Einspieler Holger, Ofner Heidemarie, Ozenil Marius, Spielvogel Clemens P, Langrate Ilva Kristiana, Hassler Melanie R, Nics Lukas, Bamminger Karsten, Baltzer Pascal A T, Shariat Shahrokh F, Hacker Marcus, Kramer Gero, Rasul Sazan
Department of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, 1090, Austria.
Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Eur J Nucl Med Mol Imaging. 2025 Jul 19. doi: 10.1007/s00259-025-07448-z.
[F] Poly-ADP-ribose polymerase inhibitors (PARPi), a novel radiotracer, enables visualization of PARP1 upregulation by PET imaging. Here, we aimed to quantify PARPi uptake in tumor lesions of metastatic castration-resistant PCa (mCRPC) patients and perform a comparison with prostate specific membrane antigen (PSMA) expression using PET/CT scans.
Data from 22 male patients with mCRPC, who underwent [F]PARPi and [Ga]Ga-PSMA-11 PET/CT scans, were retrospectively quantified. Lesions with relevant PARPi uptake (higher than background) were delineated and correlated with their [Ga]PSMA uptake using standardized uptake values (SUV). Additionally, a comparison was performed to investigate the effects of homologous recombination deficiency (HRD) alterations on PARPi tumor uptake.
The majority of metastatic PCa lesions that exhibited PARPi uptake were located in the bones (n = 57), with mean SUVmax values of 4.9 ± 1.5 for PARPi and 30.9 ± 28.3 for [Ga]PSMA. Additionally, 3 local prostate lesions, 14 lymph nodes and 4 further metastatic lesions were detected. Significant correlations were identified between PARPi- and [Ga]PSMA uptake, as measured by SUVmean (r = 0.48, p < 0.001), SUVpeak (r = 0.48, p < 0.001) and SUVmax (r = 0.43, p < 0.001) of the osseous metastatic lesions and SUVpeak (r = 0.49, p = 0.04) of extraosseous lesions. No significant differences were found between PARPi uptake of metastatic lesions in patients with or without HRD alterations (all p > 0.05).
Results showed a considerable uptake of [F]PARPi in mCRPC patients and indicated a correlation between PARPi uptake and PSMA expression, suggesting the potential of using [F]PARPi as a diagnostic imaging tool in mCRPC patients. More studies are needed to evaluate the clinical benefit of this innovative radiotracer.
[F]聚-ADP-核糖聚合酶抑制剂（PARPi）是一种新型放射性示踪剂，可通过PET成像使PARP1上调可视化。在此，我们旨在对转移性去势抵抗性前列腺癌（mCRPC）患者肿瘤病灶中的PARPi摄取进行定量，并使用PET/CT扫描与前列腺特异性膜抗原（PSMA）表达进行比较。
回顾性定量分析22例接受[F]PARPi和[Ga]Ga-PSMA-11 PET/CT扫描的mCRPC男性患者的数据。勾勒出具有相关PARPi摄取（高于背景）的病灶，并使用标准化摄取值（SUV）将其与[Ga]PSMA摄取相关联。此外，进行比较以研究同源重组缺陷（HRD）改变对PARPi肿瘤摄取的影响。
表现出PARPi摄取的大多数转移性前列腺癌病灶位于骨骼（n = 57），PARPi的平均SUVmax值为4.9±1.5，[Ga]PSMA的平均SUVmax值为30.9±28.3。此外，还检测到3个局部前列腺病灶、14个淋巴结和4个其他转移病灶。通过骨转移病灶的SUVmean（r = 0.48，p < 0.001）、SUVpeak（r = 0.48，p < 0.001）和SUVmax（r = 0.43，p < 0.001）以及骨外病灶的SUVpeak（r = 0.49，p = 0.04）确定PARPi与[Ga]PSMA摄取之间存在显著相关性。在有或无HRD改变的患者中，转移病灶的PARPi摄取没有显著差异（所有p > 0.05）。
结果显示mCRPC患者中[F]PARPi有相当程度的摄取，并表明PARPi摄取与PSMA表达之间存在相关性，提示[F]PARPi作为mCRPC患者诊断成像工具的潜力。需要更多研究来评估这种创新放射性示踪剂的临床益处。
