Matthew S Robertson, Yating Wang, SuChun Cheng, Hyesun Park, Shahar Glomski, Lauren C Harshman, Amanda Pace, Jacqueline Kilar, Meredith Flynn, Lauren Gilbert, Atish D Choudhury, Heather Jacene
{"title":"使用xSPECT Quant的SPECT/CT对阉割耐药前列腺癌的正常骨和骨转移灶进行定量：研究pembrolizumab和镭-223联合治疗与单独使用镭-223相比的2期临床试验的前瞻性成像子研究。","authors":"Matthew S Robertson, Yating Wang, SuChun Cheng, Hyesun Park, Shahar Glomski, Lauren C Harshman, Amanda Pace, Jacqueline Kilar, Meredith Flynn, Lauren Gilbert, Atish D Choudhury, Heather Jacene","doi":"10.1007/s11547-024-01931-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study is to demonstrate the consistency and reproducibility of quantitative SPECT/CT by evaluating the maximum SUV (SUV<sub>max</sub>) in normal bone, to provide the reference value of metastatic lesions, and to evaluate the clinical implication of SUV<sub>max</sub> changes of osseous metastasis during treatment.</p><p><strong>Material and methods: </strong>This prospective imaging sub-study was performed as part of a phase 2 clinical trial of patients with metastatic castration-resistant prostate cancer (mCRPC) randomized to the combination of pembrolizumab plus radium-223 or to radium-223 alone (NCT03093428). The maximum standardized uptake value (SUV<sub>max</sub>) and mean Hounsfield Unit (HU<sub>mean</sub>) of normal bone as well as metastases were measured using a 1.5 cm region of interest (ROI) on CT and xSPECT Quant reconstruction on the baseline study (S<sub>0</sub>) and restaging scans. The most tracer-avid metastatic lesion in each patient on S<sub>0</sub> was selected as a target lesion, and changes of SUV<sub>max</sub> and HU<sub>mean</sub> of the target lesion were compared on the first restaging scan (S<sub>1</sub>). Correlations between the percentage changes of SUV<sub>max</sub> of the target lesion with alkaline phosphatase (ALP) and prostate-specific antigen (PSA) were assessed.</p><p><strong>Results: </strong>Twenty-one patients were enrolled on the imaging sub-study of which 15 had paired baseline S<sub>0</sub> and S<sub>1</sub> data. On S<sub>0</sub>, the median SUV<sub>max</sub> and HU<sub>mean</sub> of normal bone was 5.85 g/mL (0.42-14.98) and 133.03 (range, 28.47-461.91), respectively. The median SUV<sub>max</sub> and HU<sub>mean</sub> of metastasis were 42.2 g/mL (range, 17.96-143.36) and 549.58 (177.87-1107.64), respectively. There was significant reduction in SUV<sub>max</sub> (- 40.1%, range - 86.2 to + 23.5%), p < 0.001) and increase in HU<sub>mean</sub> (+ 8.3%, range - 11.3 to + 61.7%, p = 0.0479, Wilcoxon signed-rank test) of target lesions between S<sub>0</sub> and S<sub>1</sub>. Spearman correlation between the percentage changes of SUV<sub>max</sub> of a target lesion and both serum PSA (r = 0.33, p = 0.226) and ALP (r = 0.45, p = 0.094) were not statistically significant.</p><p><strong>Conclusion: </strong>Quantitative SPECT/CT provides consistent and objective imaging parameters, which can help monitor tumor burden. The median SUVmax of metastasis at baseline was roughly 7.2-fold higher than normal bone. Quantitative SPECT/CT may help visualize the early osteoblastic treatment response in prostate cancer patients treated with radium-223 alone or combined with pembrolizumab.</p>","PeriodicalId":20817,"journal":{"name":"Radiologia Medica","volume":" ","pages":""},"PeriodicalIF":9.7000,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Quantification of normal bone and osseous metastases in castration-resistant prostate cancer using SPECT/CT with xSPECT Quant: prospective imaging sub-study of a phase 2 clinical trial investigating the combination of pembrolizumab plus radium-223 compared to radium-223 alone.\",\"authors\":\"Matthew S Robertson, Yating Wang, SuChun Cheng, Hyesun Park, Shahar Glomski, Lauren C Harshman, Amanda Pace, Jacqueline Kilar, Meredith Flynn, Lauren Gilbert, Atish D Choudhury, Heather Jacene\",\"doi\":\"10.1007/s11547-024-01931-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The purpose of this study is to demonstrate the consistency and reproducibility of quantitative SPECT/CT by evaluating the maximum SUV (SUV<sub>max</sub>) in normal bone, to provide the reference value of metastatic lesions, and to evaluate the clinical implication of SUV<sub>max</sub> changes of osseous metastasis during treatment.</p><p><strong>Material and methods: </strong>This prospective imaging sub-study was performed as part of a phase 2 clinical trial of patients with metastatic castration-resistant prostate cancer (mCRPC) randomized to the combination of pembrolizumab plus radium-223 or to radium-223 alone (NCT03093428). The maximum standardized uptake value (SUV<sub>max</sub>) and mean Hounsfield Unit (HU<sub>mean</sub>) of normal bone as well as metastases were measured using a 1.5 cm region of interest (ROI) on CT and xSPECT Quant reconstruction on the baseline study (S<sub>0</sub>) and restaging scans. The most tracer-avid metastatic lesion in each patient on S<sub>0</sub> was selected as a target lesion, and changes of SUV<sub>max</sub> and HU<sub>mean</sub> of the target lesion were compared on the first restaging scan (S<sub>1</sub>). Correlations between the percentage changes of SUV<sub>max</sub> of the target lesion with alkaline phosphatase (ALP) and prostate-specific antigen (PSA) were assessed.