EJNMMI Research最新文献

{"title":"An automated pheochromocytoma and paraganglioma lesion segmentation AI-model at whole-body ⁶⁸Ga- DOTATATE PET/CT.","authors":"Fahmida Haque, Jorge A Carrasquillo, Evrim B Turkbey, Esther Mena, Liza Lindenberg, Philip C Eclarinal, Naris Nilubol, Peter L Choyke, Charalampos S Floudas, Frank I Lin, Baris Turkbey, Stephanie A Harmon","doi":"10.1186/s13550-024-01168-5","DOIUrl":"10.1186/s13550-024-01168-5","url":null,"abstract":"<p><strong>Background: </strong>Somatostatin receptor (SSR) targeting radiotracer ⁶⁸Ga-DOTATATE is used for Positron Emission Tomography (PET)/Computed Tomography (CT) imaging to assess patients with Pheochromocytoma and paraganglioma (PPGL), rare types of Neuroendocrine tumor (NET) which can metastasize thereby becoming difficult to quantify. The goal of this study is to develop an artificial intelligence (AI) model for automated lesion segmentation on whole-body 3D DOTATATE-PET/CT and to automate the tumor burden calculation. 132 ⁶⁸Ga-DOTATATE PET/CT scans from 38 patients with metastatic and inoperable PPGL, were split into 70, and 62 scans, from 20, and 18 patients for training, and test sets, respectively. The training set was further divided into patient-stratified 5 folds for cross-validation. 3D-full resolution nnUNet configuration was trained with 5-fold cross-validation. The model's detection performance was evaluated at both scan and lesion levels for the PPGL test set and two other clinical cohorts with NET (n = 9) and olfactory neuroblastoma (ONB, n = 5). Additionally, quantitative statistical analysis of PET parameters including SUVmax, total lesion uptake (TLU), and total tumor volume (TTV), was conducted.</p><p><strong>Results: </strong>The nnUNet AI model achieved an average 5-fold validation dice similarity coefficient of 0.84 at the scan level. The model achieved dice similarity coefficients (DSC) of 0.88, 0.6, and 0.67 at the scan level, the sensitivity of 86%, 61.13%, and 61.64%, and a positive predictive value of 89%, 74%, and 86.54% at the lesion level for the PPGL test, NET and ONB cohorts, respectively. For PPGL cohorts, smaller lesions with low uptake were missed by the AI model (p < 0.001). Anatomical region-based failure analysis showed most of the false negative and false positive lesions within the liver for all the cohorts, mainly due to the high physiologic liver background activity and image noise on ⁶⁸Ga- DOTATATE PET scans.</p><p><strong>Conclusions: </strong>The developed deep learning-based AI model showed reliable performance for automated segmentation of metastatic PPGL lesions on whole-body ⁶⁸Ga-DOTATATE-PET/CT images, which may be beneficial for tumor burden estimation for objective evaluation during therapy follow-up. https://www.</p><p><strong>Clinicaltrials: </strong>gov/study/NCT03206060 , https://www.</p><p><strong>Clinicaltrials: </strong>gov/study/NCT04086485 , https://www.</p><p><strong>Clinicaltrials: </strong>gov/study/NCT05012098 .</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Diagnostic and evaluative efficiency of ⁶⁸Ga-FAPI-04 in skeletal muscle injury.","authors":"Yiqun Wang, La Li, Hongde Wang, Jin Cheng, Cancan Du, Luzheng Xu, Yifei Fan, Xiaoqing Hu, Yu Yin, Ruimin Wang, Yingfang Ao","doi":"10.1186/s13550-024-01166-7","DOIUrl":"10.1186/s13550-024-01166-7","url":null,"abstract":"","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Localized FDG loss in lung cancer lesions.","authors":"Davide Parodi, Edoardo Dighero, Giorgia Biddau, Francesca D'Amico, Matteo Bauckneht, Cecilia Marini, Sara Garbarino, Cristina Campi, Michele Piana, Gianmario Sambuceti","doi":"10.1186/s13550-024-01161-y","DOIUrl":"10.1186/s13550-024-01161-y","url":null,"abstract":"<p><strong>Background: </strong>Analysis of [18F]-Fluorodeoxyglucose (FDG) kinetics in cancer has been most often limited to the evaluation of the average uptake over relatively large volumes. Nevertheless, tumor lesions also contain inflammatory infiltrates whose cells are characterized by a significant radioactivity washout due to the hydrolysis of FDG-6P catalyzed by glucose-6P phosphatase. The present study aimed to verify whether voxel-wise compartmental analysis of dynamic imaging can identify tumor