Journal of nuclear medicine : official publication, Society of Nuclear Medicine最新文献

{"title":"Outcomes for Patients with Metastatic Castration-Resistant Prostate Cancer and Liver Metastasis Receiving [¹⁷⁷Lu]Lu-PSMA-617.","authors":"Miguel Muniz, Oliver Sartor, Jacob J Orme, Regina M Koch, Hana R Rosenow, Ahmed M Mahmoud, Jack R Andrews, Adam M Kase, Irbaz B Riaz, Gokce Belge Bilgin, Matthew P Thorpe, A Tuba Kendi, Geoffrey B Johnson, Praful Ravi, Eugene D Kwon, Daniel S Childs","doi":"10.2967/jnumed.124.268277","DOIUrl":"https://doi.org/10.2967/jnumed.124.268277","url":null,"abstract":"<p><p>It is well known that patients with liver metastasis from metastatic castration-resistant prostate cancer have poor or only transient responses to many forms of systemic therapy. Data on outcomes after treatment with [¹⁷⁷Lu]Lu-PSMA-617 (LuPSMA) are scarce. The VISION trial reports a hazard ratio for overall survival (OS) in the subgroup of patients with liver metastasis without disclosing the absolute duration of survival. Using real-world clinical data, we examined this important subgroup of patients, describing prostate-specific antigen (PSA) response and OS. <b>Methods:</b> A single-institution database was assembled to include all patients receiving LuPSMA at Mayo Clinic in Rochester, Minnesota, for whom treatment was initiated between March 2022 and March 2023. Baseline clinicopathologic and imaging characteristics were abstracted. Patients were then categorized by presence or absence of liver metastasis on pretreatment prostate-specific membrane antigen (PSMA) PET. PSA response and OS for the 2 groups (liver metastasis vs. no liver metastasis) were compared using χ² testing and the Kaplan-Meier method, respectively. A multivariate Cox regression analysis was performed, including established prognostic factors. Finally, those with pretreatment circulating tumor DNA as determined in an 83-gene panel were assessed for the presence of pathogenic and likely pathogenic alterations. These findings were summarized using descriptive statistics and compared between the 2 cohorts using the Fisher exact test. <b>Results:</b> The overall cohort consisted of 273 patients, including 43 (15.75%) with liver metastasis on pretreatment PSMA PET/CT. The median number of cycles received was 3 (range, 1-6) for patients with liver metastasis and 5 (range, 1-6) for those without hepatic involvement. The 50% or greater reduction in PSA from baseline response rate was lower for those with liver metastasis than for those without (30.23% [13/43] vs 49.77% [106/213], <i>P</i> = 0.019). At a median follow-up of 10 mo (interquartile range, 9-13 mo), there was a significant difference in median OS (8.35 mo vs. not reached, <i>P</i> < 0.001). On multivariate analysis, the presence of liver metastasis was independently associated with shorter survival (hazard ratio, 4.06; <i>P</i> < 0.001). <b>Conclusion:</b> Our data suggest that the presence of liver metastasis predicts poorer outcomes in patients receiving LuPSMA treatment. Alternative and combination approaches should be explored to maximize the antitumor activity of radiopharmaceutical therapy in the liver.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Posttherapy 4- and 24-Hour [¹⁷⁷Lu]Lu-PSMA SPECT/CT and Pretherapy PSMA PET/CT in Assessment of Disease in Men with Metastatic Castration-Resistant Prostate Cancer.","authors":"Mina Swiha, Sarennya Pathmanandavel, Nathan Papa, Zahra Sabahi, Sherrington Li, Alex Zheng, Sobia Khan, Maria Ayers, Shikha Sharma, Megan Crumbaker, Andrew Nguyen, Lyn Chan, Narjess Ayati, Louise Emmett","doi":"10.2967/jnumed.124.267606","DOIUrl":"https://doi.org/10.2967/jnumed.124.267606","url":null,"abstract":"<p><p>[¹⁷⁷Lu]Lu-prostate-specific membrane