Qaid Ahmed Shagera, Thierry Gil, Elisa Barraco, Petra Boegner, Paulus Kristanto, Ziad El Ali, Spyridon Sideris, Nieves Martinez Chanza, Thierry Roumeguère, Patrick Flamen, Carlos Artigas
{"title":"利用 68Ga-PSMA PET/CT 成像评估转移性阉割耐药前列腺癌患者对镭-223 的反应。","authors":"Qaid Ahmed Shagera, Thierry Gil, Elisa Barraco, Petra Boegner, Paulus Kristanto, Ziad El Ali, Spyridon Sideris, Nieves Martinez Chanza, Thierry Roumeguère, Patrick Flamen, Carlos Artigas","doi":"10.1007/s12149-024-01990-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>Conventional imaging techniques and prostate-specific antigen (PSA) values are not useful to follow-up patients during Radium-223 treatment. The study aimed to evaluate the predictive value of prostate-specific membrane antigen PSMA PET/CT-based response in patients with metastatic castration-resistant prostate cancer (mCRPC) receiving Radium-223 dichloride treatment.</p><p><strong>Materials and methods: </strong>Patients treated with radium-223, having performed two <sup>68</sup>Ga-PSMA-11 PET/CT scans (baseline 1 month before treatment initiation and follow-up 2 weeks after the third cycle), were retrospectively evaluated. Visual and quantitative PET image analyses were performed, and patients were dichotomized into progressive (PD) and non-PD according to Response Evaluation Criteria in PSMA‑imaging (RECIP1.0) and PSMA-PET Progression criteria (PPP). The primary endpoint was overall survival (OS). Cohen's Kappa (κ) was used to test the agreement between the two criteria. The Cox regression hazard model and Kaplan-Meier method were used for survival analyses.</p><p><strong>Results: </strong>Twenty-eight mCRPC patients were evaluated. Sixteen (43%) and 18 (64%) patients had PD according to RECIP1.0 and PPP, respectively; κ = 0.85 (95% CI 0.65-1.00). After a median follow-up of 16 months (interquartile IQR 9-33), 20 (71%) patients died. Patients with PSMA PD showed a higher risk of death than non-PD according to RECIP1.0 (HR = 2.9; 95% CI 1.14-7.46; p = 0.029) and PPP (HR = 2.8; 95% CI 1.04-7.64; p = 0.042). For both criteria, the median OS was shorter for PD than non-PD (37 vs. 12 months, Log-rank; p < 0.05). The C-index for RECIP1.0 and PPP were almost equal (0.66 and 0.63; respectively).</p><p><strong>Conclusion: </strong>This study demonstrated that PSMA-PET/CT imaging is valuable for monitoring radium-223 treatment. Both PSMA PET/CT response criteria (RECIP1.0 and PPP) perform similarly predicting OS at follow-up after three cycles of radium-223. These findings urge further validation in prospective trials.</p>","PeriodicalId":8007,"journal":{"name":"Annals of Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":2.5000,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluating response to radium-223 using <sup>68</sup>Ga-PSMA PET/CT imaging in patients with metastatic castration-resistant prostate cancer.\",\"authors\":\"Qaid Ahmed Shagera, Thierry Gil, Elisa Barraco, Petra Boegner, Paulus Kristanto, Ziad El Ali, Spyridon Sideris, Nieves Martinez Chanza, Thierry Roumeguère, Patrick Flamen, Carlos Artigas\",\"doi\":\"10.1007/s12149-024-01990-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>Conventional imaging techniques and prostate-specific antigen (PSA) values are not useful to follow-up patients during Radium-223 treatment. The study aimed to evaluate the predictive value of prostate-specific membrane antigen PSMA PET/CT-based response in patients with metastatic castration-resistant prostate cancer (mCRPC) receiving Radium-223 dichloride treatment.</p><p><strong>Materials and methods: </strong>Patients treated with radium-223, having performed two <sup>68</sup>Ga-PSMA-11 PET/CT scans (baseline 1 month before treatment initiation and follow-up 2 weeks after the third cycle), were retrospectively evaluated. Visual and quantitative PET image analyses were performed, and patients were dichotomized into progressive (PD) and non-PD according to Response Evaluation Criteria in PSMA‑imaging (RECIP1.0) and PSMA-PET Progression criteria (PPP). The primary endpoint was overall survival (OS). Cohen's Kappa (κ) was used to test the agreement between the two criteria. The Cox regression hazard model and Kaplan-Meier method were used for survival analyses.