Alkahtani Tahani O
Department of Radiological Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia.
BMC Med Imaging. 2025 Jan 28;25(1):28. doi: 10.1186/s12880-025-01571-x.
Quantitative molecular imaging via single-photon emission computed tomography-derived standardised uptake value (SPECT/CT-SUV) is used to assess the response of metastatic castration-resistant prostate cancer (mCRPC) patients to targeted radionuclide therapy (TRT) with [Lu]Lu-PSMA. This imaging technique determines the radiopharmaceutical distribution and internal dosimetry in patients who receive TRT. However, there is limited evidence regarding the role of image quantification in monitoring changes induced by [Lu]Lu-PSMA. This systematic examines the role of quantitative SPECT/CT-SUV during [Lu]Lu-PSMA TRT and assesses whether SUV changes correlate with quantitative imaging and biomarkers.
A systematic review was conducted in accordance with the PRISMA guidelines. The MEDLINE/PubMed databases were searched from January 2016 to July 2024 to identify relevant articles. The inclusion criterion was the use of quantitative SPECT/CT-SUV during [Lu]Lu-PSMA TRT for patients with mCRPC. The records were screened to determine their eligibility. The abstracts of 62 records were screened, and 28 were excluded because they were not relevant; the full texts of 34 original papers were retrieved and assessed for eligibility.
A total of five studies were included in this systematic review (two prospective studies and three retrospective studies). The sample sizes of the studies ranged from 6 to 73 patients. The highest number of lesions analysed was 144. Three studies reported the SPECT/CT-SUV following cycle 1, and only one study reported the correlation with pretherapy PET/CT (r = 0.9, p = 0.005). SPECT/CT-SUV changes between the first two to three cycles were reported in one study. None of the studies reported the SPECT/CT-SUV for normal organs. One study reported correlations between SPECT/CT-derived SUV and PET/CT-derived SUV in target and nontarget tissues.
Quantitative SPECT/CT-SUV can be used to predict responses to subsequent PSMA-TRT cycles. Disease burden and tumour heterogeneity are the leading causes of TRT individualisation.
通过单光子发射计算机断层扫描衍生的标准化摄取值（SPECT/CT-SUV）进行定量分子成像，用于评估转移性去势抵抗性前列腺癌（mCRPC）患者对[Lu]Lu-PSMA靶向放射性核素治疗（TRT）的反应。这种成像技术可确定接受TRT患者体内放射性药物的分布和内照射剂量。然而，关于图像定量在监测[Lu]Lu-PSMA引起的变化中的作用，证据有限。本系统评价研究了定量SPECT/CT-SUV在[Lu]Lu-PSMA TRT中的作用，并评估SUV变化是否与定量成像和生物标志物相关。
按照PRISMA指南进行系统评价。检索了2016年1月至2024年7月的MEDLINE/PubMed数据库以识别相关文章。纳入标准是在mCRPC患者的[Lu]Lu-PSMA TRT期间使用定量SPECT/CT-SUV。对记录进行筛选以确定其是否符合条件。筛选了62条记录的摘要，排除了28条不相关的记录；检索了34篇原始论文的全文并评估其是否符合条件。
本系统评价共纳入五项研究（两项前瞻性研究和三项回顾性研究）。研究的样本量从6例到73例患者不等。分析的病变数量最多为144个。三项研究报告了第1周期后的SPECT/CT-SUV，只有一项研究报告了与治疗前PET/CT的相关性（r = 0.9，p = 0.005）。一项研究报告了前两至三个周期之间的SPECT/CT-SUV变化。没有研究报告正常器官的SPECT/CT-SUV。一项研究报告了SPECT/CT衍生的SUV与PET/CT衍生的SUV在靶组织和非靶组织中的相关性。
定量SPECT/CT-SUV可用于预测对后续PSMA-TRT周期的反应。疾病负担和肿瘤异质性是TRT个体化的主要原因。
