title: A prospective pilot study of (89)Zr-J591/prostate specific membrane antigen positron emission tomography in men with localized prostate cancer undergoing radical prostatectomy.
abstract: OBJECTIVE
  In this pilot study we explored the feasibility of (89)Zr labeled J591 monoclonal antibody positron emission tomography of localized prostate cancer.
  
  
  METHODS
  Before scheduled radical prostatectomy 11 patients were injected intravenously with (89)Zr-J591, followed 6 days later by whole body positron emission tomography. Patients underwent surgery the day after imaging. Specimens were imaged by ex vivo micro positron emission tomography and a custom 3 Tesla magnetic resonance scanner coil. Positron emission tomography images and histopathology were correlated.
  
  
  RESULTS
  Median patient age was 61 years (range 47 to 68), median prostate specific antigen was 5.2 ng/ml (range 3.5 to 12.0) and median biopsy Gleason score of the 11 index lesions was 7 (range 7 to 9). On histopathology 22 lesions were identified. Median lesion size was 5.5 mm (range 2 to 21) and median Gleason score after radical prostatectomy was 7 (range 6 to 9). Eight of 11 index lesions (72.7%) were identified by in vivo positron emission tomography. Lesion identification improved with increasing lesion size for in vivo and ex vivo positron emission tomography (each p <0.0001), and increasing Gleason score (p = 0.14 and 0.01, respectively). Standardized uptake values appeared to correlate with increased Gleason score but not significantly (p = 0.19).
  
  
  CONCLUSIONS
  To our knowledge this is the first report of (89)Zr-J591/prostate specific membrane antigen positron emission tomography in localized prostate cancer cases. In this setting (89)Zr-J591 bound to tumor foci in situ and positron emission tomography identified primarily Gleason score 7 or greater and larger tumors, likely corresponding to clinically significant disease warranting definitive therapy. A future, larger clinical validation trial is planned to better define the usefulness of (89)Zr-J591 positron emission tomography for localized prostate cancer.
authors.affiliation: Molecular Imaging and Therapy Service, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Osborne
authors.affiliation: Department of Urology, Weill Medical College of Cornell University, New York, New York.
authors.forename: David A
authors.initials: DA
authors.lastname: Green
authors.affiliation: Department of Radiology, Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Spratt
authors.affiliation: Radiochemistry and Imaging Sciences Service, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Serge
authors.initials: S
authors.lastname: Lyashchenko
authors.affiliation: Molecular Imaging and Therapy Service, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Shoaib B
authors.initials: SB
authors.lastname: Fareedy
authors.affiliation: Department of Urology, Weill Medical College of Cornell University, New York, New York; Department of Pathology, Weill Medical College of Cornell University, New York, New York.
authors.forename: Brian D
authors.initials: BD
authors.lastname: Robinson
authors.affiliation: Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Beattie
authors.affiliation: Department of Urology, Weill Medical College of Cornell University, New York, New York.
authors.forename: Manu
authors.initials: M
authors.lastname: Jain
authors.affiliation: Radiochemistry and Imaging Sciences Service, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Jason S
authors.initials: JS
authors.lastname: Lewis
authors.affiliation: Division of Biostatistics and Epidemiology, Department of Public Health, Weill Medical College of Cornell University, New York, New York.
authors.forename: Paul
authors.initials: P
authors.lastname: Christos
authors.affiliation: Molecular Imaging and Therapy Service, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Larson
authors.affiliation: Department of Urology, Weill Medical College of Cornell University, New York, New York.
authors.forename: Neil H
authors.initials: NH
authors.lastname: Bander
authors.affiliation: Department of Urology, Weill Medical College of Cornell University, New York, New York. Electronic address: dss2001@med.cornell.edu.
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Scherr
mesh_terms: D000911:Antibodies, Monoclonal; D000954:Antigens, Surface; D043425:Glutamate Carboxypeptidase II; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D011868:Radioisotopes; D015040:Zirconium
chemical_list: D000911:Antibodies, Monoclonal; D000954:Antigens, Surface; C478680:J591 monoclonal antibody; D011868:Radioisotopes; D015040:Zirconium; C473848:FOLH1 protein, human; D043425:Glutamate Carboxypeptidase II
keywords: J591 monoclonal antibody; glutamate carboxypeptidase II; human; positron-emission tomography; prostatic neoplasms; zirconium