Skip to main content
Top
Published in: EJNMMI Research 1/2019

Open Access 01-12-2019 | Prostate Cancer | Original research

Repeatability of tumor blood flow quantification with 82Rubidium PET/CT in prostate cancer — a test-retest study

Authors: Mads Ryø Jochumsen, Kirsten Bouchelouche, Katrine Bødkergaard Nielsen, Jørgen Frøkiær, Michael Borre, Jens Sörensen, Lars Poulsen Tolbod

Published in: EJNMMI Research | Issue 1/2019

Login to get access

Abstract

Background

Non-invasive tumor blood flow (TBF) quantification is a candidate approach for risk stratification and monitoring of prostate cancer patients. Validation data have recently been published on prostate TBF measurement with the widely used positron emission tomography (PET) flow tracer 82Rubidium (82Rb). However, no test-retest data is available for TBF measurement with 82Rb PET in prostate cancer. Such information is important to determine the potential clinical usefulness of the technique. The aim of the present study was to determine the test-retest repeatability of TBF measurement with both dynamic and static 82Rb PET.

Methods

We recruited 10 low-to-high-risk prostate cancer patients scheduled for clinical prostate-specific membrane antigen (PSMA) PET/computed tomography (CT) or magnetic resonance imaging. Pelvic and cardiac static and dynamic 82Rb PET/CT were performed at baseline and repeated on a different day within 1 week. In total, 11 primary lesions were analyzed.

Results

For K1, standardized uptake values (SUV)max, SUVmean, and SUVpeak, prostate cancer 82Rb PET TBF has a repeatability of 32%, 51%, 53%, and 58% and an intraclass correlation of 0.98, 0.89, 0.88, and 0.88, respectively.

