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Prostate-Specific Membrane Antigen–Targeted Imaging With [18F]DCFPyL in High-Grade Gliomas

Salas Fragomeni, Roberto Andres, MD*; Menke, Joshua R., MD; Holdhoff, Matthias, MD, PhD; Ferrigno, Clare, CRNP; Laterra, John Joseph, MD, PhD; Solnes, Lilja B., MD, MBA*; Javadi, Mehrbod S., MD*; Szabo, Zsolt, MD, PhD*; Pomper, Martin G., MD, PhD*‡; Rowe, Steven P., MD, PhD*

doi: 10.1097/RLU.0000000000001769
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High-grade gliomas (World Health Organization grade III–IV) are highly lethal primary brain tumors. Imaging modalities, including MRI and FDG PET, provide a limited ability to differentiate treatment effects (such as radiation necrosis) from recurrent or residual tumor. As the first step in validating the applicability of prostate-specific membrane antigen (PSMA)–targeted imaging in high-grade gliomas, we evaluated the ability of the PSMA-targeted small molecule [18F]DCFPyL (2-(3-(1carboxy-5-(6-[18F]fluoro-pyridine-3-carbonyl)-amino]-pentyl)-ureido)-pentanedioic acid) to image high-grade gliomas in a series of 3 prospectively recruited patients. We found [18F]DCFPyL binds PSMA in the neovasculature of glioblastoma multiforme and tumor cells of anaplastic astrocytoma.

From the *The Russell H. Morgan Department of Radiology and Radiological Science, †Department of Pathology, and ‡Sidney Kimmel Comprehensive Cancer Center Johns Hopkins School of Medicine, Baltimore, MD.

Received for publication January 8, 2017; revision accepted June 16, 2017.

Conflicts of interest and sources of funding: The authors acknowledge the Yousem Family research award, CA134675, CA184288, CA103175, and CA183031 for financial support. M.H. has an uncompensated advisory role with Cavion Pharmaceutical Company (Charlottesville, VA). M.G.P. is the coinventor on a US patent covering 18F-DCFPyL and as such is entitled to a portion of any licensing fees and royalties generated by this technology. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict of interest policies. The other authors have none declared.

Author contributions: R.A.S.F. contributed to drafting and revising the manuscript for content, study concept and design, acquisition and interpretation of data, statistical analysis, and study coordination. J.R.M. participated in revising the manuscript and acquisition and analysis of data. M.H. participated in revising the manuscript, acquisition of data, and study concept. C.F. participated in acquisition of data and study coordination. J.J.L. participated in revising the manuscript, acquisition of data, and study concept. L.B.S. participated in revising the manuscript, acquisition and analysis of data, and study concept. M.S.J. participated in revising the manuscript, acquisition and analysis of data, and study concept. Z.S. participated in revising the manuscript, acquisition and analysis of data, study supervision, and study concept. M.G.P. participated in providing vital reagents and patents, revising the manuscript, acquisition and analysis of data, study supervision, and study concept. S.P.R. contributed to drafting and revising the manuscript for content, study concept and design, acquisition and interpretation of data, and study coordination.

Correspondence to: Martin G. Pomper, MD, PhD, Johns Hopkins School of Medicine, 1550 Orleans St, CRB II 492, Baltimore, MD 21287. E-mail: mpomper@jhmi.edu; or Steven P. Rowe, MD, PhD, Johns Hopkins School of Medicine, 600 N Wolfe St, Baltimore, MD 21287. E-mail: srowe8@jhmi.edu.

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