期刊
DIAGNOSTICS
卷 11, 期 3, 页码 -出版社
MDPI
DOI: 10.3390/diagnostics11030428
关键词
radioligand therapy; Lu-177-PSMA; dosimetry; SPECT; mCRPC
资金
- Deutsche Forschungsgemeinschaft (DFG)
- Research Training Group GRK 2274 [299102935]
- Ludwig-Maximilians-University (FoFoLe program)
The study found that single index-lesion-based SPECT dosimetry correlates well with the response to PSMA-RLT, suggesting it may be a fast and feasible dosimetry approach for clinical routine.
Background: Dosimetry can tailor prostate-specific membrane-antigen-targeted radioligand therapy (PSMA-RLT) for metastatic castration-resistant prostate cancer (mCRPC). However, whole-body tumor dosimetry is challenging in patients with a high tumor burden. We evaluate a simplified index-lesion-based single-photon emission computed tomography (SPECT) dosimetry method in correlation with clinical outcome. Methods: 30 mCRPC patients were included (median 71 years). The dosimetry was performed for the first cycle using quantitative Lu-177-SPECT. The response was evaluated using RECIST 1.1 and PERCIST criteria, as well as changes in PSMA-positive tumor volume (PSMA-TV) in post-therapy PSMA-PET and biochemical response according to PSA changes after two RLT cycles. Results: Mean tumor doses as well as index-lesion doses were significantly higher in PERCIST responders compared to non-responders (10.2 +/- 12.0 Gy/GBq vs. 4.0 +/- 2.9 Gy/GBq, p = 0.03 and 13.7 +/- 14.2 Gy/GBq vs. 5.9 +/- 4.4 Gy/GBq, p = 0.04, respectively). No significant differences in mean tumor and index lesion doses were observed between responders and non-responders according to RECIST 1.1, PSMA-TV, and biochemical response criteria. Conclusion: Compared to mean tumor doses on a patient level, single index-lesion-based SPECT dosimetry correlates equally well with the response to PSMA-RLT according to PERCIST criteria and may represent a fast and feasible dosimetry approach for clinical routine.
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