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

Article Figures & Data

Download figure
Open in new tab
Download powerpoint
FIGURE 1.
Comparative analysis of PSMA and ¹⁸F-FDG PET/CT scans at baseline (left 2 panels) and after ¹⁷⁷Lu-PSMA PRLT (right 2 panels) for patient 1.
Download figure
Open in new tab
Download powerpoint
FIGURE 2.
(A) Comparative analysis of ⁶⁸Ga-PSMA-11 PET/CT scans at baseline and after ¹⁷⁷Lu-PSMA-617 therapy for patient 2. (B) Maximum-intensity projection of baseline ¹⁸F-FDG PET/CT scan.
Download figure
Open in new tab
Download powerpoint
FIGURE 3.
Comparative analysis of ⁶⁸Ga-PSMA-11 PET/CT (left 2 panels) and ¹⁸F-FDG PET/CT (right 2 panels) at baseline and after ¹⁷⁷Lu-PSMA-617 PRLT for patient 3.

TABLE 1

Key Patient Characteristics and Imaging Features

Characteristic	Patient 1	Patient 2	Patient 3
Histopathology	Poorly differentiated adenocarcinoma	Conventional adenocarcinoma	Conventional adenocarcinoma
Gleason score	4 + 4	4 + 3	4 + 5
National Comprehensive Cancer Network prognostic category	High risk	Intermediate risk	High risk
PSA (ng/mL)
Baseline	65.128	751	228.03
After ¹⁷⁷Lu-PSMA	33.062	1,761.25	44.54
⁶⁸Ga-PSMA-11 uptake (SUV_max)
Baseline	64.73	27.04	116.84
After ¹⁷⁷Lu-PSMA	28.02	36.65	83.6
¹⁸F-FDG uptake (SUV_max)
Baseline	8.38	22.88	8.4
After ¹⁷⁷Lu-PSMA	4.41	9.63	4.5
Metastatic pattern of urinary bladder	Direct extension from prostate	Direct extension from prostate	Multifocal metastatic lesions involving bladder wall, hematogenous
HU of prostate
Baseline	100	125	93
After ¹⁷⁷Lu-PSMA	70	108	67
HU of urinary bladder metastases
Baseline	96	116	70
After ¹⁷⁷Lu-PSMA	67	83	41
Outcome	Partial response	Progression and death	Partial response