Whole-body parametric mapping of tumour perfusion in metastatic prostate cancer using long axial field-of-view [¹⁵O]H₂O PET.

TY - JOUR

T1 - Whole-body parametric mapping of tumour perfusion in metastatic prostate cancer using long axial field-of-view [15O]H2O PET.

AU - Jochumsen, Mads Ryø

AU - Christensen, Nana L

AU - Iversen, Peter

AU - Gormsen, Lars C

AU - Sørensen, Jens

AU - Tolbod, Lars P

PY - 2024/11

Y1 - 2024/11

N2 - Purpose: Tumour perfusion is a nutrient-agnostic biomarker for cancer metabolic rate. Use of tumour perfusion for cancer growth assessment has been limited by complicated image acquisition, image analysis and limited field-of-view scanners. Long axial field-of-view (LAFOV) PET scan using [15O]H2O, allows quantitative assessment of whole-body tumour perfusion. We created a tool for automated creation of quantitative parametric whole-body tumour perfusion images in metastatic cancer. Methods: Ten metastatic prostate cancer patients underwent dynamic LAFOV [15O]H2O PET (Siemens, Quadra) followed by [18F]PSMA-1007 PET. Perfusion was measured as [15O]H2O K1 (mL/min/mL) with a single-tissue compartment model and an automatically captured cardiac image-derived input function. Parametric perfusion images were automatically calculated using the basis-function method with initial voxel-wise delay estimation and a leading-edge approach. Subsequently, perfusion of volumes-of-interest (VOI) can be directly extracted from the parametric images. We used a [18F]PSMA-1007 SUV 4 fixed threshold for tumour delineation and transferred these VOIs to the perfusion map. Results: For 8 primary tumours, 64 lymph node metastases, and 85 bone metastases, median tumour perfusion were 0.19 (0.15–0.27) mL/min/mL, 0.16 (0.13–0.27) mL/min/mL, and 0.26 (0.21–0.39), respectively. The correlation between calculated perfusion from time-activity-curves and parametric images was excellent (r = 0.99, p < 0.0001). Conclusion: LAFOV PET imaging using [15O]H2O enables truly quantitative parametric images of whole-body tumour perfusion, a potential biomarker for guiding personalized treatment and monitoring treatment response.

AB - Purpose: Tumour perfusion is a nutrient-agnostic biomarker for cancer metabolic rate. Use of tumour perfusion for cancer growth assessment has been limited by complicated image acquisition, image analysis and limited field-of-view scanners. Long axial field-of-view (LAFOV) PET scan using [15O]H2O, allows quantitative assessment of whole-body tumour perfusion. We created a tool for automated creation of quantitative parametric whole-body tumour perfusion images in metastatic cancer. Methods: Ten metastatic prostate cancer patients underwent dynamic LAFOV [15O]H2O PET (Siemens, Quadra) followed by [18F]PSMA-1007 PET. Perfusion was measured as [15O]H2O K1 (mL/min/mL) with a single-tissue compartment model and an automatically captured cardiac image-derived input function. Parametric perfusion images were automatically calculated using the basis-function method with initial voxel-wise delay estimation and a leading-edge approach. Subsequently, perfusion of volumes-of-interest (VOI) can be directly extracted from the parametric images. We used a [18F]PSMA-1007 SUV 4 fixed threshold for tumour delineation and transferred these VOIs to the perfusion map. Results: For 8 primary tumours, 64 lymph node metastases, and 85 bone metastases, median tumour perfusion were 0.19 (0.15–0.27) mL/min/mL, 0.16 (0.13–0.27) mL/min/mL, and 0.26 (0.21–0.39), respectively. The correlation between calculated perfusion from time-activity-curves and parametric images was excellent (r = 0.99, p < 0.0001). Conclusion: LAFOV PET imaging using [15O]H2O enables truly quantitative parametric images of whole-body tumour perfusion, a potential biomarker for guiding personalized treatment and monitoring treatment response.

KW - Cancer

KW - Dynamic PET

KW - Long axial field-of-view

KW - Perfusion

KW - Prostate cancer

KW - Tumour blood flow

UR - https://www.scopus.com/pages/publications/85197937251

U2 - 10.1007/s00259-024-06799-3

DO - 10.1007/s00259-024-06799-3

M3 - Journal article

C2 - 38940842

SN - 1619-7070

VL - 51

SP - 4134

EP - 4140

JO - European Journal of Nuclear Medicine and Molecular Imaging

JF - European Journal of Nuclear Medicine and Molecular Imaging

IS - 13

ER -