Conclusion

Dynamic 82Rb PET/CT with kinetic modeling measures TBF in prostate cancer with high repeatability, which allows identification of blood flow changes of 32%. Static late-uptake 82Rb PET/CT is inferior, and only intra-individual blood flow changes above 51% can hence be recognized.
Literature
1.
go back to reference Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011;144(5):646–74.CrossRef Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011;144(5):646–74.CrossRef
2.
go back to reference de Langen AJ, van den Boogaart V, Lubberink M, Backes WH, Marcus JT, van Tinteren H, et al. Monitoring response to antiangiogenic therapy in non-small cell lung cancer using imaging markers derived from PET and dynamic contrast-enhanced MRI. J Nucl Med. 2011;52(1):48–55.CrossRef de Langen AJ, van den Boogaart V, Lubberink M, Backes WH, Marcus JT, van Tinteren H, et al. Monitoring response to antiangiogenic therapy in non-small cell lung cancer using imaging markers derived from PET and dynamic contrast-enhanced MRI. J Nucl Med. 2011;52(1):48–55.CrossRef
3.
go back to reference Scott AM, Mitchell PL, O’Keefe G, Saunder T, Hicks RJ, Poon A, et al. Pharmacodynamic analysis of tumour perfusion assessed by 15O-water-PET imaging during treatment with sunitinib malate in patients with advanced malignancies. EJNMMI Res. 2012;2(1):31.CrossRef Scott AM, Mitchell PL, O’Keefe G, Saunder T, Hicks RJ, Poon A, et al. Pharmacodynamic analysis of tumour perfusion assessed by 15O-water-PET imaging during treatment with sunitinib malate in patients with advanced malignancies. EJNMMI Res. 2012;2(1):31.CrossRef
4.
go back to reference Krak N, van der Hoeven J, Hoekstra O, Twisk J, van der Wall E, Lammertsma A. Blood flow and glucose metabolism in stage IV breast cancer: heterogeneity of response during chemotherapy. Mol Imag Biol. 2008;10(6):356–63.CrossRef Krak N, van der Hoeven J, Hoekstra O, Twisk J, van der Wall E, Lammertsma A. Blood flow and glucose metabolism in stage IV breast cancer: heterogeneity of response during chemotherapy. Mol Imag Biol. 2008;10(6):356–63.CrossRef
5.
go back to reference Mankoff DA, Dunnwald LK, Gralow JR, Ellis GK, Charlop A, Lawton TJ, et al. Blood flow and metabolism in locally advanced breast cancer: relationship to response to therapy. J Nucl Med. 2002;43(4):500–9.PubMed Mankoff DA, Dunnwald LK, Gralow JR, Ellis GK, Charlop A, Lawton TJ, et al. Blood flow and metabolism in locally advanced breast cancer: relationship to response to therapy. J Nucl Med. 2002;43(4):500–9.PubMed
6.
go back to reference Mankoff DA, Dunnwald LK, Gralow JR, Ellis GK, Schubert EK, Tseng J, et al. Changes in blood flow and metabolism in locally advanced breast cancer treated with neoadjuvant chemotherapy. J Nucl Med. 2003;44(11):1806–14.PubMed Mankoff DA, Dunnwald LK, Gralow JR, Ellis GK, Schubert EK, Tseng J, et al. Changes in blood flow and metabolism in locally advanced breast cancer treated with neoadjuvant chemotherapy. J Nucl Med. 2003;44(11):1806–14.PubMed
7.
go back to reference Specht JM, Kurland BF, Montgomery SK, Dunnwald LK, Doot RK, Gralow JR, et al. Tumor metabolism and blood flow as assessed by positron emission tomography varies by tumor subtype in locally advanced breast cancer. Clin Cancer Res. 2010;16(10):2803–10.CrossRef Specht JM, Kurland BF, Montgomery SK, Dunnwald LK, Doot RK, Gralow JR, et al. Tumor metabolism and blood flow as assessed by positron emission tomography varies by tumor subtype in locally advanced breast cancer. Clin Cancer Res. 2010;16(10):2803–10.CrossRef
8.
go back to reference Lehtio K, Oikonen V, Gronroos T, Eskola O, Kalliokoski K, Bergman J, et al. Imaging of blood flow and hypoxia in head and neck cancer: initial evaluation with [(15)O]H(2)O and [(18)F]fluoroerythronitroimidazole PET. J Nucl Med. 2001;42(11):1643–52.PubMed Lehtio K, Oikonen V, Gronroos T, Eskola O, Kalliokoski K, Bergman J, et al. Imaging of blood flow and hypoxia in head and neck cancer: initial evaluation with [(15)O]H(2)O and [(18)F]fluoroerythronitroimidazole PET. J Nucl Med. 2001;42(11):1643–52.PubMed
9.
