Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Centre Annexe, Jerbai Wadia Road, Parel.
Homi Bhabha National Institute, Mumbai, India.
Nucl Med Commun. 2021 May 1;42(5):566-574. doi: 10.1097/MNM.0000000000001371.
To develop and examine a scoring system in metastatic castration-resistant prostate carcinoma (mCRPC) that integrates findings of both 68Ga-prostate-specific membrane antigen (PSMA) and flurodeoxyglucose (FDG) PET-CT imaging in a single combined parameter and referred to as the 'Pro-PET' score.
A six-tier integrated dual tracer PET-CT (68Ga-PSMA and FDG) Image Scoring System ('Pro-PET' score) was conceptualized, based on the findings of both 68Ga-PSMA-11 and FDG PET-CT in patients of mCRPC. This proposed integrated scoring was examined in a retrospective analytical study assessing mCRPC patients (n = 47) referred for 177Lu-PSMA-617 peptide receptor radioligand therapy (PRLT) and had both FDG and 68Ga-PSMA PET-CT undertaken within 15 days of each other without any interim treatment intervention. The 'Pro-PET' score grades and subgrades were assigned and compared with clinical data, such as histopathology, Gleason score, serum prostate-specific antigen (PSA), treatment response (symptomatic, biochemical, metabolic and anatomical) and survival [overall survival (OS) and progression-free survival (PFS)].
The Pro-PET score significantly correlated with symptomatic (P = 0.05), biochemical (P = 0.05), metabolic (P = 0.001) and anatomical (P = 0.012) responses, PFS (P = 0.03) and OS (P = 0.027). On multivariate analysis, histopathology, Gleason score and PSA as individual parameters were not significantly associated with OS and PFS, whereas the Pro-PET score was found to have a significant association (P = 0.001 for PFS and 0.011 for OS).
The 'Pro-PET' scoring system integrating dual tracer PET-CT imaging findings in a single parameter appeared as a potentially promising prognostic marker that has the potential to enhance the objectivity and scientific basis of prostate carcinoma theranostics and prognostication.
开发并检验一种评分系统，该系统将转移性去势抵抗性前列腺癌（mCRPC）中 68Ga-前列腺特异性膜抗原（PSMA）和氟脱氧葡萄糖（FDG）PET-CT 成像的结果整合到一个单一的联合参数中，并称为“Pro-PET”评分。
根据 mCRPC 患者的 68Ga-PSMA-11 和 FDG PET-CT 结果，提出了一种六级综合双示踪剂 PET-CT（68Ga-PSMA 和 FDG）图像评分系统（“Pro-PET”评分）。在回顾性分析研究中，对接受 177Lu-PSMA-617 肽受体放射性配体治疗（PRLT）的 mCRPC 患者（n=47）进行了评估，这些患者在 15 天内接受了 FDG 和 68Ga-PSMA PET-CT 检查，且没有接受任何中间治疗干预。对“Pro-PET”评分等级和亚等级进行了分配，并与临床数据（如组织病理学、Gleason 评分、血清前列腺特异性抗原（PSA）、治疗反应（症状、生化、代谢和解剖）和生存情况（总生存（OS）和无进展生存（PFS））进行了比较。
Pro-PET 评分与症状（P=0.05）、生化（P=0.05）、代谢（P=0.001）和解剖（P=0.012）反应、PFS（P=0.03）和 OS（P=0.027）显著相关。多变量分析显示，组织病理学、Gleason 评分和 PSA 作为单一参数与 OS 和 PFS 无显著相关性，而 Pro-PET 评分与之显著相关（PFS 的 P=0.001，OS 的 P=0.011）。
将双示踪剂 PET-CT 成像结果整合到单一参数中的“Pro-PET”评分系统似乎是一种有前途的预后标志物，有可能提高前列腺癌治疗和预后的客观性和科学性。
