Kunte Sophie Carina, Holzgreve Adrien, Unterrainer Marcus, Zahner Josef, Schmid Hans Peter, Schöll Magdalena, Blajan Iulia, Sheikh Gabriel T, Mehrens Dirk, Casuscelli Jozefina, Tamalunas Alexander J, Werner Rudolf A, Stief Christian G, Staehler Michael, Unterrainer Lena M
Department of Nuclear Medicine, LMU University Hospital, LMU Munich, 81377 Munich, Germany.
Bavarian Cancer Research Center (BZKF), Partner Site Munich, 80539 Munich, Germany.
Cancers (Basel). 2025 May 22;17(11):1736. doi: 10.3390/cancers17111736.
: Early treatment assessment in metastatic renal cell carcinoma (mRCC) remains challenging due to the limited accuracy of current imaging methods. Given prostate-specific membrane antigen (PSMA) overexpression in mRCC, PSMA PET is a promising approach. Despite numerous studies on PSMA imaging in mRCC, data on PSMA uptake changes during systemic therapy are scarce. We analyzed PSMA uptake on PET after treatment initiation in mRCC patients. : A retrospective single-center analysis of mRCC patients who underwent [F]PSMA-1007 PET/CT before (PET) and at a mean of 9.5 weeks after (PET) starting systemic therapy was conducted. PSMA uptake in metastatic lesions was compared by region and RCC subtype. Uptake differences between PET and PET were analyzed using an unpaired -test. : This study included 25 patients (mean age 65.2 ± 14.7 years; 20 male) with mRCC. A total of 113 (PET) and 48 (PET) metastases were assessed. Lymph node metastases showed stable PSMA uptake (median SUV) after treatment (7.8 vs. 7.7, = 0.77), while uptake by bone (6.4 vs. 12.4, = 0.03) and lung metastases (4.5 vs. 8.1, = 0.004) increased significantly. SUV stability in lymph nodes was independent of RCC subtype (ccRCC: = 0.48, pRCC: > 0.99). Bone (6.6 vs. 15.9, = 0.008) and lung metastases (4.8 vs. 8.1, = 0.02) had higher PSMA uptake in ccRCC, unlike pRCC (bone: 6.2 vs. 6.0, = 0.86). : Alterations of PSMA-radioligand uptake are seen in bone and pulmonary metastases but not in lymph node metastases after initiation of systemic treatment in patients with mRCC. ccRCC has a higher PSMA uptake than other RCC subtypes.
由于当前成像方法的准确性有限，转移性肾细胞癌（mRCC）的早期治疗评估仍然具有挑战性。鉴于前列腺特异性膜抗原（PSMA）在mRCC中过表达，PSMA PET是一种有前景的方法。尽管对mRCC中PSMA成像进行了大量研究，但关于全身治疗期间PSMA摄取变化的数据却很少。我们分析了mRCC患者开始治疗后PET上的PSMA摄取情况。：对在开始全身治疗前（PET）和平均9.5周后（PET）接受[F]PSMA-1007 PET/CT的mRCC患者进行了一项回顾性单中心分析。通过区域和RCC亚型比较转移灶中的PSMA摄取。使用不成对t检验分析PET和PET之间的摄取差异。：本研究纳入了25例mRCC患者（平均年龄65.2±14.7岁；20例男性）。共评估了113个（PET）和48个（PET）转移灶。治疗后淋巴结转移灶的PSMA摄取稳定（SUV中位数）（7.8对7.7，P=0.77），而骨转移灶（6.4对12.4，P=0.03）和肺转移灶（4.5对8.1，P=0.004）的摄取显著增加。淋巴结中SUV的稳定性与RCC亚型无关（透明细胞肾细胞癌：P=0.48，乳头状肾细胞癌：P>0.99）。与乳头状肾细胞癌相比，透明细胞肾细胞癌的骨转移灶（6.6对15.9, P=0.008）和肺转移灶（4.8对8.1, P=0.02）具有更高的PSMA摄取（骨转移：6.2对6.0，P=0.86）。：mRCC患者开始全身治疗后，骨转移灶和肺转移灶中可见PSMA放射性配体摄取改变，但淋巴结转移灶中未见。透明细胞肾细胞癌的PSMA摄取高于其他RCC亚型。
