[18]F-Fluoride Positron Emission Tomographic Imaging of Penile Arteries and Erectile Dysfunction.
J Am Coll Cardiol. 2019 Apr 02; 73(12):1386-1394.JACC

Abstract

BACKGROUND

Fluorine-18 sodium fluoride (NaF), a bone-seeking radiopharmaceutical used to detect osseous metastases, localizes in regions of microcalcification in atherosclerosis.

OBJECTIVES

To determine if atherosclerosis of penile arteries plays a role in erectile dysfunction (ED), this study analyzed NaF images in prostate cancer patients.

METHODS

NaF positron emission tomography-computed tomography bone scans were evaluated in 437 prostate cancer patients (age 66.6 ± 8.7 years). Their urologic histories were reviewed for prevalent ED (diagnosed before the scan date) or incident ED (no ED at first scan, but developed during 1-year follow-up); patients with no ED (neither before the scan nor during follow-up) were included as a control group. A semicircular region of interest was set on the dorsal one-half of the penis (to avoid residual excreted activity in the urethra) on 5 contiguous slices at the base of the penis on positron emission tomography-computed tomography coronal reconstructions, and the average standardized uptake value (SUVmax) was described as NaF uptake.

RESULTS

Of 437 patients, 336 (76.9%) had prevalent ED, 60 incident ED (13.7%), and 41 had no ED (9.4%). SUVmax in patients with prevalent (median 1.88; interquartile range [IQR]: 1.67 to 2.16) or incident (median 1.86; IQR: 1.72 to 2.08) ED was significantly higher than no ED (median 1.42; IQR: 1.25 to 1.54) patients (p < 0.001). After adjustment for other risk factors, the odds ratio of prevalent or incident ED was 25.2 (95% confidence interval: 9.5 to 67.0) for every 0.5-U increment in SUVmax with receptor operating characteristic area of 0.91 (95% confidence interval: 0.88 to 0.94).

CONCLUSIONS

NaF uptake in penile vessels suggests that atherosclerosis is associated with ED in prostate cancer patients. The importance of NaF uptake needs to be tested in noncancer subjects and cause-effect relationship needs to be established.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Nakahara T

Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, New York; Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Diagnostic Radiology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.

Narula J

Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: narula@mountsinai.org.

Tijssen JGP

Department of Cardiology, Academic Medical Center-University of Amsterdam, Amsterdam, the Netherlands.

Agarwal S

Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, New York.

Chowdhury MM

Department of Vascular Surgery, University of Cambridge, Cambridge, United Kingdom.

Coughlin PA

Department of Vascular Surgery, University of Cambridge, Cambridge, United Kingdom.

Dweck MR

BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom.

Rudd JHF

Division of Cardiovascular Medicine, University of Cambridge, Cambridge, United Kingdom.

Jinzaki M

Department of Diagnostic Radiology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.

Mulhall J

Sexual and Reproductive Medicine Program, Memorial Sloan Kettering Cancer Center, New York, New York.

Strauss HW

MeSH

AgedErectile DysfunctionFluorine RadioisotopesHumansMaleMiddle AgedPenisPositron Emission Tomography Computed TomographyRetrospective StudiesSodium Fluoride

Pub Type(s)

Journal Article

Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30846336

Citation

Nakahara, Takehiro, et al. "[18]F-Fluoride Positron Emission Tomographic Imaging of Penile Arteries and Erectile Dysfunction." Journal of the American College of Cardiology, vol. 73, no. 12, 2019, pp. 1386-1394.

Nakahara T, Narula J, Tijssen JGP, et al. [18]F-Fluoride Positron Emission Tomographic Imaging of Penile Arteries and Erectile Dysfunction. J Am Coll Cardiol. 2019;73(12):1386-1394.

Nakahara, T., Narula, J., Tijssen, J. G. P., Agarwal, S., Chowdhury, M. M., Coughlin, P. A., Dweck, M. R., Rudd, J. H. F., Jinzaki, M., Mulhall, J., & Strauss, H. W. (2019). [18]F-Fluoride Positron Emission Tomographic Imaging of Penile Arteries and Erectile Dysfunction. Journal of the American College of Cardiology, 73(12), 1386-1394. https://doi.org/10.1016/j.jacc.2018.10.076

Nakahara T, et al. [18]F-Fluoride Positron Emission Tomographic Imaging of Penile Arteries and Erectile Dysfunction. J Am Coll Cardiol. 2019 04 2;73(12):1386-1394. PubMed PMID: 30846336.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - [18]F-Fluoride Positron Emission Tomographic Imaging of Penile Arteries and Erectile Dysfunction. AU - Nakahara,Takehiro, AU - Narula,Jagat, AU - Tijssen,Jan G P, AU - Agarwal,Sunil, AU - Chowdhury,Mohammed M, AU - Coughlin,Patrick A, AU - Dweck,Marc R, AU - Rudd,James H F, AU - Jinzaki,Masahiro, AU - Mulhall,John, AU - Strauss,H William, Y1 - 2019/03/04/ PY - 2018/05/16/received PY - 2018/09/19/revised PY - 2018/10/18/accepted PY - 2019/3/9/pubmed PY - 2020/2/23/medline PY - 2019/3/9/entrez KW - NaF KW - atherosclerosis KW - calcification KW - erectile dysfunction KW - sodium fluoride SP - 1386 EP - 1394 JF - Journal of the American College of Cardiology JO - J Am Coll Cardiol VL - 73 IS - 12 N2 - BACKGROUND: Fluorine-18 sodium fluoride (NaF), a bone-seeking radiopharmaceutical used to detect osseous metastases, localizes in regions of microcalcification in atherosclerosis. OBJECTIVES: To determine if atherosclerosis of penile arteries plays a role in erectile dysfunction (ED), this study analyzed NaF images in prostate cancer patients. METHODS: NaF positron emission tomography-computed tomography bone scans were evaluated in 437 prostate cancer patients (age 66.6 ± 8.7 years). Their urologic histories were reviewed for prevalent ED (diagnosed before the scan date) or incident ED (no ED at first scan, but developed during 1-year follow-up); patients with no ED (neither before the scan nor during follow-up) were included as a control group. A semicircular region of interest was set on the dorsal one-half of the penis (to avoid residual excreted activity in the urethra) on 5 contiguous slices at the base of the penis on positron emission tomography-computed tomography coronal reconstructions, and the average standardized uptake value (SUVmax) was described as NaF uptake. RESULTS: Of 437 patients, 336 (76.9%) had prevalent ED, 60 incident ED (13.7%), and 41 had no ED (9.4%). SUVmax in patients with prevalent (median 1.88; interquartile range [IQR]: 1.67 to 2.16) or incident (median 1.86; IQR: 1.72 to 2.08) ED was significantly higher than no ED (median 1.42; IQR: 1.25 to 1.54) patients (p < 0.001). After adjustment for other risk factors, the odds ratio of prevalent or incident ED was 25.2 (95% confidence interval: 9.5 to 67.0) for every 0.5-U increment in SUVmax with receptor operating characteristic area of 0.91 (95% confidence interval: 0.88 to 0.94). CONCLUSIONS: NaF uptake in penile vessels suggests that atherosclerosis is associated with ED in prostate cancer patients. The importance of NaF uptake needs to be tested in noncancer subjects and cause-effect relationship needs to be established. SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/30846336/full_citation DB - PRIME DP - Unbound Medicine ER -

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[18]F-Fluoride Positron Emission Tomographic Imaging of Penile Arteries and Erectile Dysfunction.J Am Coll Cardiol. 2019 Apr 02; 73(12):1386-1394.JACC