antigen (PSMA) is an effective treatment for metastatic castration-resistant prostate cancer (mCRPC). [¹⁷⁷Lu]Lu-PSMA SPECT/CT 24 h after injection has shown potential as a response biomarker for [¹⁷⁷Lu]Lu-PSMA therapy but is not convenient for patients. This study investigated 4-h [¹⁷⁷Lu]Lu-PSMA SPECT/CT as an alternative to 24-h [¹⁷⁷Lu]Lu-PSMA SPECT/CT for evaluation of treatment response. <b>Methods:</b> This prospective analysis enrolled 23 patients diagnosed with mCRPC commencing [¹⁷⁷Lu]Lu-PSMA-I&T therapy. Two patients were excluded because of incomplete imaging data. Posttherapy SPECT/CT was performed at 4 and 24 h after the first dose and 4 h after the second dose. Baseline [⁶⁸Ga]Ga-PSMA-11 PET/CT and 4- and 24-h [¹⁷⁷Lu]Lu-PSMA SPECT/CT were analyzed both visually and semiquantitatively. Bland-Altman plots assessed agreement of semiquantitative parameters from the 4- and 24-h scans. Quantitative assessment of the change in the total tumor volume (TTV) on the 4-h [¹⁷⁷Lu]Lu-PSMA SPECT/CT after the first and second doses was correlated to patient outcomes. <b>Results:</b> All patients had mCRPC previously treated with an androgen receptor pathway inhibitor, and 11 (52%) received prior taxane chemotherapy. Median age was 78 y, and median prostate-specific antigen level was 54 ng/mL. On visual analysis, disease distribution was unchanged among the 3 imaging methods. Eleven patients (52%) had a median of 1 lesion not identified on 4-h [¹⁷⁷Lu]Lu-PSMA SPECT/CT compared with 24-h [¹⁷⁷Lu]Lu-PSMA SPECT/CT. All missed lesions on the 4-h [¹⁷⁷Lu]Lu SPECT/CT were smaller than 2 cm. Mean differences and agreement between 4- and 24-h SPECT/CT quantitative parameters were within acceptable bounds for lesion number, SUV_max, and SUV_mean, with higher variation observed for TTV. The change in TTV between dose 1 and 2 [¹⁷⁷Lu]Lu-PSMA SPECT/CT predicted prostate-specific antigen progression-free survival. <b>Conclusion:</b> [¹⁷⁷Lu]Lu-PSMA SPECT/CT at 4 h after injection appears a promising alternative to 24-h [¹⁷⁷Lu]Lu-PSMA SPECT/CT for treatment response assessment, with improved patient convenience.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncologist, Business Leader, and Investor Arie S. Belldegrun Discusses a Career in Innovative Medical Entrepreneurship: A Conversation with Ken Herrmann and Johannes Czernin.","authors":"Arie S Belldegrun, Ken Herrmann, Johannes Czernin","doi":"10.2967/jnumed.124.268904","DOIUrl":"https://doi.org/10.2967/jnumed.124.268904","url":null,"abstract":"","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT Enhancement of a Nasal Leech After Thrombectomy.","authors":"Kaiwu Meng, Dian He","doi":"10.2967/jnumed.124.268796","DOIUrl":"https://doi.org/10.2967/jnumed.124.268796","url":null,"abstract":"","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply: One Bite from the Apple, One Bite from the Orange in the PRECISE-MDT Study and Limitations of Retrospective Study Design and Potential Bias in the PRECISE-MDT Study.","authors":"Matteo Bauckneht, Francesco Lanfranchi, Liliana Belgioia","doi":"10.2967/jnumed.124.268781","DOIUrl":"https://doi.org/10.2967/jnumed.124.268781","url":null,"abstract":"","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limitations of Retrospective Study Design and Potential Bias in the PRECISE-MDT Study.","authors":"Tadashi Watabe","doi":"10.2967/jnumed.124.268447","DOIUrl":"https://doi.org/10.2967/jnumed.124.268447","url":null,"abstract":"","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One Bite from the Apple, One Bite from the Orange in the PRECISE-MDT Study.","authors":"Andrei Fodor, Cristiano Pini, Gaia Ninatti, Nadia Di Muzio, Arturo Chiti","doi":"10.2967/jnumed.124.268395","DOIUrl":"https://doi.org/10.2967/jnumed.124.268395","url":null,"abstract":"","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Radiopharmaceuticals: