{"doi":"10.2967/jnumed.121.262347","title":"Predictors of <sup>18</sup>F-DCFPyL PET/CT Positivity in Patients with Biochemical Recurrence of Prostate Cancer After Local Therapy","abstract":"<b>Purpose:</b> To investigate the factors predicting scan positivity and disease location in patients with biochemical relapse (BCR) prostate cancer (PCa) after primary local therapy using prostate-specific membrane antigen (PSMA)-targeted <sup>18</sup>F-DCFPyL-PET/CT. <b>Methods:</b> This is a two-institution study including 245 BCR PCa patients after primary local therapy and negative conventional imaging. Patients underwent <sup>18</sup>F-DCFPyL-PET/CT. Lesion detection rate and disease location were correlated with patient’s tumor characteristics, time from the initial therapy, prostate-specific-antigen (PSA) and PSA doubling time (PSAdt). Multivariate logistic regression analyses were used to determine predictors of a positive scan. Regression-based coefficients were used to develop nomograms predicting scan positivity and extra-pelvic disease. <b>Results:</b> Overall, 79.2% (194/245) of patients had a positive <sup>18</sup>F-DCFPyL-PET/CT, with detection rates of 48.2% (27/56), 74.3% (26/35), 84% (37/44), 96.7% (59/61) and 91.8% (45/49) for PSA &lt;0.5, 0.5 to &lt;1.0, 1.0 to &lt;2.0, 2.0 to &lt;5.0 and ≥5.0 ng/mL, respectively. Patients with lesions confined to the pelvis had lower PSAs than those with distant sites (1.6±3.5 vs. 3.0±6.3 ng/mL, p&lt;0.001). In patients treated with prostatectomy (<i>n</i> = 195), 24.1% (47/195) had a negative scan, 46.1% (90/195) showed intra-pelvic disease and 29.7% (58/195) extra-pelvic disease. In the post-radiation subgroup (<i>n</i> = 50), <sup>18</sup>F-DCFPyL-PET/CTs were always negative at PSA lower than 1.0 ng/mL and extra-pelvic disease was seen only when PSA &gt;2.0 ng/mL. At multivariate analysis, PSA, PSAdt were independent predictive factors of scan positivity and the presence of extra-pelvic disease in post-surgical patients, with area under the curve (AUC) of 78% and 76%, respectively. PSA and PSAdt were independent predictors of the presence of extra-pelvic disease in the post-radiation cohort, with AUC of 85%. Time from treatment to scan was significantly longer for prostatectomy-bed-only recurrences than for those with bone or visceral disease (6.2±6.4 vs. 2.4±1.3 years, p&lt;0.001). <b>Conclusion:</b><sup>18</sup>F-DCFPyL-PET/CT offers high detection rates in BCR PCa patients. PSA and PSAdt are able to predict scan positivity and disease location. Furthermore, the presence of bone/visceral lesions are associated with shorter intervals from treatment compared to prostate-bed-only recurrences. These tools might guide clinicians to select the most suitable candidates for <sup>18</sup>F-DCFPyL-PET/CT imaging.","journal":"Journal of Nuclear Medicine","year":2021,"id":187103,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":19,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9367,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":267038,"name":"Steven P. Rowe","orcid":"0000-0003-2897-4694","position":1,"is_corresponding":false},{"id":89257,"name":"Joanna H. Shih","orcid":"0000-0001-9815-3651","position":2,"is_corresponding":false},{"id":289934,"name":"Liza Lindenberg","orcid":"0000-0002-8514-0648","position":3,"is_corresponding":false},{"id":110339,"name":"Barış Türkbey","orcid":"0000-0003-0853-6494","position":4,"is_corresponding":false},{"id":746058,"name":"Aloÿse Fourquet","orcid":"0000-0002-9013-5085","position":5,"is_corresponding":false},{"id":464208,"name":"Frank I. Lin","orcid":"0000-0003-3539-1454","position":6,"is_corresponding":false},{"id":342837,"name":"Stephen Adler","orcid":"0000-0002-4399-6923","position":7,"is_corresponding":false},{"id":464209,"name":"Philip Eclarinal","orcid":"0000-0002-3115-7495","position":8,"is_corresponding":false},{"id":464855,"name":"Yolanda McKinney","orcid":null,"position":9,"is_corresponding":false},{"id":281159,"name":"Deborah E. Citrin","orcid":"0000-0002-4391-2734","position":10,"is_corresponding":false},{"id":263633,"name":"William L. Dahut","orcid":"0000-0002-2766-9703","position":11,"is_corresponding":false},{"id":110338,"name":"Bradford J. Wood","orcid":"0000-0002-4297-0051","position":12,"is_corresponding":false},{"id":464210,"name":"Richard Chang","orcid":"0000-0002-8265-5064","position":13,"is_corresponding":false},{"id":464856,"name":"Elliot Levy","orcid":null,"position":14,"is_corresponding":false},{"id":218403,"name":"Maria J. Merino","orcid":"0000-0003-2098-8426","position":15,"is_corresponding":false},{"id":267828,"name":"Michael A. Gorin","orcid":"0000-0002-8315-6603","position":16,"is_corresponding":false},{"id":7932,"name":"Martin G. Pomper","orcid":"0000-0001-6753-3010","position":17,"is_corresponding":false},{"id":69965,"name":"Peter A. Pinto","orcid":"0000-0002-0190-5931","position":18,"is_corresponding":false},{"id":464857,"name":"Janet F. Eary","orcid":null,"position":19,"is_corresponding":false},{"id":110328,"name":"Peter L. Choyke","orcid":"0000-0003-1086-8826","position":20,"is_corresponding":false},{"id":64727,"name":"Kenneth J. Pienta","orcid":"0000-0002-4138-2186","position":21,"is_corresponding":false},{"id":403782,"name":"Esther Mena","orcid":"0000-0003-0015-0597","position":0,"is_corresponding":true}],"reference_count":31,"raw_metadata":null,"created_at":"2026-07-18T23:48:51.315888Z","pmid":"34916246","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}