</p><p><strong>Results: </strong>Twenty-eight mCRPC patients were evaluated. Sixteen (43%) and 18 (64%) patients had PD according to RECIP1.0 and PPP, respectively; κ = 0.85 (95% CI 0.65-1.00). After a median follow-up of 16 months (interquartile IQR 9-33), 20 (71%) patients died. Patients with PSMA PD showed a higher risk of death than non-PD according to RECIP1.0 (HR = 2.9; 95% CI 1.14-7.46; p = 0.029) and PPP (HR = 2.8; 95% CI 1.04-7.64; p = 0.042). For both criteria, the median OS was shorter for PD than non-PD (37 vs. 12 months, Log-rank; p < 0.05). The C-index for RECIP1.0 and PPP were almost equal (0.66 and 0.63; respectively).</p><p><strong>Conclusion: </strong>This study demonstrated that PSMA-PET/CT imaging is valuable for monitoring radium-223 treatment. Both PSMA PET/CT response criteria (RECIP1.0 and PPP) perform similarly predicting OS at follow-up after three cycles of radium-223. These findings urge further validation in prospective trials.</p>\",\"PeriodicalId\":8007,\"journal\":{\"name\":\"Annals of Nuclear Medicine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-10-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Nuclear Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s12149-024-01990-w\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Nuclear Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12149-024-01990-w","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
摘要
目的：传统的成像技术和前列腺特异性抗原（PSA）值对镭-223治疗期间的患者随访没有帮助。本研究旨在评估基于前列腺特异性膜抗原 PSMA PET/CT 的反应对接受二氯化镭-223 治疗的转移性阉割耐药前列腺癌（mCRPC）患者的预测价值：对接受镭-223治疗的患者进行回顾性评估，这些患者接受过两次68Ga-PSMA-11 PET/CT扫描（治疗开始前1个月的基线扫描和第三个周期后2周的随访扫描）。根据PSMA成像反应评估标准（RECIP1.0）和PSMA-PET进展标准（PPP），将患者分为进展期（PD）和非PD。主要终点是总生存期（OS）。科恩卡帕（κ）用于检验两种标准之间的一致性。生存分析采用 Cox 回归危险模型和 Kaplan-Meier 法：共评估了 28 例 mCRPC 患者。根据RECIP1.0和PPP标准，分别有16例（43%）和18例（64%）患者出现PD；κ = 0.85 (95% CI 0.65-1.00)。中位随访 16 个月（四分位间 IQR 9-33）后，20 例（71%）患者死亡。根据RECIP1.0（HR = 2.9；95% CI 1.14-7.46；P = 0.029）和PPP（HR = 2.8；95% CI 1.04-7.64；P = 0.042），PSMA PD患者的死亡风险高于非PD患者。在这两个标准中，PD 的中位 OS 均短于非 PD（37 个月 vs. 12 个月，Log-rank；P 结论：PSMA-PCT 是一种用于诊断肺癌的方法：本研究表明，PSMA-PET/CT成像对监测镭-223治疗很有价值。两种 PSMA PET/CT 反应标准（RECIP1.0 和 PPP）在预测镭-223 治疗三个周期后的随访 OS 方面表现相似。这些发现需要在前瞻性试验中进一步验证。
Evaluating response to radium-223 using 68Ga-PSMA PET/CT imaging in patients with metastatic castration-resistant prostate cancer.
Aim: Conventional imaging techniques and prostate-specific antigen (PSA) values are not useful to follow-up patients during Radium-223 treatment. The study aimed to evaluate the predictive value of prostate-specific membrane antigen PSMA PET/CT-based response in patients with metastatic castration-resistant prostate cancer (mCRPC) receiving Radium-223 dichloride treatment.
Materials and methods: Patients treated with radium-223, having performed two 68Ga-PSMA-11 PET/CT scans (baseline 1 month before treatment initiation and follow-up 2 weeks after the third cycle), were retrospectively evaluated. Visual and quantitative PET image analyses were performed, and patients were dichotomized into progressive (PD) and non-PD according to Response Evaluation Criteria in PSMA‑imaging (RECIP1.0) and PSMA-PET Progression criteria (PPP). The primary endpoint was overall survival (OS). Cohen's Kappa (κ) was used to test the agreement between the two criteria. The Cox regression hazard model and Kaplan-Meier method were used for survival analyses.
Results: Twenty-eight mCRPC patients were evaluated. Sixteen (43%) and 18 (64%) patients had PD according to RECIP1.0 and PPP, respectively; κ = 0.85 (95% CI 0.65-1.00). After a median follow-up of 16 months (interquartile IQR 9-33), 20 (71%) patients died. Patients with PSMA PD showed a higher risk of death than non-PD according to RECIP1.0 (HR = 2.9; 95% CI 1.14-7.46; p = 0.029) and PPP (HR = 2.8; 95% CI 1.04-7.64; p = 0.042). For both criteria, the median OS was shorter for PD than non-PD (37 vs. 12 months, Log-rank; p < 0.05). The C-index for RECIP1.0 and PPP were almost equal (0.66 and 0.63; respectively).
Conclusion: This study demonstrated that PSMA-PET/CT imaging is valuable for monitoring radium-223 treatment. Both PSMA PET/CT response criteria (RECIP1.0 and PPP) perform similarly predicting OS at follow-up after three cycles of radium-223. These findings urge further validation in prospective trials.
期刊介绍：
Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine.
The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.
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