A Sustainable Path to the Improvement of Patient Care.","authors":"Andrei Gafita, Andrew R Menard, Lilja B Solnes","doi":"10.2967/jnumed.124.268608","DOIUrl":"https://doi.org/10.2967/jnumed.124.268608","url":null,"abstract":"","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Theranostics for Meningioma on the Rise: New EANM/EANO/RANO/SNMMI Guidelines Pave the Way to Improved Patient Outcomes Using Radiolabeled Somatostatin Receptor Ligands.","authors":"Nathalie L Albert, Matthias Preusser, Norbert Galldiks, Jana Ivanidze","doi":"10.2967/jnumed.124.268314","DOIUrl":"https://doi.org/10.2967/jnumed.124.268314","url":null,"abstract":"","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of ¹⁸F-FDG PET/MRI on Therapeutic Management of Women with Newly Diagnosed Breast Cancer: Results from a Prospective Double-Center Trial.","authors":"Kai Jannusch, Lale Umutlu, Julian Kirchner, Nils-Martin Bruckmann, Janna Morawitz, Ken Herrmann, Wolfgang Peter Fendler, Ann-Kathrin Bittner, Oliver Hoffmann, Svjetlana Mohrmann, Eugen Ruckhäberle, Martin Stuschke, Werner Schmid, Frederik Giesel, Lena Häberle, Irene Esposito, Wilfried Budach, Johannes Grueneisen, Christiane Matuschek, Bernd Kowall, Andreas Stang, Gerald Antoch, Christian Buchbender","doi":"10.2967/jnumed.124.268065","DOIUrl":"https://doi.org/10.2967/jnumed.124.268065","url":null,"abstract":"<p><p>Our rationale was to investigate whether ¹⁸F-FDG PET/MRI in addition to (guideline-recommended) conventional staging leads to changes in therapeutic management in patients with newly diagnosed breast cancer and compare the diagnostic accuracy of ¹⁸F-FDG PET/MRI with that of conventional staging for determining the Union for International Cancer Control (UICC) stage. <b>Methods:</b> In this prospective, double-center study, 208 women with newly diagnosed, therapy-naïve invasive breast cancer were enrolled in accordance with the inclusion criteria. All patients underwent guideline-recommended conventional staging and whole-body ¹⁸F-FDG PET/MRI with a dedicated breast examination. A multidisciplinary tumor board served to determine 2 different therapy recommendations for each patient, one based on conventional staging alone and another based on combined assessment of conventional staging and ¹⁸F-FDG PET/MRI examinations. Major changes in therapy recommendations and differences between the conventional staging algorithm and ¹⁸F-FDG PET/MRI for determining the correct UICC stage were reported and evaluated. <b>Results:</b> Major changes in therapeutic management based on combined assessment of conventional staging and ¹⁸F-FDG PET/MRI were detected in 5 of 208 patients, amounting to changes in therapeutic management in 2.4% (95% CI, 0.78%-5.2%) of the study population. In determining the UICC stage, the guideline-based staging algorithm and ¹⁸F-FDG PET/MRI were concordant in 135 of 208 (64.9%; 95% CI, 58%-71.4%) patients. The conventional guideline algorithm correctly determined the UICC stage in 130 of 208 (62.5%; 95% CI, 55.5%-69.1%) patients, and ¹⁸F-FDG PET/MRI correctly determined the UICC stage in 170 of 208 (81.9%; 95% CI, 75.8%-86.7%) patients. <b>Conclusion:</b> Despite the diagnostic superiority of ¹⁸F-FDG PET/MRI over conventional staging in determining the correct UICC stage, the current (guideline-recommended) conventional staging algorithm is sufficient for adequate therapeutic management of patients with newly diagnosed breast cancer, and ¹⁸F-FDG PET/MRI does not have an impact on patient management.</p>","PeriodicalId":94099,"journal":{"name":"Journal of nuclear medicine : official publication, Society of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}