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Value of Combined PET Imaging with [ 18 F]FDG and [ 68 Ga]Ga-PSMA-11 in mCRPC Patients with Worsening Disease during [ 177 Lu]Lu-PSMA-617 RLT.
- Source :
-
Cancers [Cancers (Basel)] 2021 Aug 17; Vol. 13 (16). Date of Electronic Publication: 2021 Aug 17. - Publication Year :
- 2021
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Abstract
- Despite the promising results of prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT) in metastatic castration-resistant prostate cancer (mCRPC), some patients show worsening disease during PSMA-RLT. We investigated the value of combined [ <superscript>18</superscript> F]FDG and [ <superscript>68</superscript> Ga]Ga-PSMA-11 PET imaging in this setting. In n = 29 mCRPC patients with worsening disease after a median of four cycles of [ <superscript>177</superscript> Lu]Lu-PSMA-617 RLT, combined [ <superscript>18</superscript> F]FDG and [ <superscript>68</superscript> Ga]Ga-PSMA-11 PET imaging was performed to detect [ <superscript>18</superscript> F]FDG-avid lesions with low or no PSMA expression (mismatch lesions). To evaluate prognostic implication of mismatch, survival analyses regarding presence, location, and [ <superscript>18</superscript> F]FDG PET-derived parameters such as SUV <subscript>max</subscript> , metabolic tumor volume (MTV <subscript>m</subscript> ), and total lesion glycolysis (TLG <subscript>m</subscript> ) of mismatch findings were performed. Seventeen patients (59%) showed at least one mismatch metastasis. From the time point of combined PET imaging, the median overall survival (OS) of patients with mismatch findings was significantly (p = 0.008) shorter than those without (3.3 vs. 6.1 mo). Patients with a high MTV <subscript>m</subscript> revealed a significantly ( p = 0.034) shorter OS of 2.6 mo than patients with low MTV <subscript>m</subscript> (5.3 mo). Furthermore, patients with hepatic mismatch showed a significantly ( p = 0.049) shorter OS than those without (2.9 vs. 5.3 mo). Difference in OS regarding SUV <subscript>max</subscript> and TLG <subscript>m</subscript> was not significant. In mCRPC patients with worsening disease during PSMA-RLT, combined [ <superscript>18</superscript> F]FDG and [ <superscript>68</superscript> Ga]Ga-PSMA-11 PET imaging is essential to identify mismatch findings, as these are associated with poor outcomes requiring a change in therapy management.
Details
- Language :
- English
- ISSN :
- 2072-6694
- Volume :
- 13
- Issue :
- 16
- Database :
- MEDLINE
- Journal :
- Cancers
- Publication Type :
- Academic Journal
- Accession number :
- 34439287
- Full Text :
- https://doi.org/10.3390/cancers13164134