Burcak Yilmaz1, Serap Nisli2, Nurhan Ergul2, Riza Umar Gursu3, Ozgur Acikgoz4, Tevfik Fikret Çermik2. 1. Nuclear Medicine Department, Istanbul Research and Training Hospital, University of Health Sciences, Istanbul, Turkey drburcak@gmail.com. 2. Nuclear Medicine Department, Istanbul Research and Training Hospital, University of Health Sciences, Istanbul, Turkey. 3. Medical Oncology Department, Istanbul Research and Training Hospital, University of Health Sciences, Istanbul, Turkey; and. 4. Medical Oncology Department, Kanuni Sultan Suleyman Research and Training Hospital, University of Health Sciences, Istanbul, Turkey.
Abstract
Recent years have seen the start of treatment of metastatic castration-resistant prostate cancer with prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (PRLT), especially 177Lu-PSMA-617. However, PRLT has side effects on the salivary glands that limit the safety of the treatment. The current study aimed to show the effect of external cooling with ice packs on 177Lu-PSMA-617 uptake by the parotid glands (PGs). Methods: The study included 19 patients (mean age, 72.9 y) with metastatic castration-resistant prostate cancer who had been referred for the first time for 177Lu-PSMA-617 treatment and underwent pretreatment 68Ga-PSMA-11 PET/CT. Before the initiation of PRLT, the SUVmax and SUVmean of the right and left PGs were measured on 68Ga-PSMA PET/CT. Frozen ice packs were then affixed over the right PG of each patient for approximately 5 h; 1 h after they were affixed, PRLT was administered. At 4 h after PRLT, head-and-neck SPECT/CT was performed, and at both 4 and 24 h after PRLT, whole-body planar scintigraphy was performed. Regions and volumes of interest were applied for the right and left PGs, and the counts and volumes were determined. Results: Before PRLT, 68Ga-PSMA-11 PET/CT showed no significant difference in SUVmax or SUVmean between the right and left PGs (P > 0.05). At 4 and 24 h after PRLT, planar imaging showed no significant difference in counts between the cooled and noncooled PGs (P > 0.05). Furthermore, at 4 h after PRLT, SPECT/CT showed no significant difference in counts or volumes between the cooled and noncooled PGs (P > 0.05). Conclusion: External cooling does not reduce uptake of 177Lu-PSMA-617 by the PGs.
Recent years have seen the start of treatment of metastatic castration-resistant prostate cancer with prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (PRLT), especially 177Lu-PSMA-617. However, PRLT has side effects on the salivary glands that limit the safety of the treatment. The current study aimed to show the effect of external cooling with ice packs on 177Lu-PSMA-617 uptake by the parotid glands (PGs). Methods: The study included 19 patients (mean age, 72.9 y) with metastatic castration-resistant prostate cancer who had been referred for the first time for 177Lu-PSMA-617 treatment and underwent pretreatment 68Ga-PSMA-11 PET/CT. Before the initiation of PRLT, the SUVmax and SUVmean of the right and left PGs were measured on 68Ga-PSMA PET/CT. Frozen ice packs were then affixed over the right PG of each patient for approximately 5 h; 1 h after they were affixed, PRLT was administered. At 4 h after PRLT, head-and-neck SPECT/CT was performed, and at both 4 and 24 h after PRLT, whole-body planar scintigraphy was performed. Regions and volumes of interest were applied for the right and left PGs, and the counts and volumes were determined. Results: Before PRLT, 68Ga-PSMA-11 PET/CT showed no significant difference in SUVmax or SUVmean between the right and left PGs (P > 0.05). At 4 and 24 h after PRLT, planar imaging showed no significant difference in counts between the cooled and noncooled PGs (P > 0.05). Furthermore, at 4 h after PRLT, SPECT/CT showed no significant difference in counts or volumes between the cooled and noncooled PGs (P > 0.05). Conclusion: External cooling does not reduce uptake of 177Lu-PSMA-617 by the PGs.
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