Clinical impact of changes in tumor uptake on PSMA-PET/CT during [177Lu]Lu-PSMA in metastatic castration-resistant prostate cancer

IF 0.2 4区医学 Q4 PATHOLOGY

Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique Pub Date : 2025-03-01 DOI:10.1016/j.mednuc.2025.01.164

L. Djaileb , F. Andrea , I.I. Rauscher , W.P. Fendler , B. Hadaschik , K. Herrmann , L.B. Solnes , M.R. Benz , E. Matthias , A. Gafita

{"title":"Clinical impact of changes in tumor uptake on PSMA-PET/CT during [177Lu]Lu-PSMA in metastatic castration-resistant prostate cancer","authors":"L. Djaileb , F. Andrea , I.I. Rauscher , W.P. Fendler , B. Hadaschik , K. Herrmann , L.B. Solnes , M.R. Benz , E. Matthias , A. Gafita","doi":"10.1016/j.mednuc.2025.01.164","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>To investigate the prognostic value of changes in tumor uptake on PSMA-PET/CT during [177Lu]Lu-PSMA (Lu-PSMA) radioligand therapy in metastatic castration-resistant prostate cancer.</div></div><div><h3>Method</h3><div>This multicenter retrospective study included men who received Lu-PSMA between 2014 and 2019. PSMA PET/CT images performed at baseline and after 2 cycles were evaluated by nuclear medicine specialists for changes in tumor SUVmax at a region-based level and occurrence of new lesions (NL). Whole-body tumor SUVmax, SUVmean, and total tumor volume (ΔTTV) were calculated using qPSMA software. Region-based analysis was stratified as bone, lymph node and visceral disease. Primary outcomes were the associations of ΔSUVmax, ΔSUVmean, ΔTTV, and NL with PSA progression-free survival (PSA-PFS) and overall survival (OS).</div></div><div><h3>Results</h3><div>124 men (median age, 73 years [IQR, 67–76 years]) were included. ΔTTV and NL were significantly associated with PSA-PFS (<em>P</em>  <0.001). In patient-based analysis, ΔSUVmax and ΔSUVmean,were not associated with outcome. In region-based analysis, only ΔSUVmax in visceral lesion was significantly associated with PSA-PFS (<em>P</em>  <!-->0.007) but not with OS.</div></div><div><h3>Conclusion</h3><div>ΔTTV and NL provide significant prognostic value and should be considered when evaluating treatment response. In contrast, changes in tumor uptake on interim PSMA-PET imaging during 177Lu-PSMA radioligand therapy were not associated with survival outcome.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 2","pages":"Page 100"},"PeriodicalIF":0.2000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0928125825001640","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PATHOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

To investigate the prognostic value of changes in tumor uptake on PSMA-PET/CT during [177Lu]Lu-PSMA (Lu-PSMA) radioligand therapy in metastatic castration-resistant prostate cancer.

Method

This multicenter retrospective study included men who received Lu-PSMA between 2014 and 2019. PSMA PET/CT images performed at baseline and after 2 cycles were evaluated by nuclear medicine specialists for changes in tumor SUVmax at a region-based level and occurrence of new lesions (NL). Whole-body tumor SUVmax, SUVmean, and total tumor volume (ΔTTV) were calculated using qPSMA software. Region-based analysis was stratified as bone, lymph node and visceral disease. Primary outcomes were the associations of ΔSUVmax, ΔSUVmean, ΔTTV, and NL with PSA progression-free survival (PSA-PFS) and overall survival (OS).

Results

124 men (median age, 73 years [IQR, 67–76 years]) were included. ΔTTV and NL were significantly associated with PSA-PFS (P < 0.001) and OS (P < 0.001). In patient-based analysis, ΔSUVmax and ΔSUVmean,were not associated with outcome. In region-based analysis, only ΔSUVmax in visceral lesion was significantly associated with PSA-PFS (P = 0.007) but not with OS.

Conclusion

ΔTTV and NL provide significant prognostic value and should be considered when evaluating treatment response. In contrast, changes in tumor uptake on interim PSMA-PET imaging during 177Lu-PSMA radioligand therapy were not associated with survival outcome.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique PATHOLOGY-

CiteScore

0.30

自引率

0.00%

发文量

160

审稿时长

19.8 weeks

期刊介绍： Le but de Médecine nucléaire - Imagerie fonctionnelle et métabolique est de fournir une plate-forme d''échange d''informations cliniques et scientifiques pour la communauté francophone de médecine nucléaire, et de constituer une expérience pédagogique de la rédaction médicale en conformité avec les normes internationales.