Predictive value of metastatic distribution patterns on [⁶⁸Ga]Ga-PSMA PET/CT for [¹⁷⁷Lu]Lu-PSMA therapy.

Revista espanola de medicina nuclear e imagen molecular Pub Date : 2025-09-01 DOI:10.1016/j.remnie.2025.500205

Y B Cayirli, U Elboga, I Dogan

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引用次数: 0

Abstract

Objective: This study aimed to assess the predictive value of metastatic distribution patterns on ⁶⁸Ga-PSMA-11 PET/CT in patients with chemotherapy- and castration-resistant prostate cancer undergoing ¹⁷⁷Lu-PSMA-617 radioligand therapy.

Materials and methods: A retrospective analysis was conducted on 48 patients who received ¹⁷⁷Lu-PSMA-617 therapy between April 2019 and August 2023. Demographic, clinical, and laboratory data, along with pre- and post-treatment ⁶⁸Ga-PSMA-11 PET/CT images, were evaluated for associations with molecular response and progression. Whole-body PET/CT segmentation was performed using METAVOL software. Treatment response was classified using RECIP 1.0 criteria, and predictive values were analyzed using SPSS 22.0, with statistical significance set at p < 0.05.

Results: Based on RECIP 1.0 criteria, 58.3% (n = 28) responded to therapy, while 41.7% (n = 20) did not. Disease progression was observed in 29.2% (n = 14), and 70.8% (n = 34) showed no progression. Molecular response was significantly associated with parotid SUVmean (OR = 1.137, p = 0.047) and highest miM1 stage (OR = 0.241, p = 0.046). Molecular progression was significantly associated with lymph node metastasis (OR = 0.144, p = 0.006), bone-only metastasis (OR = 4.333, p = 0.030), ln/metTL-PSMA ratio (OR = 0.070, p = 0.042), b/metTL-PSMA ratio (OR = 13.085, p = 0.040), and TL-PSMA-based lymph node dominance over bone metastases (OR = 0.385, p = 0.044).

Conclusion: This study highlights the predictive value of metastatic burden distribution on ⁶⁸Ga-PSMA PET/CT in determining treatment outcomes of ¹⁷⁷Lu-PSMA therapy.

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[68Ga]Ga-PSMA PET/CT转移分布模式对[177Lu]Lu-PSMA治疗的预测价值

目的：本研究旨在评估68Ga-PSMA-11 PET/CT在接受¹⁷Lu-PSMA-617放射配体治疗的化疗和去势抵抗性前列腺癌患者转移分布模式的预测价值。材料和方法：对2019年4月至2023年8月期间接受¹⁷Lu-PSMA-617治疗的48例患者进行回顾性分析。人口统计学、临床和实验室数据，以及治疗前后的68Ga-PSMA-11 PET/CT图像，评估与分子反应和进展的关系。使用METAVOL软件进行全身PET/CT分割。采用RECIP 1.0标准对治疗反应进行分类，并采用SPSS 22.0软件对预测值进行分析，差异有统计学意义(p)。结果：根据RECIP 1.0标准，58.3% （n = 28）患者对治疗有反应，41.7% （n = 20）患者对治疗无反应。29.2% （n = 14）患者出现疾病进展，70.8% （n = 34）患者无进展。分子反应与腮腺SUVmean （OR = 1.137, p = 0.047）和最高miM1分期（OR = 0.241, p = 0.046）显著相关。分子进展与淋巴结转移（OR = 0.144, p = 0.006）、骨转移（OR = 4.333, p = 0.030）、ln/metTL-PSMA比值（OR = 0.070, p = 0.042）、b/metTL-PSMA比值（OR = 13.085, p = 0.040）、tl - psma为基础的淋巴结优于骨转移（OR = 0.385, p = 0.044）显著相关。结论：该研究强调了68Ga-PSMA PET/CT转移负担分布在决定¹⁷Lu-PSMA治疗结果中的预测价值。

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Revista espanola de medicina nuclear e imagen molecular

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