Department of Nuclear Medicine, University Hospital RWTH Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany.
Institute for Neuroscience and Medicine (INM-4), Research Centre Jülich, Jülich, Germany.
Eur J Nucl Med Mol Imaging. 2019 May;46(5):1054-1062. doi: 10.1007/s00259-019-4258-6. Epub 2019 Jan 29.
To evaluate the use of Ga-PSMA PET/CT for monitoring response to Lu-617 PSMA radioligand therapy in patients with metastatic castrate-resistant prostate cancer (mCRPC).
Patients from the University Hospital Bonn and the University Hospital Aachen were retrospectively reviewed for this study. We included 48 patients with mCRPC who were treated with Lu-PSMA-617 and whose records included Ga-PSMA PET/CT imaging before the first and after the third or fourth treatment cycle. A treatment response based on Ga-PSMA PET/CT was defined according to a modified version of the PERCIST criteria. A decline in PSA level of ≥50% was considered the reference standard. The sensitivity, specificity, positive and negative predictive values, and ROC curves were calculated, and patient survival times in relation to the PET results were also analysed.
Ga-PSMA PET/CT had a sensitivity of about 85% and a specificity of between 55% and 65%. The negative and positive predictive values ranged between 70% and 78%. The fitted ROC area was 0.70. The survival time was about 19.6 months in patients with a treatment response, while nonresponders had a survival time of about 15.9 months. However, this difference between the groups was not statistically significant.
Our results indicate that Ga-PSMA PET/CT could be a useful tool for the evaluation of response to Lu-PSMA-617 radioligand therapy within a theranostic framework.
评估 Ga-PSMA PET/CT 在监测转移性去势抵抗性前列腺癌（mCRPC）患者接受 Lu-617 PSMA 放射性配体治疗反应中的应用。
本研究回顾性分析了来自波恩大学医院和亚琛大学医院的患者。共纳入 48 例接受 Lu-PSMA-617 治疗的 mCRPC 患者，其病历中包括治疗前第一次和第三次或第四次治疗周期后的 Ga-PSMA PET/CT 影像学检查。根据 PERCIST 标准的改良版，将基于 Ga-PSMA PET/CT 的治疗反应定义为标准。PSA 水平下降≥50%被认为是参考标准。计算了敏感性、特异性、阳性和阴性预测值以及 ROC 曲线，并分析了患者与 PET 结果相关的生存时间。
Ga-PSMA PET/CT 的敏感性约为 85%，特异性在 55%至 65%之间。阴性和阳性预测值在 70%至 78%之间。拟合的 ROC 面积为 0.70。治疗反应患者的生存时间约为 19.6 个月，而无反应者的生存时间约为 15.9 个月。然而，两组之间的差异没有统计学意义。
我们的结果表明，Ga-PSMA PET/CT 可能是 Lu-PSMA-617 放射性配体治疗反应评估的有用工具，在治疗框架内。
