Effect of forced diuresis during 18F-DCFPyL PET/CT in patients with prostate cancer: activity in ureters, kidneys and bladder and occurrence of halo artefacts around kidneys and bladder

Nucl Med Commun. 2019 Jun;40(6):652-656. doi: 10.1097/MNM.0000000000001007.

Abstract

Forced diuresis may improve readability of 2-(3-(1-carboxy-5-[(6-[F]fluoro-pyridine-3-carbonyl)-amino]-pentyl)-ureido)-pentanedioic acid (F-DCFPyL) PET/computed tomography (CT) by reducing focal ureteral activity. A total of 40 patients received furosemide simultaneously with F-DCFPyL (cohort 1) and 40 patients received furosemide 85 min after F-DCFPyL administration (cohort 2). The frequency of occurrence of activity depositions in ureters and halo artefacts near the kidneys and bladder was measured, as well as intensity of F-DCFPyL uptake in kidneys and bladder. At 120 min after injection of F-DCFPyL, a significantly lower number of F-DCFPyL depositions in ureters was found in cohort 2. Moreover, F-DCFPyL uptake in kidneys and bladder was significantly lower in this cohort; however, the occurrence of halo artefacts was similar in both groups. Administration of furosemide may improve interpretation of F-DCFPyL PET/CT as it results in less activity depositions in ureters. However, the effect depends on the timing of furosemide administration in relation to F-DCFPyL administration and PET/CT acquisition time. Acquisition of PET-images 120 min after F-DCFPyL administration benefits from late furosemide administration (85 min after injection).

MeSH terms

  • Aged
  • Aged, 80 and over
  • Artifacts*
  • Cohort Studies
  • Diuresis / drug effects*
  • Female
  • Furosemide / pharmacology
  • Humans
  • Kidney / drug effects
  • Kidney / physiopathology
  • Lysine / analogs & derivatives*
  • Male
  • Middle Aged
  • Positron Emission Tomography Computed Tomography*
  • Prostatic Neoplasms / diagnostic imaging*
  • Prostatic Neoplasms / physiopathology*
  • Retrospective Studies
  • Urea / analogs & derivatives*
  • Ureter / drug effects
  • Ureter / physiopathology
  • Urinary Bladder / drug effects
  • Urinary Bladder / physiopathology

Substances

  • 2-(3-(1-carboxy-5-((6-fluoropyridine-3-carbonyl)amino)pentyl)ureido)pentanedioic acid
  • Furosemide
  • Urea
  • Lysine