/CT 90-120 minutes after 5±2mCi of 68Ga-PSMA-11 injection and 2-4 days after 10mg IAB2M labeled with 2.5 mCi of 89Zr injection. Image results were read and mapped by a Nuclear Medicine MD without knowledge of the surgical pathology. Mapped findings were later compared with a surgical pathology map. RESULTS: 20 patients with median age 64.5 (46-79) and PSA 7.5(1.6-36.56) were enrolled. The first 11 patients were imaged only by IAB2M while last 9 patients were imaged by both IAB2M and PSMA-11. IAB2M detected 18 of 19 (95%) dominant lesions which had a median Gleason score 7.5 (6-9) in 19 patients; PSMA-11 detected 100% of dominant lesions with median Gleason score 8(6-9) in 8 patients. One patient refused surgery. The smallest dominant lesion detected was 8mm in size. The one dominant lesion missed by IAB2M was 7mm. Median SUVmax for dominant lesions was 3.1 (1.0-7.5) on IAB2M and 7.1 (1.6-23.2) on PSMA-11; median MR PIRADS was 4 (4-5). Of 17 Gleason 6 lesions identified on pathology, IAB2M detected 7 (41%) and of 9 lesions on pathology, PSMA-11 detected 3 (33%). Extraprostatic lesions: in the first 11 patients who got only IAB2M, 3 patients had 7 extra-prostatic lesions; 4 extra-prostatic lesions were detected and confirmed by surgical path and 3 lesions were missed. In the subsequent 9 patients who got both PET scans, 4 extra-prostatic lesions in one patient were detected by both PET agents, 3 were confirmed by surgical pathology and 1 confirmed on bone scan 2 months post-op. 15 false positive lesions were detected by IAB2M in 20 patients and 5 false positives were detected by PSMA-11 in the last 9 patients. There were 11 false negative lesions on IAB2M in all 19 patients and 3 false negatives on PSMA-11 in 8 patients. Of these false negatives, 7 were GS 6 and 2 were 3+4 and LNs median size was 2mm (0.5-15). CONCLUSIONS: In this small series, the performance of both PET agents was very similar. An advantage of IAB2M is its hepatobiliary rather than renal/urinary clearance, which makes it potentially easier to visualize the PCa and/or pelvic disease; an advantage of PSMA-11 is the ability to image within 1-2 hours. Source of Funding: Department of Urology, Weill Cornell Medical College, New York New York, NY© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e1161-e1162 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Muhammad Junaid Niaz* More articles by this author Yuliya Jhanwar More articles by this author Thomas Flynn More articles by this author Shankar Vallabhajosula More articles by this author Jaspreet Batra More articles by this author Scott Tagawa More articles by this author Francesca Khani More articles by this author Brian Robinson More articles by this author Neil Bander More articles by this author Douglas Scherr More articles by this author Expand All Advertisement PDF downloadLoading ...