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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

Wondergem, Maurits; van der Zant, Friso M.; Rafimanesh-Sadr, Ladan; Knol, Remco J.J.

Nuclear Medicine Communications: June 2019 - Volume 40 - Issue 6 - p 652–656
doi: 10.1097/MNM.0000000000001007

Forced diuresis may improve readability of 2-(3-(1-carboxy-5-[(6-[18F]fluoro-pyridine-3-carbonyl)-amino]-pentyl)-ureido)-pentanedioic acid (18F-DCFPyL) PET/computed tomography (CT) by reducing focal ureteral activity. A total of 40 patients received furosemide simultaneously with 18F-DCFPyL (cohort 1) and 40 patients received furosemide 85 min after 18F-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 18F-DCFPyL uptake in kidneys and bladder. At 120 min after injection of 18F-DCFPyL, a significantly lower number of 18F-DCFPyL depositions in ureters was found in cohort 2. Moreover, 18F-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 18F-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 18F-DCFPyL administration and PET/CT acquisition time. Acquisition of PET-images 120 min after 18F-DCFPyL administration benefits from late furosemide administration (85 min after injection).

Department of Nuclear Medicine, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands

Correspondence to Maurits Wondergem, MD, PhD, NWZ, Wilhelminalaan 12, 1815 JD, 0030, The Netherlands Tel: +31 725 483 480; fax: +31 725 483 484; e-mail:

Received October 22, 2018

Received in revised form February 5, 2019

Accepted February 14, 2019

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