de Laroche Romain, Bourhis David, Robin Philippe, Delcroix Olivier, Querellou Solène, Malhaire Jean-Pierre, Schlurmann Friederike, Bourbonne Vincent, Salaün Pierre-Yves, Schick Ulrike, Abgral Ronan
Nuclear Medicine Department, University Hospital Morvan, Brest, France.
Université de Bretagne Occidentale, Brest, France.
Front Med (Lausanne). 2020 Jan 22;6:342. doi: 10.3389/fmed.2019.00342. eCollection 2019.
We assessed the prognostic value of quantitative indices extracted from bone SPECT-CT to evaluate the response of bone metastatic castrate-resistant prostate cancer (BmCRPC) to abiraterone. Consecutive patients with BmCRPC initiating treatment with abiraterone from March 2014 to March 2015 were prospectively included. Three 2-bed SPECT-CT [at baseline [M0], after 3 months [M3], and 6 months [M6] of treatment], were planned (Symbia Intevo, Siemens). SPECT data were reconstructed using an Ordered Subset Conjugate Gradient Minimization (OSCGM) algorithm allowing SUV quantification. SUVmax and SUVpeak of the highest uptake lesion were measured in each SPECT-CT. Total Neoplastic Osteoblastic Metabolic Volume (NOMV) was assessed. PSA level was recorded at baseline, M3, and M6 of treatment. Overall survival (OS), progression-free survival (PFS), and disease-specific survival (DSS) were calculated. Nineteen patients aged 71.1 ± 7.7 years were included. Low M0 SUVmax was significantly predictive of longer OS ( = 0.04). Low NOMV at M0 were significantly predictive of longer PFS ( = 0.02). Patients with increase of at least 12.5% of the SUVpeak of the highest uptake lesion between M0 and M3 (ΔSUVpeakM0M3) had a significantly longer OS ( = 0.03). Patients with increase (or decrease lesser than 25%) of ΔSUVpeakM0M3 had a significantly longer DSS ( = 0.01). Patients with increase of NOMV of at least 45% between M0 and M6 had a significantly shorter PFS ( < 0.001). Variations of NOMV between M0 and M6 were significantly correlated with PSA variations between M0 and M6 ( = 0.73, = 0.02). Quantitative bone SPECT-CT appears to be a promising tool of BmCRPC assessment. Early flare-up phenomenon seems to predict longer OS.
我们评估了从骨SPECT-CT中提取的定量指标对评估骨转移性去势抵抗性前列腺癌（BmCRPC）对阿比特龙反应的预后价值。前瞻性纳入了2014年3月至2015年3月开始接受阿比特龙治疗的连续BmCRPC患者。计划进行三次双床位SPECT-CT检查（在基线[M0]、治疗3个月后[M3]和6个月后[M6]）（Symbia Intevo，西门子）。使用有序子集共轭梯度最小化（OSCGM）算法重建SPECT数据，以实现SUV定量。在每次SPECT-CT中测量最高摄取病灶的SUVmax和SUVpeak。评估总肿瘤成骨代谢体积（NOMV）。在治疗的基线、M3和M6记录PSA水平。计算总生存期（OS）、无进展生存期（PFS）和疾病特异性生存期（DSS）。纳入了19例年龄为71.1±7.7岁的患者。低M0 SUVmax显著预测更长的OS（P = 0.04）。M0时低NOMV显著预测更长的PFS（P = 0.02）。在M0和M3之间最高摄取病灶的SUVpeak增加至少12.5%（ΔSUVpeakM0M3）的患者有显著更长的OS（P = 0.03）。ΔSUVpeakM0M3增加（或减少小于25%）的患者有显著更长的DSS（P = 0.01）。在M0和M6之间NOMV增加至少45%的患者有显著更短的PFS（P < 0.001）。M0和M6之间NOMV的变化与M0和M6之间PSA的变化显著相关（r = 0.73，P = 0.02）。定量骨SPECT-CT似乎是评估BmCRPC的一个有前景的工具。早期 flare-up现象似乎预测更长的OS。