regions characterized by tracer washout. The study included 11 patients with lung cancer submitted to PET/CT imaging for staging purposes. Tumour was defined by drawing a volume of interest loosely surrounding the lesion and considering all inside voxels with a standardized uptake value (SUV) > 40% of the maximum. Eight whole-body scans were repeated after 20 min of dynamic imaging centered on the heart. Six parametric maps were generated progressively by computing a Patlak regression line for each voxel. Each analysis considered a different set of frames: starting with all eight frames, then the last seven frames, and so on, down to the last three frames.</p><p><strong>Results: </strong>Delaying the starting point of the compartmental analysis revealed a progressive increase in the prevalence of voxels with a negative slope. In the most delayed parametric map, these voxels represented 0.5-4.5% (median 2%) of the tumor volume. This effect was independent of tumor size and was predominantly located at the lesion borders.</p><p><strong>Conclusions: </strong>The voxel-wise parametric maps provided by compartmental analysis identify a measurable volume characterized by radioactivity washout. The spatial localization of this pattern is compatible with the recognized preferential site of inflammatory infiltrates populating the tumor stroma and might improve the power of FDG imaging in monitoring the effectiveness of treatments aimed at empowering the host immune response against cancer.</p><p><strong>Trial registration: </strong>ClinicalTrials. The study was approved by the local ethical committee and it represented a single Institution ancillary trial within the expanded-access program for Nivolumab. NCT02475382. Registered 2015-06-16. URL: https://clinicaltrials.gov/study/NCT02475382?id=NCT02475382.&rank=1.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective phase II trial of [⁶⁸Ga]Ga-NOTA-AE105 uPAR-PET/MRI in patients with primary gliomas: Prognostic value and Implications for uPAR-targeted Radionuclide Therapy.","authors":"Aleena Azam, Sorel Kurbegovic, Esben Andreas Carlsen, Thomas Lund Andersen, Vibeke André Larsen, Ian Law, Jane Skjøth-Rasmussen, Andreas Kjaer","doi":"10.1186/s13550-024-01164-9","DOIUrl":"10.1186/s13550-024-01164-9","url":null,"abstract":"<p><strong>Background: </strong>Treatment of patients with low-grade and high-grade gliomas is highly variable due to the large difference in survival expectancy. New non-invasive tools are needed for risk stratification prior to treatment. The urokinase plasminogen activator receptor (uPAR) is expressed in several cancers, associated with poor prognosis and may be non-invasively imaged using uPAR-PET. We aimed to investigate the uptake of the uPAR-PET tracer [⁶⁸Ga]Ga-NOTA-AE105 in primary gliomas and establish its prognostic value regarding overall survival (OS), and progression-free survival (PFS). Additionally, we analyzed the proportion of uPAR-PET positive tumors to estimate the potential number of candidates for future uPAR-PRRT.</p><p><strong>Methods: </strong>In a prospective phase II clinical trial, 24 patients suspected of primary glioma underwent a dynamic 60-min PET/MRI following the administration of approximately 200 MBq (range: 83-222 MBq) [⁶⁸Ga]Ga-NOTA-AE105. Lesions were considered uPAR positive if the tumor-to-background ratio, calculated as the ratio of TumorSUVmax-to-Normal-BrainSUVmean tumor-SUVmax-to-background-SUVmean, was ≥ 2.0. The patients were followed over time to assess OS and PFS and stratified into high and low uPAR expression groups based on TumorSUVmax.</p><p><strong>Results: </strong>Of the 24 patients, 16 (67%) were diagnosed with WHO grade 4 gliomas, 6 (25%) with grade 3, and 2 (8%) with grade 2. Two-thirds of all patients (67%) presented with uPAR positive lesions and 94% grade 4 gliomas. At median follow up of 18.8 (2.1-45.6) months, 19 patients had disease progression and 14 had died. uPAR expression dichotomized into high and low, revealed significant worse prognosis for the high uPAR group for OS and PFS with HR of 14.3 (95% CI, 1.8-112.3; P = 0.011), and HR of 26.5 (95% CI, 3.3-214.0; P = 0.0021), respectively. uPAR expression as a continuous variable was associated with worse prognosis for OS and PFS with HR of 2.7 (95% CI, 1.5-4.8; P = 0.0012), and HR of 2.5 (95% CI, 1.5-4.2; P = 0.00073), respectively.