go back to reference Lubberink M, Golla SS, Jonasson M, Rubin K, Glimelius B, Sorensen J, et al. (15)O-water PET study of the effect of imatinib, a selective platelet-derived growth factor receptor inhibitor, versus anakinra, an IL-1R antagonist, on water-perfusable tissue fraction in colorectal cancer metastases. J Nucl Med. 2015;56(8):1144–9.CrossRef Lubberink M, Golla SS, Jonasson M, Rubin K, Glimelius B, Sorensen J, et al. (15)O-water PET study of the effect of imatinib, a selective platelet-derived growth factor receptor inhibitor, versus anakinra, an IL-1R antagonist, on water-perfusable tissue fraction in colorectal cancer metastases. J Nucl Med. 2015;56(8):1144–9.CrossRef
10.
go back to reference Bruehlmeier M, Roelcke U, Schubiger PA, Ametamey SM. Assessment of hypoxia and perfusion in human brain tumors using PET with 18F-fluoromisonidazole and 15O-H2O. J Nucl Med. 2004;45(11):1851–9.PubMed Bruehlmeier M, Roelcke U, Schubiger PA, Ametamey SM. Assessment of hypoxia and perfusion in human brain tumors using PET with 18F-fluoromisonidazole and 15O-H2O. J Nucl Med. 2004;45(11):1851–9.PubMed
11.
go back to reference Kurdziel KA, Figg WD, Carrasquillo JA, Huebsch S, Whatley M, Sellers D, et al. Using positron emission tomography 2-deoxy-2-[18F]fluoro-D-glucose, 11CO, and 15O-water for monitoring androgen independent prostate cancer. Mol Imaging Biol. 2003;5(2):86–93.CrossRef Kurdziel KA, Figg WD, Carrasquillo JA, Huebsch S, Whatley M, Sellers D, et al. Using positron emission tomography 2-deoxy-2-[18F]fluoro-D-glucose, 11CO, and 15O-water for monitoring androgen independent prostate cancer. Mol Imaging Biol. 2003;5(2):86–93.CrossRef
12.
go back to reference Inaba T. Quantitative measurements of prostatic blood flow and blood volume by positron emission tomography. J Urol. 1992;148(5):1457–60.CrossRef Inaba T. Quantitative measurements of prostatic blood flow and blood volume by positron emission tomography. J Urol. 1992;148(5):1457–60.CrossRef
13.
go back to reference Tolbod LP, Nielsen MM, Pedersen BG, Hoyer S, Harms HJ, Borre M, et al. Non-invasive quantification of tumor blood flow in prostate cancer using (15)O-H2O PET/CT. Am J Nucl Med Mol Imag. 2018;8(5):292–302. Tolbod LP, Nielsen MM, Pedersen BG, Hoyer S, Harms HJ, Borre M, et al. Non-invasive quantification of tumor blood flow in prostate cancer using (15)O-H2O PET/CT. Am J Nucl Med Mol Imag. 2018;8(5):292–302.
14.
go back to reference Lodge MA, Carson RE, Carrasquillo JA, Whatley M, Libutti SK, Bacharach SL. Parametric images of blood flow in oncology PET studies using [15O]water. J Nucl Med. 2000;41(11):1784–92.PubMed Lodge MA, Carson RE, Carrasquillo JA, Whatley M, Libutti SK, Bacharach SL. Parametric images of blood flow in oncology PET studies using [15O]water. J Nucl Med. 2000;41(11):1784–92.PubMed
15.
go back to reference Lodge MA, Jacene HA, Pili R, Wahl RL. Reproducibility of tumor blood flow quantification with 15O-water PET. J Nucl Med. 2008;49(10):1620–7.CrossRef Lodge MA, Jacene HA, Pili R, Wahl RL. Reproducibility of tumor blood flow quantification with 15O-water PET. J Nucl Med. 2008;49(10):1620–7.CrossRef
16.
go back to reference van der Veldt AA, Hendrikse NH, Harms HJ, Comans EF, Postmus PE, Smit EF, et al. Quantitative parametric perfusion images using 15O-labeled water and a clinical PET/CT scanner: test-retest variability in lung cancer. J Nucl Med. 2010;51(11):1684–90.CrossRef van der Veldt AA, Hendrikse NH, Harms HJ, Comans EF, Postmus PE, Smit EF, et al. Quantitative parametric perfusion images using 15O-labeled water and a clinical PET/CT scanner: test-retest variability in lung cancer. J Nucl Med. 2010;51(11):1684–90.CrossRef
17.
go back to reference Wells P, Jones T, Price P. Assessment of inter- and intrapatient variability in C15O2 positron emission tomography measurements of blood flow in patients with intra-abdominal cancers. Clin Cancer Res. 2003;9(17):6350–6.PubMed Wells P, Jones T, Price P. Assessment of inter- and intrapatient variability in C15O2 positron emission tomography measurements of blood flow in patients with intra-abdominal cancers. Clin Cancer Res. 2003;9(17):6350–6.PubMed
18.
go back to reference Lu Y. FDG and (82)Rb PET/MRI features of brain metastasis of breast cancer. Clin Nucl Med. 2015;40(6):494–5.CrossRef Lu Y. FDG and (82)Rb PET/MRI features of brain metastasis of breast cancer. Clin Nucl Med. 2015;40(6):494–5.CrossRef
