Gaertner Florian C, Halabi Khalil, Ahmadzadehfar Hojjat, Kürpig Stefan, Eppard Elisabeth, Kotsikopoulos Charalambos, Liakos Nikolaos, Bundschuh Ralph A, Strunk Holger, Essler Markus
Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany.
Department of Radiology, University Hospital Bonn, Bonn, Germany.
Oncotarget. 2017 Jul 6;8(33):55094-55103. doi: 10.18632/oncotarget.19049. eCollection 2017 Aug 15.
Radioligand therapy (RLT) with Lu-177-labeled PSMA-ligands is a new therapy option for prostate cancer. Biodistribution in normal tissues is of interest for therapy planning. We evaluated if the biodistribution of Ga-68-PSMA-11 is influenced by tumor load.
In patients with high tumor load, SUV was reduced to 61.5% in the lacrimal glands, to 56.6% in the parotid glands, to 63.7% in the submandibular glands, to 61.3% in the sublingual glands and to 55.4% in the kidneys ( < 0.001). Further significant differences were observed for brain, mediastinum, liver, spleen and muscle. Total tracer retention was higher in patients with high tumor load ( < 0.05). SUV in lacrimal, salivary glands and kidneys correlated negatively with PSA.
135 patients were retrospectively evaluated. SUV was measured in the lacrimal and salivary glands, brain, heart, liver, spleen, kidneys, muscle and bone. SUV was correlated with visual tumor load, total tracer retention and PSA.
Patients with high tumor load show a significant reduction of tracer uptake in dose-limiting organs. As similar effects might occur when performing RLT using Lu-177-labeled PSMA-ligands, individual adaptations of therapy protocols based on diagnostic PSMA PET imaging before therapy might help to further increase efficacy and safety of RLT.
用镥 - 177标记的前列腺特异性膜抗原（PSMA）配体进行放射性配体治疗（RLT）是前列腺癌的一种新治疗选择。正常组织中的生物分布对于治疗计划很重要。我们评估了镓 - 68 - PSMA - 11的生物分布是否受肿瘤负荷影响。
在肿瘤负荷高的患者中，泪腺的标准化摄取值（SUV）降至61.5%，腮腺降至56.6%，颌下腺降至63.7%，舌下腺降至61.3%，肾脏降至55.4%（<0.001）。在脑、纵隔、肝脏、脾脏和肌肉中也观察到进一步的显著差异。肿瘤负荷高的患者中示踪剂总滞留量更高（<0.05）。泪腺、唾液腺和肾脏中的SUV与前列腺特异性抗原（PSA）呈负相关。
对135例患者进行回顾性评估。在泪腺、唾液腺、脑、心脏、肝脏、脾脏、肾脏、肌肉和骨骼中测量SUV。SUV与视觉肿瘤负荷、示踪剂总滞留量和PSA相关。
肿瘤负荷高的患者在剂量限制器官中的示踪剂摄取显著降低。由于使用镥 - 177标记的PSMA配体进行RLT时可能会出现类似效果，在治疗前基于诊断性PSMA正电子发射断层扫描（PET）成像对治疗方案进行个体化调整可能有助于进一步提高RLT的疗效和安全性。
