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@ARTICLE{Kind:275254,
author = {F. Kind and A.-C. Eder$^*$ and C. A. Jilg and P. E.
Hartrampf and P. T. Meyer$^*$ and J. Ruf$^*$ and K.
Michalski},
title = {{P}rognostic {V}alue of {T}umor {V}olume {A}ssessment on
{PSMA} {PET} {A}fter 177{L}u-{PSMA} {R}adioligand {T}herapy
{E}valuated by {PSMA} {PET}/{CT} {C}onsensus {S}tatement and
{RECIP} 1.0.},
journal = {Journal of nuclear medicine},
volume = {64},
number = {4},
issn = {0097-9058},
address = {New York, NY},
publisher = {Soc.},
reportid = {DKFZ-2023-00701},
pages = {605 - 610},
year = {2023},
abstract = {Quantitative evaluation of prostate-specific membrane
antigen (PSMA)-targeting PET/CT remains challenging but is
urgently needed for the use of standardized PET-based
response criteria, such as the PSMA PET/CT consensus
statement or Response Evaluation Criteria in PSMA PET/CT
(RECIP 1.0). A recent study evaluated the prognostic value
of whole-body tumor volume using a semiautomatic method
relying on a $50\%$ threshold of lesion SUVmax (PSMATV50).
In the present study, we analyzed the suitability of this
approach comparing 18F-PSMA-1007 with 68Ga-PSMA-11 PET/CT
scans and the potential of PSMATV50 for the prediction of
overall survival (OS) in patients before 177Lu-PSMA
radioligand therapy (RLT). Moreover, PSMATV50 was integrated
into the PSMA PET/CT consensus statement as well as RECIP
1.0, and the prognostic value of these response
classification systems was compared. Methods: This
retrospective study included 70 patients with metastatic
castration-resistant prostate cancer undergoing PSMA RLT.
Thirty-three patients were monitored by 68Ga-PSMA-11 PET/CT,
and 37 patients by 18F-PSMA-1007 PET/CT. PET/CT scans before
(baseline) and at the end of PSMA RLT after 2-4 cycles
(follow-up) were separately analyzed by 2 readers. PSMATV50
at baseline and its change at the time of follow-up
(ΔPSMATV50, expressed as a ratio) were correlated with OS
using Cox proportional-hazards regression. The results of
both subgroups were compared. The integration of ΔPSMATV50
in existing response classification systems was evaluated.
To assess and compare the discriminatory strength of these
classification systems, Gönen and Heller concordance
probability estimates were calculated. Results: PSMATV50
determination was technically feasible in all examinations.
A higher PSMATV50 at baseline and a higher ΔPSMATV50 were
strongly associated with a shorter OS for both 68Ga-PSMA-11
(PSMATV50: hazard ratio [HR] of 1.29 $[95\%$ CI, 1.05-1.55],
P = 0.009; ΔPSMATV50: HR of 1.83 $[95\%$ CI, 1.08-3.09], P
= 0.024) and 18F-PSMA-1007 (PSMATV50: HR of 1.84 $[95\%$ CI,
1.13-2.99], P = 0.014; ΔPSMATV50: HR of 1.23 $[95\%$ CI,
1.04-1.51], P = 0.03). Response assessment provided high
discriminatory power for OS for the PSMA PET/CT consensus
statement (concordance probability estimate, 0.73) as well
as RECIP 1.0 (concordance probability estimate, 0.74).
Conclusion: PSMATV50 and ΔPSMATV50 proved to be predictive
of OS not only for 68Ga-PSMA-11 but also for 18F-PSMA-1007
PET/CT scans. Subsequent integration of ΔPSMATV50 into the
PSMA PET/CT consensus statement and RECIP 1.0 provided
equally high prognostic value for both classification
systems.},
keywords = {Male / Humans / Prognosis / Positron Emission Tomography
Computed Tomography: methods / Retrospective Studies /
Treatment Outcome / Prostate-Specific Antigen / Tumor Burden
/ Prostatic Neoplasms, Castration-Resistant: diagnostic
imaging / Prostatic Neoplasms, Castration-Resistant:
radiotherapy / Dipeptides: adverse effects / Heterocyclic
Compounds, 1-Ring: adverse effects / Lutetium / PSMA PET/CT
(Other) / PSMATV50 (Other) / RECIP 1.0 (Other) / radioligand
therapy (Other) / response assessment (Other) / gallium 68
PSMA-11 (NLM Chemicals) / Prostate-Specific Antigen (NLM
Chemicals) / Dipeptides (NLM Chemicals) / Heterocyclic
Compounds, 1-Ring (NLM Chemicals) / Lutetium (NLM
Chemicals)},
cin = {FR01},
ddc = {610},
cid = {I:(DE-He78)FR01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:36302658},
doi = {10.2967/jnumed.122.264489},
url = {https://inrepo02.dkfz.de/record/275254},
}