19.
go back to reference Mirpour S, Khandani AH. Extracardiac abnormalities on rubidium-82 cardiac positron emission tomography/computed tomography. Nucl Med Commun. 2011;32(4):260–4.CrossRef Mirpour S, Khandani AH. Extracardiac abnormalities on rubidium-82 cardiac positron emission tomography/computed tomography. Nucl Med Commun. 2011;32(4):260–4.CrossRef
20.
go back to reference Neumann DR, Basile KE, Bravo EL, Chen EQ, Go RT. Malignant pheochromocytoma of the anterior mediastinum: PET findings with [18F]FDG and 82Rb. J Comput Assist Tomogr. 1996;20(2):312–6.CrossRef Neumann DR, Basile KE, Bravo EL, Chen EQ, Go RT. Malignant pheochromocytoma of the anterior mediastinum: PET findings with [18F]FDG and 82Rb. J Comput Assist Tomogr. 1996;20(2):312–6.CrossRef
21.
go back to reference Murthy VL, Brown RK, Corbett JR. Metastatic renal cell carcinoma avid for 82Rb but not 18F-FDG. Clin Nucl Med. 2014;39(10):908–9.CrossRef Murthy VL, Brown RK, Corbett JR. Metastatic renal cell carcinoma avid for 82Rb but not 18F-FDG. Clin Nucl Med. 2014;39(10):908–9.CrossRef
23.
go back to reference El Fakhri G, Kardan A, Sitek A, Dorbala S, Abi-Hatem N, Lahoud Y, et al. Reproducibility and accuracy of quantitative myocardial blood flow assessment with (82)Rb PET: comparison with (13)N-ammonia PET. J Nucl Med. 2009;50(7):1062–71.CrossRef El Fakhri G, Kardan A, Sitek A, Dorbala S, Abi-Hatem N, Lahoud Y, et al. Reproducibility and accuracy of quantitative myocardial blood flow assessment with (82)Rb PET: comparison with (13)N-ammonia PET. J Nucl Med. 2009;50(7):1062–71.CrossRef
24.
go back to reference Bland JM, Altman DG. Measurement error proportional to the mean. BMJ. 1996;313(7049):106.CrossRef Bland JM, Altman DG. Measurement error proportional to the mean. BMJ. 1996;313(7049):106.CrossRef
25.
go back to reference Bland JM, Altman DG. Measuring agreement in method comparison studies. Stat Methods Med Res. 1999;8(2):135–60.CrossRef Bland JM, Altman DG. Measuring agreement in method comparison studies. Stat Methods Med Res. 1999;8(2):135–60.CrossRef
26.
go back to reference Euser AM, Dekker FW, le Cessie S. A practical approach to Bland-Altman plots and variation coefficients for log transformed variables. J Clin Epidemiol. 2008;61(10):978–82.CrossRef Euser AM, Dekker FW, le Cessie S. A practical approach to Bland-Altman plots and variation coefficients for log transformed variables. J Clin Epidemiol. 2008;61(10):978–82.CrossRef
27.
go back to reference Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Informatics. 2009;42(2):377–81.CrossRef Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Informatics. 2009;42(2):377–81.CrossRef
28.
go back to reference de Langen AJ, Lubberink M, Boellaard R, Spreeuwenberg MD, Smit EF, Hoekstra OS, et al. Reproducibility of tumor perfusion measurements using 15O-labeled water and PET. J Nucl Med. 2008;49(11):1763–8.CrossRef de Langen AJ, Lubberink M, Boellaard R, Spreeuwenberg MD, Smit EF, Hoekstra OS, et al. Reproducibility of tumor perfusion measurements using 15O-labeled water and PET. J Nucl Med. 2008;49(11):1763–8.CrossRef
29.
go back to reference Indrayan A. Clinical agreement in quantitative measurements. Limits of disagreement and the intraclass correlation. In: Doi SAR, Williams GM, editors. Methods of clinical epidemiology. Berlin; New York: Springer; 2013. p. 17–27.CrossRef Indrayan A. Clinical agreement in quantitative measurements. Limits of disagreement and the intraclass correlation. In: Doi SAR, Williams GM, editors. Methods of clinical epidemiology. Berlin; New York: Springer; 2013. p. 17–27.CrossRef
Metadata
Title
Repeatability of tumor blood flow quantification with 82Rubidium PET/CT in prostate cancer — a test-retest study
Authors
Mads Ryø Jochumsen
Kirsten Bouchelouche
Katrine Bødkergaard Nielsen
Jørgen Frøkiær
Michael Borre
Jens Sörensen
Lars Poulsen Tolbod
Publication date
01-12-2019
Publisher
Springer Berlin Heidelberg
Published in
EJNMMI Research / Issue 1/2019
Electronic ISSN: 2191-219X
DOI
https://doi.org/10.1186/s13550-019-0529-2

Other articles of this Issue 1/2019

EJNMMI Research 1/2019 Go to the issue