评估 TENIS 患者在 68Ga-DOTATATE PET-CT 上的 Krenning 评分和在 68Ga-PSMA-11 PET-CT 上的 miPSMA 评分:与 FDG PET/CT 的比较,并研究放射性核素靶向治疗的可行性。

IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Nuclear Medicine Communications Pub Date : 2024-08-01 Epub Date: 2024-06-03 DOI:10.1097/MNM.0000000000001856
Sunita Sonavane, Omkar Salvi, Ramesh V Asopa, Sandip Basu
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引用次数: 0

摘要

研究目的本研究的目的是评估甲状腺球蛋白进行性升高和碘闪烁扫描阴性的转移性分化型甲状腺癌患者的受体表达情况,我们使用了68Ga-DOTATATE[1,4,7,10-四氮杂环十二烷-1、4,7,10-四乙酸(DOTA)-辛酸盐(DOTATATE)](克伦宁氏评分)和 68Ga-PSMA-11(镓-68 前列腺特异性膜抗原-11)正电子发射计算机断层扫描(CT)[分子成像前列腺特异性膜抗原(miPSMA)评分]。我们考虑了克伦宁评分 3 分及以上和 miPSMA 评分 2 分及以上的患者,以确定符合使用 177Lu-DOTATATE/PSMA [Lutetium-177 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA)-octreotate (DOTATATE)/prostate-specific membrane antigen]治疗条件的患者人数。此外,我们还将68Ga-DOTATATE和68Ga-PSMA-11 PET-CT与2-脱氧-2-[F-18]荧光葡萄糖(18F-FDG)PET-CT(使用最大标准化摄取值)进行了比较:回顾性研究了74例经组织病理学证实的转移性分化型甲状腺癌患者,这些患者均伴有甲状腺球蛋白升高和碘闪烁综合征阴性。他们都有18F-FDG、68Ga-DOTATATE和68Ga-PSMA-11 PET-CT扫描可供分析。通过 68Ga-DOTATATE 和 68Ga-PSMA-11 检测到的病变采用 Krenning 评分和 miPSMA 评分进行评估。此外,还对 68Ga-DOTATATE 和 68Ga-PSMA-11 以及 18F-FDG 的最大标准化摄取值进行了定量比较:对患者的分析显示,68Ga-DOTATATE 的阳性率为 40.5%,68Ga-PSMA-11 为 41.89%,18F-FDG 为 75.67%。在 74 名患者中,有 14 人(18.91%)被认为符合接受 177Lu-DOTATATE/PSMA-617 治疗的条件,其依据是克伦宁评分 3 分及以上(含 3 分)/68Ga-DOTATATE 或 68Ga-PSMA-11 PET-CT miPSMA 评分 2 分及以上(含 2 分)。在该亚组中,74 名患者中有 7 名(9.45%)符合 177Lu-DOTATATE 治疗条件,74 名患者中有 9 名(12.16%)符合 177Lu-PSMA 靶向治疗条件。结论:在甲状腺球蛋白升高的患者中,有4名患者(12.16%)符合177Lu-PSMA靶向治疗的条件:结论:在甲状腺球蛋白升高和碘闪烁扫描阴性患者亚组中,9.45%的患者符合177Lu-DOTATATE治疗条件,12.16%的患者符合177Lu-PSMA-617治疗条件。有 4 人同时符合两种疗法的条件。鉴于缺乏有效的治疗方法,这部分患者值得考虑进行放射性核素治疗探索。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessing Krenning's score on 68 Ga-DOTATATE PET-CT and miPSMA score on 68 Ga-PSMA-11 PET-CT in TENIS: a comparison with FDG PET/CT and examining the feasibility of targeted radionuclide therapy.

Objectives: The objective of this study was to assess receptor expression in metastatic differentiated thyroid carcinoma patients with progressive elevated thyroglobulin and negative iodine scintigraphy, we used 68 Ga-DOTATATE [Gallium-68 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA)-octreotate (DOTATATE)] (Krenning's score) and 68 Ga-PSMA-11 (Gallium-68 prostate-specific membrane antigen-11) PET-computed tomography (CT) [molecular imaging prostate-specific membrane antigen (miPSMA) score]. Patients with Krenning's score 3 and above and miPSMA score 2 and above were considered to determine the incidence of patients, who would qualify for treatment with 177 Lu-DOTATATE/PSMA [Lutetium-177 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA)-octreotate (DOTATATE)/prostate-specific membrane antigen]-based therapy. In addition, we compared 68 Ga-DOTATATE and 68 Ga-PSMA-11 PET-CT with 2-deoxy-2-[F-18]fluoroglucose ( 18 F-FDG) PET-CT (using maximum standardized uptake value).

Materials and methods: A total of 74 patients with histopathologically proven metastatic differentiated thyroid carcinoma with thyroglobulin elevation and negative iodine scintigraphy syndrome were studied retrospectively. They all had 18 F-FDG, 68 Ga-DOTATATE, and 68 Ga-PSMA-11 PET-CT scans available for undertaking this analysis. The lesions detected by 68 Ga-DOTATATE and 68 Ga-PSMA-11 were evaluated using Krenning's and miPSMA scores. In addition, quantitative comparisons of maximum standardized uptake values for 68 Ga-DOTATATE and 68 Ga-PSMA-11, as well as with 18 F-FDG, were conducted.

Results: Patient-wise analysis revealed positivity rates of 40.5% for 68 Ga-DOTATATE, 41.89% for 68 Ga-PSMA-11, and 75.67% for 18 F-FDG. Among the 74 patients, 14 (18.91%) were deemed eligible for 177 Lu-DOTATATE/PSMA-617 therapy based on Krenning's score of 3 and above both/either miPSMA score of 2 and above on 68 Ga-DOTATATE or 68 Ga-PSMA-11 PET-CT. Within this subgroup, seven out of 74 patients (9.45%) were eligible for 177 Lu-DOTATATE therapy, and nine out of 74 patients (12.16%) were eligible for 177 Lu-PSMA-targeted therapy. Four patients were eligible for both therapies.

Conclusion: Among thyroglobulin elevation and negative iodine scintigraphy patient's subgroup, 9.45% could qualify for 177 Lu-DOTATATE and 12.16% for 177 Lu-PSMA-617. Four were eligible for both therapies. Given the lack of effective therapies, this subset of patients warrants consideration for radionuclide therapy exploration.

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来源期刊
CiteScore
2.20
自引率
6.70%
发文量
212
审稿时长
3-8 weeks
期刊介绍: Nuclear Medicine Communications, the official journal of the British Nuclear Medicine Society, is a rapid communications journal covering nuclear medicine and molecular imaging with radionuclides, and the basic supporting sciences. As well as clinical research and commentary, manuscripts describing research on preclinical and basic sciences (radiochemistry, radiopharmacy, radiobiology, radiopharmacology, medical physics, computing and engineering, and technical and nursing professions involved in delivering nuclear medicine services) are welcomed, as the journal is intended to be of interest internationally to all members of the many medical and non-medical disciplines involved in nuclear medicine. In addition to papers reporting original studies, frankly written editorials and topical reviews are a regular feature of the journal.
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