Schmuck Sebastian, von Klot Christoph A, Henkenberens Christoph, Sohns Jan M, Christiansen Hans, Wester Hans-Jürgen, Ross Tobias L, Bengel Frank M, Derlin Thorsten
Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany.
Department of Urology and Urologic Oncology, Hannover Medical School, Hannover, Germany.
J Nucl Med. 2017 Dec;58(12):1962-1968. doi: 10.2967/jnumed.117.193581. Epub 2017 May 18.
A quantitative imaging biomarker is desirable to provide a comprehensive measure of whole-body tumor burden in patients with metastatic prostate cancer, and to standardize the evaluation of treatment-related changes. Therefore, we evaluated whether prostate-specific membrane antigen (PSMA) ligand PET/CT may be applied to provide PSMA-derived volumetric parameters for quantification of whole-body tumor burden. One hundred one patients who underwent Ga-PSMA I&T PET/CT because of increasing prostate-specific antigen (PSA) levels after radical prostatectomy were included in this retrospective analysis. Tracer uptake was quantified using SUVs. Volumetric parameters, that is, PSMA-derived tumor volume (PSMA-TV) and total lesion PSMA (TL-PSMA), were calculated for each patient using a 3-dimensional segmentation and computerized volumetry technique and compared with serum PSA levels. In a group of 10 patients, volumetric parameters were applied for treatment monitoring. Volumetric parameters, that is, whole-body PSMA-TV and whole-body TL-PSMA, demonstrated a statistically significant correlation with PSA levels ( < 0.0001) as a surrogate marker of tumor burden, whereas SUV ( = 0.22) or SUV ( = 0.45) did not. Treatment response and treatment failure were paralleled by concordant changes in both whole-body PSMA-TV and whole-body TL-PSMA ( = 0.02), whereas neither the change in SUV ( = 1.0) nor the change in SUV ( = 1.0) concordantly paralleled changes in PSA levels. PSMA-derived volumetric parameters provide a quantitative imaging biomarker for whole-body tumor burden, capable of standardizing quantitative changes in PET imaging of patients with metastatic prostate cancer and of facilitating therapy monitoring.
对于转移性前列腺癌患者，需要一种定量成像生物标志物来全面衡量全身肿瘤负荷，并使治疗相关变化的评估标准化。因此，我们评估了前列腺特异性膜抗原（PSMA）配体PET/CT是否可用于提供源自PSMA的体积参数，以量化全身肿瘤负荷。本回顾性分析纳入了101例因前列腺癌根治术后前列腺特异性抗原（PSA）水平升高而接受镓-PSMA I&T PET/CT检查的患者。使用SUV对示踪剂摄取进行定量。使用三维分割和计算机容积测量技术为每位患者计算体积参数，即源自PSMA的肿瘤体积（PSMA-TV）和总病变PSMA（TL-PSMA），并与血清PSA水平进行比较。在一组10例患者中，应用体积参数进行治疗监测。体积参数，即全身PSMA-TV和全身TL-PSMA，与作为肿瘤负荷替代标志物的PSA水平呈现出统计学上的显著相关性（<0.0001），而SUV（=0.22）或SUV（=0.45）则未显示出相关性。全身PSMA-TV和全身TL-PSMA的一致变化与治疗反应和治疗失败情况平行（=0.02），而SUV的变化（=1.0）和SUV的变化（=1.0）均未与PSA水平的变化一致平行。源自PSMA的体积参数为全身肿瘤负荷提供了一种定量成像生物标志物，能够使转移性前列腺癌患者PET成像中的定量变化标准化，并有助于治疗监测。
