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Research ArticleImaging

Comparison of Dual-Tracer PET and CT Features to Conventional Risk Categories in Assessing Response to 177Lu-PSMA-617 Therapy for Metastatic Prostate Adenocarcinoma with Urinary Bladder Involvement

Aadil Adnan and Sandip Basu
Journal of Nuclear Medicine Technology June 2020, 48 (2) 148-153; DOI: https://doi.org/10.2967/jnmt.119.235960
Aadil Adnan
Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Centre Annexe, and Homi Bhabha National Institute, Mumbai, India
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Sandip Basu
Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Centre Annexe, and Homi Bhabha National Institute, Mumbai, India
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Abstract

The present communication details the imaging characteristics, peculiarities, and response to 177Lu-labeled prostate-specific membrane antigen (PSMA)-617–targeted radioligand therapy (PRLT) in accordance with Gleason score and use of dual-tracer PET (68Ga-PSMA-11 and 18F-FDG) in patients with urinary bladder invasion or metastasis by prostate cancer, including the prognostic value of 18F-FDG PET in predicting response to treatment. The CT attenuation units (Hounsfield units) correlated with the prostate primary in the case of direct tumor extension from the prostate, whereas in hematogenous metastatic seeding the Hounsfield units were lower than in the primary prostatic tumor. A favorable outcome to 177Lu-PSMA-617 PRLT was observed in patients with low or no baseline 18F-FDG uptake despite a high Gleason score and a high-risk National Comprehensive Cancer Network prognostic category and did not correlate with the latter alone, whereas a high SUVmax on 18F-FDG PET/CT was associated with an adverse outcome. These findings suggest a promising role for 18F-FDG PET/CT in predicting therapeutic outcomes more confidently, and hence the concept of dual-tracer PET appears to hold good in prostate adenocarcinoma theranostics.

  • metastatic prostate adenocarcinoma
  • mCRPC
  • 68Ga-PSMA-11 PET/CT
  • 18F-FDG PET/CT
  • 177Lu-PSMA-617
  • peptide receptor radioligand therapy

Footnotes

  • Published online Feb. 28, 2020.

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Journal of Nuclear Medicine Technology: 48 (2)
Journal of Nuclear Medicine Technology
Vol. 48, Issue 2
June 1, 2020
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Comparison of Dual-Tracer PET and CT Features to Conventional Risk Categories in Assessing Response to 177Lu-PSMA-617 Therapy for Metastatic Prostate Adenocarcinoma with Urinary Bladder Involvement
Aadil Adnan, Sandip Basu
Journal of Nuclear Medicine Technology Jun 2020, 48 (2) 148-153; DOI: 10.2967/jnmt.119.235960

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Comparison of Dual-Tracer PET and CT Features to Conventional Risk Categories in Assessing Response to 177Lu-PSMA-617 Therapy for Metastatic Prostate Adenocarcinoma with Urinary Bladder Involvement
Aadil Adnan, Sandip Basu
Journal of Nuclear Medicine Technology Jun 2020, 48 (2) 148-153; DOI: 10.2967/jnmt.119.235960
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Keywords

  • Metastatic Prostate Adenocarcinoma
  • mCRPC
  • 68Ga-PSMA-11 PET/CT
  • 18F-FDG PET/CT
  • 177Lu-PSMA-617
  • peptide receptor radioligand therapy
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