</p><p><strong>Results: </strong>Twenty-one patients were enrolled on the imaging sub-study of which 15 had paired baseline S<sub>0</sub> and S<sub>1</sub> data. On S<sub>0</sub>, the median SUV<sub>max</sub> and HU<sub>mean</sub> of normal bone was 5.85 g/mL (0.42-14.98) and 133.03 (range, 28.47-461.91), respectively. The median SUV<sub>max</sub> and HU<sub>mean</sub> of metastasis were 42.2 g/mL (range, 17.96-143.36) and 549.58 (177.87-1107.64), respectively. There was significant reduction in SUV<sub>max</sub> (- 40.1%, range - 86.2 to + 23.5%), p < 0.001) and increase in HU<sub>mean</sub> (+ 8.3%, range - 11.3 to + 61.7%, p = 0.0479, Wilcoxon signed-rank test) of target lesions between S<sub>0</sub> and S<sub>1</sub>. Spearman correlation between the percentage changes of SUV<sub>max</sub> of a target lesion and both serum PSA (r = 0.33, p = 0.226) and ALP (r = 0.45, p = 0.094) were not statistically significant.</p><p><strong>Conclusion: </strong>Quantitative SPECT/CT provides consistent and objective imaging parameters, which can help monitor tumor burden. The median SUVmax of metastasis at baseline was roughly 7.2-fold higher than normal bone. Quantitative SPECT/CT may help visualize the early osteoblastic treatment response in prostate cancer patients treated with radium-223 alone or combined with pembrolizumab.</p>\",\"PeriodicalId\":20817,\"journal\":{\"name\":\"Radiologia Medica\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":9.7000,\"publicationDate\":\"2024-11-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Radiologia Medica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11547-024-01931-7\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiologia Medica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11547-024-01931-7","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Quantification of normal bone and osseous metastases in castration-resistant prostate cancer using SPECT/CT with xSPECT Quant: prospective imaging sub-study of a phase 2 clinical trial investigating the combination of pembrolizumab plus radium-223 compared to radium-223 alone.
Objective: The purpose of this study is to demonstrate the consistency and reproducibility of quantitative SPECT/CT by evaluating the maximum SUV (SUVmax) in normal bone, to provide the reference value of metastatic lesions, and to evaluate the clinical implication of SUVmax changes of osseous metastasis during treatment.
Material and methods: This prospective imaging sub-study was performed as part of a phase 2 clinical trial of patients with metastatic castration-resistant prostate cancer (mCRPC) randomized to the combination of pembrolizumab plus radium-223 or to radium-223 alone (NCT03093428). The maximum standardized uptake value (SUVmax) and mean Hounsfield Unit (HUmean) of normal bone as well as metastases were measured using a 1.5 cm region of interest (ROI) on CT and xSPECT Quant reconstruction on the baseline study (S0) and restaging scans. The most tracer-avid metastatic lesion in each patient on S0 was selected as a target lesion, and changes of SUVmax and HUmean of the target lesion were compared on the first restaging scan (S1). Correlations between the percentage changes of SUVmax of the target lesion with alkaline phosphatase (ALP) and prostate-specific antigen (PSA) were assessed.
Results: Twenty-one patients were enrolled on the imaging sub-study of which 15 had paired baseline S0 and S1 data. On S0, the median SUVmax and HUmean of normal bone was 5.85 g/mL (0.42-14.98) and 133.03 (range, 28.47-461.91), respectively. The median SUVmax and HUmean of metastasis were 42.2 g/mL (range, 17.96-143.36) and 549.58 (177.87-1107.64), respectively. There was significant reduction in SUVmax (- 40.1%, range - 86.2 to + 23.5%), p < 0.001) and increase in HUmean (+ 8.3%, range - 11.3 to + 61.7%, p = 0.0479, Wilcoxon signed-rank test) of target lesions between S0 and S1. Spearman correlation between the percentage changes of SUVmax of a target lesion and both serum PSA (r = 0.33, p = 0.226) and ALP (r = 0.45, p = 0.094) were not statistically significant.
Conclusion: Quantitative SPECT/CT provides consistent and objective imaging parameters, which can help monitor tumor burden. The median SUVmax of metastasis at baseline was roughly 7.2-fold higher than normal bone. Quantitative SPECT/CT may help visualize the early osteoblastic treatment response in prostate cancer patients treated with radium-223 alone or combined with pembrolizumab.
期刊介绍：
Felice Perussia founded La radiologia medica in 1914. It is a peer-reviewed journal and serves as the official journal of the Italian Society of Medical and Interventional Radiology (SIRM). The primary purpose of the journal is to disseminate information related to Radiology, especially advancements in diagnostic imaging and related disciplines. La radiologia medica welcomes original research on both fundamental and clinical aspects of modern radiology, with a particular focus on diagnostic and interventional imaging techniques. It also covers topics such as radiotherapy, nuclear medicine, radiobiology, health physics, and artificial intelligence in the context of clinical implications. The journal includes various types of contributions such as original articles, review articles, editorials, short reports, and letters to the editor. With an esteemed Editorial Board and a selection of insightful reports, the journal is an indispensable resource for radiologists and professionals in related fields. Ultimately, La radiologia medica aims to serve as a platform for international collaboration and knowledge sharing within the radiological community.
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