¹⁸F-DCFPyL (2-(3-{1-carboxy-5-[(6-¹⁸F-fluoropyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid) is a promising PET radiopharmaceutical targeting prostate-specific membrane antigen (PSMA). We present our experience with this single-academic-center prospective study evaluating the positivity rate of ¹⁸F-DCFPyL PET/CT in patients with biochemical recurrence (BCR) of prostate cancer (PC). Methods: We prospectively enrolled 72 men (52–91 y old; mean ± SD, 71.5 ± 7.2) with BCR after primary definitive treatment with prostatectomy (n = 42) or radiotherapy (n = 30). The presence of lesions compatible with PC was evaluated by 2 independent readers. Fifty-nine patients had scans concurrent with at least one other conventional scan: bone scanning (24), CT (21), MR (20), ¹⁸F-fluciclovine PET/CT (18), or ¹⁸F-NaF PET (14). Findings from ¹⁸F-DCFPyL PET/CT were compared with those from other modalities. Impact on patient management based on ¹⁸F-DCFPyL PET/CT was recorded from clinical chart review. Results: ¹⁸F-DCFPyL PET/CT had an overall positivity rate of 85%, which increased with higher prostate-specific antigen (PSA) levels (ng/mL): 50% (PSA < 0.5), 69% (0.5 ≤ PSA < 1), 100% (1 ≤ PSA < 2), 91% (2 ≤ PSA < 5), and 96% (PSA ≥ 5). ¹⁸F-DCFPyL PET detected more lesions than conventional imaging. For anatomic imaging, 20 of 41 (49%) CT or MRI scans had findings congruent with ¹⁸F-DCFPyL, whereas ¹⁸F-DCFPyL PET was positive in 17 of 41 (41%) cases with negative CT or MRI findings. For bone imaging, 26 of 38 (68%) bone or ¹⁸F-NaF PET scans were congruent with ¹⁸F-DCFPyL PET, whereas ¹⁸F-DCFPyL PET localized bone lesions in 8 of 38 (21%) patients with negative results on bone or ¹⁸F-NaF PET scans. In 8 of 18 (44%) patients, ¹⁸F-fluciclovine PET had located the same lesions as did ¹⁸F-DCFPyL PET, whereas 5 of 18 (28%) patients with negative ¹⁸F-fluciclovine findings had positive ¹⁸F-DCFPyL PET findings and 1 of 18 (6%) patients with negative ¹⁸F-DCFPyL findings had uptake in the prostate bed on ¹⁸F-fluciclovine PET. In the remaining 4 of 18 (22%) patients, ¹⁸F-DCFPyL and ¹⁸F-fluciclovine scans showed different lesions. Lastly, 43 of 72 (60%) patients had treatment changes after ¹⁸F-DCFPyL PET and, most noticeably, 17 of these patients (24% total) had lesion localization only on ¹⁸F-DCFPyL PET, despite negative results on conventional imaging. Conclusion: ¹⁸F-DCFPyL PET/CT is a promising diagnostic tool in the work-up of biochemically recurrent PC, given the high positivity rate as compared with Food and Drug Administration–approved currently available imaging modalities and its impact on clinical management in 60% of patients.

¹⁸ F-DCFPyL（2-（3- {1-羧基-5-[（6- ¹⁸ F-氟吡啶-3-羰基）-氨基]-戊基}-脲基）-戊二酸）是一种有前途的靶向前列腺的PET放射性药物特异性膜抗原（PSMA）。我们介绍了这项单学术中心前瞻性研究的经验，该研究评估了¹⁸ F-DCFPyL PET / CT在前列腺癌（PC）生化复发（BCR）患者中的阳性率。方法：我们采用前列腺切除术（n = 42）或放疗（n = 42）的72名男性（52-91岁；平均±SD，71.5±7.2）接受BCR。= 30）。由2位独立读者评估与PC相容的病变的存在。59例患者进行了至少与其他常规扫描同时进行的扫描：骨扫描（24），CT（21），MR（20），¹⁸ F-氟西洛芬PET / CT（18）或¹⁸ F-NaF PET（14 ）。将¹⁸ F-DCFPyL PET / CT的结果与其他方法的结果进行了比较。从临床图表审查中记录了基于¹⁸ F-DCFPyL PET / CT对患者管理的影响。结果： ¹⁸ F-DCFPyL PET / CT的总体阳性率为85％，并随着较高的前列腺特异性抗原（PSA）水平（ng / mL）而增加：50％（PSA <0.5），69％（0.5≤PSA） <1），100％（1≤PSA <2），91％（2≤PSA <5）和96％（PSA≥5）。^18岁F-DCFPyL PET检测到的病变比常规成像更多。对于解剖学成像，41例CT或MRI扫描中有20例（49％）与¹⁸ F-DCFPyL一致，而41例CT或MRI阴性的17例（41％）中¹⁸ F-DCFPyL PET阳性。对于骨骼成像，在38例骨骼中有26例（68％）或^18例F-NaF PET扫描与^18例F-DCFPyL PET吻合，而^18例F-DCFPyL PET在38例（21％）患者中有8例局部骨病变，结果阴性。骨骼或¹⁸ F-NaF PET扫描。在18名患者中的8名（44％）中，¹⁸ F-氟氯乙烯PET的病变与¹⁸ F-DCFPyL PET相同，而18名患者中的5名（28％）的¹⁸F-flucloclovine PET检查结果阳性的有¹⁸ F-DCFPyL PET，而¹⁸ F-DCFPyL PET检测结果阴性的^18名患者中的1名（6％）在前列腺床上摄取了¹⁸ F-fluciclovine PET。在18位患者中的其余4位（22％）中，¹⁸ F-DCFPyL和¹⁸ F-flucloclovine扫描显示出不同的病变。最后，在72例（60％）患者中，有43例在进行¹⁸ F-DCFPyL PET手术后发生了治疗变化，最值得注意的是，尽管常规影像学检查结果阴性，但其中17例（占总数的24％）仅在¹⁸ F-DCFPyL PET上发生了病变。结论： ¹⁸F-DCFPyL PET / CT是一种有前途的生化复发PC诊断工具，与食品药品监督管理局批准的目前可用的影像学检查方法相比，其阳性率高，并且对60％的患者的临床治疗有影响。