Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California.
Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California.
J Nucl Med. 2024 Mar 1;65(3):409-415. doi: 10.2967/jnumed.123.266614.
Posttreatment imaging of γ-emissions after peptide receptor radionuclide therapy (PRRT) can be used to perform quantitative dosimetry as well as assessment response using qualitative measures. We aimed to assess the impact of qualitative posttreatment imaging on the management of patients undergoing PRRT. In this retrospective study, we evaluated 100 patients with advanced well-differentiated neuroendocrine tumors undergoing PRRT, who had posttreatment SPECT/CT imaging at 24 h. First, we evaluated the qualitative assessment of response at each cycle. Then using a chart review, we determined the impact on management from the posttreatment imaging. The changes in management were categorized as major or minor, and the cycles at which these changes occurred were noted. Additionally, tumor grade was also evaluated. Of the 100 sequential patients reviewed, most (80% after cycle 2, 79% after cycle 3, and 73% after cycle 4) showed qualitatively stable disease during PRRT. Management changes were observed in 27% ( = 27) of patients; 78% of those ( = 21) were major, and 30% ( = 9) were minor. Most treatment changes occurred after cycle 2 (33% major, 67% minor) and cycle 3 (62% major, 33% minor). Higher tumor grade correlated with increased rate of changes in management ( = 0.006). In this retrospective study, qualitative analysis of posttreatment SPECT/CT imaging informed changes in management in 27% of patients. Patients with higher-grade tumors had a higher rate of change in management, and most of the management changes occurred after cycles 2 and 3. Incorporating posttreatment imaging into standard PRRT workflows could potentially enhance patient management.
肽受体放射性核素治疗 (PRRT) 后γ射线发射的治疗后成像可用于进行定量剂量测定以及使用定性测量评估反应。我们旨在评估定性治疗后成像对接受 PRRT 的患者管理的影响。 在这项回顾性研究中，我们评估了 100 例接受 PRRT 的晚期高分化神经内分泌肿瘤患者，他们在 24 小时后进行了 SPECT/CT 治疗后成像。首先，我们评估了每个周期反应的定性评估。然后，通过病历回顾，我们确定了治疗后成像对管理的影响。管理上的变化分为主要或次要变化，并记录了这些变化发生的周期。此外，还评估了肿瘤分级。 在回顾的 100 例连续患者中，大多数患者（第 2 周期后 80%，第 3 周期后 79%，第 4 周期后 73%）在 PRRT 期间表现出定性稳定的疾病。观察到 27%（=27）的患者管理发生变化；其中 78%（=21）为主要变化，30%（=9）为次要变化。大多数治疗变化发生在第 2 周期（33%主要，67%次要）和第 3 周期（62%主要，33%次要）后。较高的肿瘤分级与管理变化率的增加相关（=0.006）。 在这项回顾性研究中，治疗后 SPECT/CT 成像的定性分析导致 27%的患者管理发生变化。肿瘤分级较高的患者管理变化率较高，大多数管理变化发生在第 2 周期和第 3 周期后。将治疗后成像纳入 PRRT 标准工作流程中可能会增强患者管理。
