Early lesion detection with 18F-DCFPyL PET/CT in 248 patients with biochemically recurrent prostate cancer

Purpose Prostate-specific membrane antigen (PSMA) PET/CT is increasingly used in patients with biochemically recurrent prostate cancer (BCR), mostly using gallium-68 ( 168 Ga)-labelled radiotracers. Alternatively, fluorine-18 ( 18 F)-labelled PSMA tracers are available, such as 18 F-DCFPyL, which offer enhanced image quality and therefore potentially increased detection of small metastases. In this study we evaluate the lesion detection efficacy of 18 F-DCFPyL PET/CT in patients with BCR and determine the detection efficacy as a function of their PSA value. Methods A total of 248 consecutive patients were evaluated and underwent scanning with 18 F-DCFPyL PET/CT for BCR between November 2016 and 2018 in two hospitals in the Netherlands. Patients were examined after radical prostatectomy (52%), external-beam radiation therapy (42%) or brachytherapy (6%). Imaging was performed 120 min after injection of a median dose of 311 MBq 18 F-DCFPyL. Results In 214 out of 248 PET/CT scans (86.3%), at least one lesion suggestive of cancer recurrence was detected (‘positive scan’). Scan positivity increased with higher PSA values: 17/29 scans (59%) with PSA values