</p><p><strong>Conclusions: </strong>The majority of glioma patients and almost all with grade 4 gliomas displayed uPAR positive lesions underlining the feasibility of ⁶⁸Ga-NOTA-AE105 PET/MRI in gliomas. High uPAR expression is significantly correlated with worse survival outcomes for patients. Additionally, the high proportion of uPAR positive gliomas underscores the potential of uPAR-targeted radionuclide therapy in these patients.</p><p><strong>Trail registration: </strong>EudraCT No: 2016-002417-21; the Scientific Ethics Committee: H-16,035,303; the Danish Data Protection Agency: 2012-58-0004; clinical trials registry: NCT02945826, 26Oct2016, URL: https://classic.</p><p><strong>Clinicaltrials: </strong>gov/ct2/show/NCT02945826 .</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The intra- and interobserver variability of PSMA-expression scores in patients with primary prostate cancer.","authors":"Maarten L Donswijk, Rosemarijn H Ettema, Suzanne van der Gaag, Maurits Wondergem, Zing Cheung, Henk G van der Poel, André N Vis, Daniela E Oprea-Lager","doi":"10.1186/s13550-024-01152-z","DOIUrl":"https://doi.org/10.1186/s13550-024-01152-z","url":null,"abstract":"","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appearance time of blood in the brain as a possible indicator of oxygen extraction fraction: a feasibility study.","authors":"Mitsumasa Murao, Nobuyuki Kudomi, Katsuya Mitamura, Takashi Norikane, Yuri Manabe, Yukito Maeda, Yuka Yamamoto, Tetsuhiro Hatakeyama, Yoshihiro Nishiyama","doi":"10.1186/s13550-024-01160-z","DOIUrl":"https://doi.org/10.1186/s13550-024-01160-z","url":null,"abstract":"<p><strong>Background: </strong>Imaging examination of cerebral blood flow (CBF), oxygen extraction fraction (OEF), and metabolic rate of oxygen is crucial for understanding the normal functioning and pathophysiology of the brain. A recently developed method estimates the appearance time of cerebral blood (ATB) pixel-wise from the imaging examination of CBF alone. In this study, we aimed to test the potential of ATB as an indicator of OEF.</p><p><strong>Results: </strong>We retrospectively reviewed patients (n = 62) with suspected cerebrovascular disorders including steno-occlusive disease who underwent positron emission tomography (PET) with ¹⁵O-labelled tracers. Regarding the generated OEF and ATB images, a visual assessment was performed to test the consistency of the elevated OEF and delayed ATB. The OEF and ATB values and the absolute differences between their ipsilateral and contralateral sides were extracted and obtained for the entire hemisphere and the middle, anterior, and posterior cerebral arterial regions. Consistency was observed in 52 PET scans (83.9%) in visual assessment. The OEF and ATB values were moderately correlated (r = 0.553, p < 0.001), and the differences between their ipsilateral and contralateral sides were weakly correlated (r = 0.276, p < 0.001).</p><p><strong>Conclusion: </strong>Our results indicate the potential of ATB as an indicator of OEF.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative benefits of Ki and SUV images in lesion detection during PET/CT imaging.","authors":"Danjie Cai, Yibo He, Haojun Yu, Yiqiu Zhang, Hongcheng Shi","doi":"10.1186/s13550-024-01162-x","DOIUrl":"https://doi.org/10.1186/s13550-024-01162-x","url":null,"abstract":"<p><strong>Background: </strong>Clinical application of the tracer net influx rate (Ki) imaging in PET/CT remains limited, due to a lack of evidence demonstrating the superiority of Ki images in lesion detection, and guidelines on when to utilize Ki images. This study aims to compare the benefits of Ki and standardized uptake value (SUV) images in lesion detection during PET/CT imaging. By analyzing the performance of both techniques in identifying tumor lesions, the study seeks to provide guidance for the clinical application of Ki images.