一项关于镓-PSMA-617正电子发射断层扫描/计算机断层扫描成像及镥-EB-PSMA-617放射性配体疗法用于腺样囊性癌患者的初步研究。
A pilot study of Ga-PSMA-617 PET/CT imaging and Lu-EB-PSMA-617 radioligand therapy in patients with adenoid cystic carcinoma.
作者信息
Wang Guochang, Zhou Mengjiao, Zang Jie, Jiang Yuanyuan, Chen Xiaohong, Zhu Zhaohui, Chen Xiaoyuan
机构信息
Department of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China.
Department of Otolaryngology Head and Neck Surgery, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otolaryngology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
出版信息
EJNMMI Res. 2022 Aug 19;12(1):52. doi: 10.1186/s13550-022-00922-x.
BACKGROUND
This pilot study was designed to evaluate the diagnostic value of Ga-PSMA-617 and F-FDG PET/CT in adenoid cystic carcinoma (ACC) and to assess the safety and therapeutic response to PSMA radioligand therapy (RLT) in ACC patients.
METHODS
Thirty patients pathologically diagnosed with ACC were recruited into the cohort. Each patient underwent Ga-PSMA-617 and F-FDG PET/CT within 1 week. The number and SUVmax of PET-positive lesions were recorded and compared. Four patients accepted RLT using Lu-EB-PSMA-617, in a dosage of approximately 1.85 GBq (50 mCi) per cycle for up to 3 cycles.
RESULTS
Compared with F-FDG, Ga-PSMA-617 revealed more PET-positive extrapulmonary tumors (157 vs. 141, P = 0.016) and higher SUVmax (8.8 ± 3.6 vs. 6.4 ± 4.2, P = 0.027). However, Ga-PSMA-617 revealed less PET-positive pulmonary lesions (202 vs. 301, P < 0.001) and lower SUVmax of tumors (3.1 ± 3.0 vs. 4.2 ± 3.9, P < 0.001) than F-FDG. The combination of Ga-PSMA-617 and F-FDG can detect 469 PET-positive lesions, which was superior to each alone (469 vs. 359 vs. 442, P < 0.001). Two patients achieved remarkable response after PSMA RLT, while the other two patients showed reduced tumor uptake of recurrent foci, lung and liver metastases, whereas increased SUVmax of bone metastases.
CONCLUSIONS
Ga-PSMA-617 PET/CT is a valuable imaging modality for the detection of ACC and combining with F-FDG PET/CT will achieve a higher detection efficiency. PSMA RLT may be a promising treatment for ACC and is worth of further investigation.
TRIAL REGISTRATION
Diagnosis of Adenoid Cystic Carcinoma on Ga-PSMA-617 PET-CT and Therapy With Lu-EB-PSMA-617 (NCT04801264, Registered 16 March 2021, retrospectively registered). URL of registry: https://clinicaltrials.gov/ct2/show/NCT04801264 .
背景
本前瞻性研究旨在评估⁶⁸Ga-PSMA-617和¹⁸F-FDG PET/CT在腺样囊性癌（ACC）中的诊断价值，并评估ACC患者接受PSMA放射性配体治疗（RLT）的安全性和治疗反应。
方法
30例经病理诊断为ACC的患者纳入本队列。每位患者在1周内接受⁶⁸Ga-PSMA-617和¹⁸F-FDG PET/CT检查。记录并比较PET阳性病变的数量和SUVmax。4例患者接受了¹⁷⁷Lu-EB-PSMA-617的RLT治疗，每个周期的剂量约为1.85GBq（50mCi），最多3个周期。
结果
与¹⁸F-FDG相比，⁶⁸Ga-PSMA-617显示出更多的PET阳性肺外肿瘤（157个对141个，P = 0.016）和更高的SUVmax（8.8±3.6对6.4±4.2，P = 0.027）。然而，⁶⁸Ga-PSMA-617显示出的PET阳性肺部病变较少（202个对301个，P < 0.001），肿瘤的SUVmax也较低（3.1±3.0对4.2±3.9，P < 0.001）。⁶⁸Ga-PSMA-617和¹⁸F-FDG联合使用可检测到469个PET阳性病变，优于单独使用任何一种（469个对359个对442个，P < 0.001）。2例患者在接受PSMA RLT后取得了显著反应，而另外2例患者复发灶、肺和肝转移的肿瘤摄取减少，而骨转移的SUVmax增加。
结论
⁶⁸Ga-PSMA-617 PET/CT是检测ACC的一种有价值的成像方式，与¹⁸F-FDG PET/CT联合使用将获得更高的检测效率。PSMA RLT可能是ACC的一种有前景的治疗方法，值得进一步研究。
试验注册
⁶⁸Ga-PSMA-617 PET-CT诊断腺样囊性癌及¹⁷⁷Lu-EB-PSMA-617治疗（NCT04801264，2021年3月16日注册，回顾性注册）。注册网址：https://clinicaltrials.gov/ct2/show/NCT04801264 。
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