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Cited by 14Radiopharmaceutical Chemistry and ApplicationsMedical Imaging Techniques and ApplicationsProstate Cancer Diagnosis and Treatment

The role of Ga68 PSMA PET/CT imaging in Lu177 PSMA treatment planning in metastatic castration-resistant prostate cancer

Erdogan, Mehmet, Sengul, Sevim S., Cetin, Bulent, Avcı, Mustafa, Yagci, Samet, Ozkoç, Ismail, Barikan, Damla Ezgi, Yildiz, Mustafa·2022·Annals of Nuclear Medicine
DOI 10.1007/s12149-022-01739-3
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Abstract

Objective Lutetium-177 (Lu 177) prostate-specific membrane antigen (Lu 177 PSMA) is a novel targeted treatment for patients with metastatic castration-resistant prostate cancer (CRPC). The purpose of the study was to determine the molecular volumetric Gallium-68 (Ga 68) PSMA PET/CT parameters that can predict patients who will respond to treatment.Methods These single-center retrospective data were obtained from metastatic CRPC patients receiving intravenous 6.0-8.5 GBq Lu 177 PSMA treatment every 6-8 weeks for a maximum of 3-8 cycles, with baseline Ga 68 PSMA PET/CT scan, clinical data, and information on treatment responses. All lesions were divided into two groups according to the increase and decrease in PSMA expression levels of 600 bone lesions and 85 lymph nodes that were compatible with metastasis of 23 patients after the treatment. The primary endpoint of our study was the evaluation of the relation between the baseline SUVmax, PSMA TV, TL PSMA values, and the treatment response of the two groups. The threshold values were determined for the parameters that had significant relations. In the present study, the prostate-specific antigen (PSA) response and treatment-induced toxicities were also evaluated as the secondary endpoint.Results It was found that SUVmax, PSMA TV, and TL PSMA values in bone metastases showed significant differences between the groups with decreased and increased PSMA expression levels after the treatment. The AUC value for SUVmax was significant (AUC = 0.677; p < 0.001). The cutoff value was > 10.50 (sensitivity = 91.8%, Specificity = 41.5%) for SUVmax, > 1.50 cm 3 (sensitivity = 49.1%, specificity = 70%) for PSMA TV and > 8.50 g (sensitivity = %60.9, specificity = %72.2) for TL PSMA. The median SUVmax value before the treatment in all metastatic lymph nodes was found to be 7.1 (5.4-12.4), and the median SUVmax after the treatment was 2.5 (1.6-12.1) (p < 0.001).Conclusion It was shown in the present study that Lu 177 PSMA treatment response may be higher in CRPC patients with metastatic bone lesion with high baseline PSMA expression level, and better treatment response may be achieved in patients with lymph node metastases than in bone metastases.

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Authors
Erdogan, M., Sengul, S. S., Cetin, B., Avcı, M., Yagci, S., Ozkoç, I., Barikan, D. E., & Yildiz, M.
Affiliations
Süleyman Demirel Üniversitesi (TR)
Corresponding author
Erdogan, Mehmet
ORCID
Venue
Annals of Nuclear Medicine
Publisher
Springer Science and Business Media LLC
Published
2022-04-09
Volume
36
Issue
6
Pages
562-569
ISSN
  • 0914-7187 (ISSN-L)
  • 1864-6433
DOI
10.1007/s12149-022-01739-3
OpenAlex
W4223602018
Cited by
14
References
24
Citations by year
2026: 3 · 2025: 3 · 2024: 2 · 2023: 5 · 2022: 1
FWCI
1.56
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Annals of Nuclear Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiopharmaceutical Chemistry and Applications
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Diagnosis and Treatment
Keywords
metastatic castration-resistant prostate cancer, treatment response prediction, SUVmax, PSMA expression, bone metastasis, lymph node metastasis, PSA response, treatment toxicity, predictive biomarkers, PSMA-targeted therapy, treatment planning
MeSH terms
Positron Emission Tomography Computed Tomography, Bone Neoplasms, Gallium Radioisotopes, Heterocyclic Compounds, 1-Ring, Humans, Lutetium, Lymphatic Metastasis, Male, Retrospective Studies, Treatment Outcome, Prostate-Specific Antigen, Prostatic Neoplasms, Castration-Resistant

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