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.
| Original language | English |
|---|---|
| Pages (from-to) | 1386-1394 |
| Number of pages | 9 |
| Journal | Journal of the American College of Cardiology |
| Volume | 73 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - 2019 Apr 2 |
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Keywords
- atherosclerosis
- calcification
- erectile dysfunction
- NaF
- sodium fluoride
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
18 F-Fluoride Positron Emission Tomographic Imaging of Penile Arteries and Erectile Dysfunction . / Nakahara, Takehiro; Narula, Jagat; Tijssen, Jan G.P.; Agarwal, Sunil; Chowdhury, Mohammed M.; Coughlin, Patrick A.; Dweck, Marc R.; Rudd, James H.F.; Jinzaki, Masahiro; Mulhall, John; Strauss, H. William.
In: Journal of the American College of Cardiology, Vol. 73, No. 12, 02.04.2019, p. 1386-1394.Research output: Contribution to journal › Article
}
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
PY - 2019/4/2
Y1 - 2019/4/2
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.
AB - 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.
KW - atherosclerosis
KW - calcification
KW - erectile dysfunction
KW - NaF
KW - sodium fluoride
UR - http://www.scopus.com/inward/record.url?scp=85063097302&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85063097302&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2018.10.076
DO - 10.1016/j.jacc.2018.10.076
M3 - Article
VL - 73
SP - 1386
EP - 1394
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 12
ER -