Use of 111in-capromab pendetide immunoscintigraphy to image localized prostate cancer foci within the prostate gland.
OBJECTIVE
We compared the results of a preoperative (111)In-capromab pendetide scan co-registered with computerized tomography with pathological findings in the surgically excised prostate to determine whether the scan can efficiently detect cancer in the prostate.


METHODS
This prospective trial included 25 hormone naïve men with clinically localized prostate cancer who underwent (111)In-capromab pendetide single photon emission computerized tomography/computerized tomography as part of the preoperative evaluation. In addition to routine histological analysis, representative prostate sections were stained for prostate specific membrane antigen using the same antibody used in the scan. A pathologist and a radiologist were blinded to pathology and imaging findings, respectively. Prostate specific membrane antigen immunohistochemistry was correlated with the 3-dimensional location of the prostate specific membrane antigen signal detected by scan.


RESULTS
Scan sensitivity was 37% to 87% for 4 quadrants (right vs left and apical vs basal) with 0% to 50% specificity, as validated by final pathological assessment of the same quadrants. Stratifying positive scan signal strength did not statistically improve specificity (p = 0.35). There was no significant correlation between prostate specific membrane antigen over expression and tumor stage distribution (p = 0.23).


CONCLUSIONS
The scan did not localize prostate cancer to a particular quadrant based on comparison with radical prostatectomy specimen pathology. The antibody used has affinity for benign and malignant prostatic glands in excised, formalin fixed prostate tissue, which may contribute to low scan specificity in vivo. The scan cannot be used to reliably detect or image cancer foci in the prostate.
Mouraviev
Vladimir
V
Division of Urologic Surgery, Department of Surgery, Duke University Medical Center, Duke Prostate Center, Durham, North Carolina 27710, USA.
Madden
John F
JF
Broadwater
Gloria
G
Mayes
Janice M
JM
Burchette
James L
JL
Schneider
Frank
F
Smith
Jill
J
Tsivian
Matvey
M
Wong
Terence
T
Polascik
Thomas J
TJ
D000368:Aged; D000911:Antibodies, Monoclonal; D006801:Humans; D007205:Indium Radioisotopes; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011467:Prostate / Q000000981:diagnostic imaging* / Q000473:pathology; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011877:Radionuclide Imaging; D014057:Tomography, X-Ray Computed
D000911:Antibodies, Monoclonal; D007205:Indium Radioisotopes; C101315:Capromab Pendetide