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Digital Trial Lecture - time and place
Adjudication committee
- First opponent: Associate Professor Ivan Jambor, University of Turku, Finland
- Second opponent: Professor Live Eikenes, Norwegian University of Science and Technology, Trondheim
- Third member and chair of the evaluation committee: Associate Professor Stig Müller, Institute of Clinical Medicine, University of Oslo
Chair of defence
Associate Professor Gunnar Sandbæk, Institute of Clinical Medicine, University of Oslo
Principal supervisor
Therese Seierstad, Oslo University Hospital
Summary
Multiparametric magnetic resonance imaging (mpMRI) and positron emission tomography (PET) is increasingly used for the management of prostate cancer. This thesis investigated the use of FACBC PET/CT (anti-1-amino-2-[18F]fluorocyclobutane-1-carboxylic acid positron emission tomography/computed tomography) for assessment of primary and recurrent prostate cancer.
In Paper I we explored the molecular uptake mechanism of FACBC by comparing the uptake of FACBC in prostate tumours at PET, and the gene- and protein expression of several amino acid transporters in tissue biopsies from these tumours. We found that the uptake of FACBC into prostate cancer cells is complex and not likely mediated by a few specific amino acid transporters as proposed in earlier preclinical studies. We also found that high FACBC uptake reflects high metabolism and cell growth.
In Paper II we compared dynamic FACBC PET and dynamic contrast enhanced (DCE) MRI for the assessment of vascularization in primary prostate tumours. We found that the two modalities provided similar information in the initial perfusion phase (0-1.5 minutes), but different information thereafter: FACBC were contained within the tumor tissue, as opposed to the MRI contrast agent that was removed.
In Papers III and IV we compared the performance of FACBC PET and mpMRI, in two clinical studies, to localize and define the extent of the index tumour in patients with primary prostate cancer prior to surgery, and to localize radio-recurrences within the prostate prior to salvage brachytherapy. Histopathology was used as reference standard. We found that FACBC PET had high specificity but limited sensitivity to detect the index tumour. We also found that mpMRI was better than FACBC PET and that dynamic acquisition did not improve the ability of FACBC PET to define the extent of the index tumour. FACBC PET detected fewer radio-recurrences within the prostate than mpMRI.
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