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Correlation of an Index-Lesion-Based SPECT Dosimetry Method with Mean Tumor Dose and Clinical Outcome after (177)Lu-PSMA-617 Radioligand Therapy
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-base...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999994/ https://www.ncbi.nlm.nih.gov/pubmed/33802417 http://dx.doi.org/10.3390/diagnostics11030428 |
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author | Völter, Friederike Mittlmeier, Lena Gosewisch, Astrid Brosch-Lenz, Julia Gildehaus, Franz Josef Zacherl, Mathias Johannes Beyer, Leonie Stief, Christian G. Holzgreve, Adrien Rübenthaler, Johannes Cyran, Clemens C. Böning, Guido Bartenstein, Peter Todica, Andrei Ilhan, Harun |
author_facet | Völter, Friederike Mittlmeier, Lena Gosewisch, Astrid Brosch-Lenz, Julia Gildehaus, Franz Josef Zacherl, Mathias Johannes Beyer, Leonie Stief, Christian G. Holzgreve, Adrien Rübenthaler, Johannes Cyran, Clemens C. Böning, Guido Bartenstein, Peter Todica, Andrei Ilhan, Harun |
author_sort | Völter, Friederike |
collection | PubMed |
description | 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 (177)Lu-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. |
format | Online Article Text |
id | pubmed-7999994 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-79999942021-03-28 Correlation of an Index-Lesion-Based SPECT Dosimetry Method with Mean Tumor Dose and Clinical Outcome after (177)Lu-PSMA-617 Radioligand Therapy Völter, Friederike Mittlmeier, Lena Gosewisch, Astrid Brosch-Lenz, Julia Gildehaus, Franz Josef Zacherl, Mathias Johannes Beyer, Leonie Stief, Christian G. Holzgreve, Adrien Rübenthaler, Johannes Cyran, Clemens C. Böning, Guido Bartenstein, Peter Todica, Andrei Ilhan, Harun Diagnostics (Basel) Article 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 (177)Lu-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. MDPI 2021-03-03 /pmc/articles/PMC7999994/ /pubmed/33802417 http://dx.doi.org/10.3390/diagnostics11030428 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ). |
spellingShingle | Article Völter, Friederike Mittlmeier, Lena Gosewisch, Astrid Brosch-Lenz, Julia Gildehaus, Franz Josef Zacherl, Mathias Johannes Beyer, Leonie Stief, Christian G. Holzgreve, Adrien Rübenthaler, Johannes Cyran, Clemens C. Böning, Guido Bartenstein, Peter Todica, Andrei Ilhan, Harun Correlation of an Index-Lesion-Based SPECT Dosimetry Method with Mean Tumor Dose and Clinical Outcome after (177)Lu-PSMA-617 Radioligand Therapy |
title | Correlation of an Index-Lesion-Based SPECT Dosimetry Method with Mean Tumor Dose and Clinical Outcome after (177)Lu-PSMA-617 Radioligand Therapy |
title_full | Correlation of an Index-Lesion-Based SPECT Dosimetry Method with Mean Tumor Dose and Clinical Outcome after (177)Lu-PSMA-617 Radioligand Therapy |
title_fullStr | Correlation of an Index-Lesion-Based SPECT Dosimetry Method with Mean Tumor Dose and Clinical Outcome after (177)Lu-PSMA-617 Radioligand Therapy |
title_full_unstemmed | Correlation of an Index-Lesion-Based SPECT Dosimetry Method with Mean Tumor Dose and Clinical Outcome after (177)Lu-PSMA-617 Radioligand Therapy |
title_short | Correlation of an Index-Lesion-Based SPECT Dosimetry Method with Mean Tumor Dose and Clinical Outcome after (177)Lu-PSMA-617 Radioligand Therapy |
title_sort | correlation of an index-lesion-based spect dosimetry method with mean tumor dose and clinical outcome after (177)lu-psma-617 radioligand therapy |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999994/ https://www.ncbi.nlm.nih.gov/pubmed/33802417 http://dx.doi.org/10.3390/diagnostics11030428 |
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