</p><p><strong>Results: </strong>This retrospective study included 134 patients with 244 pathologically confirmed lesions (200 malignant and 44 benign). Patients with a histopathological diagnosis received a weight-based ¹⁸F-FDG injection and underwent 60-min total-body PET/CT dynamic imaging. SUV images were reconstructed using data collected from the last 10 min of the scans. Ki images were generated using the Patlak methods with data from minutes 12-60. The background SUV_max, SUV_mean, SUV_SD, Ki_max, Ki_mean, and Ki_SD values were recorded. The signal-to-noise ratios of the SUV (SUV_SNR) and Ki (Ki_SNR) images were calculated. The lesion detection rate and sensitivity of the SUV and Ki images were evaluated. The lesion-detection rates were 97.7% (214/219) and 99.5% (218/219) for the SUV and Ki images, respectively (p = .22). Five false-negative lesions on the SUV images were true-positive on the Ki images (3 hepatic malignancies and 2 metastatic lymph nodes). The sensitivity (94.0% vs. 96.0%, p = .22), specificity (41.9% vs. 41.9%, p > .99), accuracy (84.4% vs. 86.1%, p = .61), positive predictive value (87.9% vs. 88.1%, p = .94), negative predictive value (60.0% vs. 69.2%, p = .47), and the area under the curve [0.68 (95% confidence interval, 0.61-0.73) vs. 0.69 (95% confidence interval, 0.62-0.74)] were similar in the SUV and Ki images (all p ≥ .10).</p><p><strong>Conclusion: </strong>Ki images exhibit benefits in lesion detection compared to SUV images, particularly in organs with high background such as liver. The enhanced contrast provided by Ki imaging is recommended to clinically improve detection rates in such cases.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"All that glitters is not gold: high uptake on PSMA PET in non-prostate cancers does not mean that treatment with [¹⁷⁷Lu]Lu-PSMA-radioligand will be successful.","authors":"Trond Velde Bogsrud, Ola Engelsen, Thuy Thu Thi Lu, Andreas Stensvold, Derek R Johnson, Brian J Burkett, Ayse Tuba Kendi, Mukesh K Pandey, Rune Sundset, Jolanta M Durski","doi":"10.1186/s13550-024-01156-9","DOIUrl":"https://doi.org/10.1186/s13550-024-01156-9","url":null,"abstract":"<p><strong>Background: </strong>The main objective is to discuss why treatment of non-prostate cancers with [¹⁷⁷Lu]Lu-PSMA-radioligand achieved only low tumor dose in most published cases, despite high uptake on PSMA PET. We use a patient with renal cell carcinoma as an illustrative example. Furthermore, we discuss how the problem with early washout and low tumor dose might be overcome by using a radionuclide with shorter half-life, matching the target binding residence time.</p><p><strong>Case presentation: </strong>[⁶⁸Ga]Ga-PSMA-11 PET/CT of a 56-year old man with metastatic renal cell carcinoma showed high lesion uptake. One dose of 6.9 GBq [¹⁷⁷Lu]Lu-PSMA-I&T was administrated. Post-therapy dosimetry was performed with SPECT/CT and whole-body planar imaging after 5, 24 and 48 h. Doses to target lesions were only 0.2-0.5 Gy. No treatment effect was achieved.</p><p><strong>Conclusion: </strong>Rapid tumor washout of [¹⁷⁷Lu]Lu-PSMA-I&T and low tumor dose despite high uptake of [⁶⁸Ga]Ga-PSMA-11 are most likely caused by localization of PSMA-receptors on neovasculature rather than on the tumor cells, and unlike in prostate cancer cells, the PSMA-RL / PSMA-receptor complex is not internalized. To overcome the problem with early washout, the use of a radionuclide with shorter half-life matching the target binding residence time will be needed.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of radiolabelled exendin for beta cell imaging by ex vivo autoradiography and immunohistochemistry of human pancreas.","authors":"Theodorus J P Jansen, Sevilay Tokgöz, Mijke Buitinga, Sanne A M van Lith, Lieke Joosten, Cathelijne Frielink, Esther M M Smeets, Martijn W J Stommel, Marion B van der Kolk, Bastiaan E de Galan, Maarten Brom, Marti Boss, Martin Gotthardt","doi":"10.1186/s13550-024-01159-6","DOIUrl":"https://doi.org/10.1186/s13550-024-01159-6","url":null,"abstract":"<p><strong>Background: </strong>Estimation of beta cell mass is currently restricted to evaluating pancreatic tissue samples, which provides limited information. A non-invasive imaging technique that reliably quantifies beta cell mass enables monitoring of changes of beta cell mass during the progression of diabetes mellitus and may contribute to monitoring of therapy effectiveness. We