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Uptake of Prostate-Specific Membrane Antigen–Targeted 18F-DCFPyL in Cerebral Radionecrosis

Implications for Diagnostic Imaging of High-Grade Gliomas

Salas Fragomeni, Roberto A., MD*; Pienta, Kenneth J., MD; Pomper, Martin G., MD, PhD*†; Gorin, Michael A., MD*†; Rowe, Steven P., MD, PhD*†

doi: 10.1097/RLU.0000000000002280
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Recent PET imaging of glioblastoma multiforme and other high-grade gliomas using prostate-specific membrane antigen (PSMA)–targeted small-molecule radiotracers suggests a role for these agents in diagnostic imaging of recurrent/residual tumor and that PSMA-targeted endoradiotherapies may provide a new approach to therapy for patients with these difficult-to-treat tumors. We present a case of cerebral radionecrosis demonstrating PSMA-targeted radiotracer uptake. Our findings may represent a potential pitfall and limitation to the diagnostic application of PSMA-targeted agents for high-grade gliomas.

From the *The Russell H. Morgan Department of Radiology and Radiological Science; and

The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD.

Received for publication July 26, 2018; revision accepted August 8, 2018.

Conflicts of interest and sources of funding: M.G.P. is a 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. M.A.G. has served as a consultant for Progenics Pharmaceuticals, Inc, the licensee of 18F-DCFPyL. All authors have received research funding from Progenics Pharmaceuticals, Inc. Funding was received from the Prostate Cancer Foundation Young Investigator Award and National Institutes of Health grants CA134675, CA184228, EB024495, and CA183031.

Correspondence to: Steven P. Rowe, MD, PhD, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, 600 N Wolfe St, Baltimore, MD 21287. E-mail: srowe8@jhmi.edu.

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