assessed the specificity of radiolabelled exendin for beta cell mass quantification in humans. Fourteen adults with pancreas tumours were injected with ¹¹¹In-labeled exendin-4 prior to pancreatic resection. In resected pancreas tissue, endocrine-exocrine ratios of tracer uptake were determined by digital autoradiography and accumulation of ¹¹¹In-labeled exendin-4 was compared to insulin and GLP-1 receptor staining. Of four participants, abdominal single photon emission computed tomography/computed tomography (SPECT/CT) images were acquired to quantify pancreatic uptake in vivo RESULTS: Tracer uptake was predominantly present in the endocrine pancreas (endocrine-exocrine ratio: 3.6 [2.8-10.8]. Tracer accumulation showed overlap with insulin-positive regions, which overlapped with GLP-1 receptor positive areas. SPECT imaging showed pancreatic uptake of radiolabelled exendin in three participants.</p><p><strong>Conclusion: </strong>Radiolabelled exendin specifically accumulates in the islets of Langerhans in human pancreas tissue. The clear overlap between regions positive for insulin and the GLP-1 receptor substantiate the beta cell specificity of the tracer. Radiolabelled exendin is therefore a valuable imaging agent for human beta cell mass quantification and has the potential to be used for a range of applications, including improvement of diabetes treatment by assessment of the effects of current and novel diabetes therapies on the beta cell mass.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT03889496, registered 26,032,019, URL https://clinicaltrials.gov/study/NCT03889496?term=NCT03889496 .</p><p><strong>Clinicaltrials: </strong>gov NCT04733508, registered 02022021, URL https://clinicaltrials.gov/study/NCT04733508 .</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11480297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Matched-pair analysis of mCRPC patients receiving ¹⁷⁷Lu-labeled PSMA-targeted radioligand therapy in a 4-week versus 6-week treatment interval.","authors":"Amir Karimzadeh, Charlotte-Sophie Hecker, Matthias M Heck, Robert Tauber, Calogero D'Alessandria, Wolfgang A Weber, Matthias Eiber, Isabel Rauscher","doi":"10.1186/s13550-024-01143-0","DOIUrl":"https://doi.org/10.1186/s13550-024-01143-0","url":null,"abstract":"<p><strong>Background: </strong>The optimal regimen for ¹⁷⁷Lu-labeled prostate-specific membrane antigen-targeted radioligand therapy, including treatment intervals, remains under study, with evidence suggesting shorter intervals could benefit patients with high disease volume and rapid progression. This retrospective analysis evaluated treatment toxicity, PSA response, PSA-progression-free survival (PSA-PFS), and overall survival (OS) in matched cohorts of mCRPC patients receiving 177Lu-PSMA-RLT at 4-week versus 6-week intervals.</p><p><strong>Results: </strong>A PSA response (PSA decline ≥ 50%) was achieved in 47.8% and 21.7% of patients in the 4-week and 6-week treatment interval groups, respectively (p = 0.12). There was a trend towards longer PSA-PFS in the 4-week group compared to the 6-week group (median PSA-PFS, 26.0 weeks vs. 18.0 weeks; HR 0.6; p = 0.2). Although not statistically significant, there was a trend towards shorter OS in the 4-week group compared to the 6-week group (median OS, 15.1 months vs. 18.4 months; HR 1.3; p = 0.5). The 4-week group had a significantly greater decrease in leucocyte and platelet counts compared to the 6-week group (38.5% vs. 18.2% and 26.7% vs. 10.7%; p = 0.047 and p = 0.02). Severe adverse events were modest in both groups.</p><p><strong>Conclusions: </strong>Intensifying treatment intervals from 6 weeks to 4 weeks showed some improvements in PSA response and PSA-PFS for mCRPC patients, but did not significantly affect OS. Additionally, bone marrow reserve was significantly reduced with the intensified regimen. Therefore, the overall benefit remains uncertain, and further prospective studies are needed to compare 4-week and 6-week intervals regarding toxicity, treatment response, and outcome.</p>","PeriodicalId":11611,"journal":{"name":"EJNMMI Research","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11473467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}