Christian Schmidkonz1,2, Michael Cordes3, Theresa Ida Goetz3,4, Olaf Prante3, Torsten Kuwert3, Philipp Ritt3, Michael Uder5, Bernd Wullich6, Peter Goebell6, Tobias Bäuerle5. 1. Department of Nuclear Medicine, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany. christian.schmidkonz@uk-erlangen.de. 2. Clinic of Nuclear Medicine, University of Erlangen-Nuremberg, Ulmenweg 18, 91054, Erlangen, Germany. christian.schmidkonz@uk-erlangen.de. 3. Department of Nuclear Medicine, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany. 4. Pattern Recognition Lab, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany. 5. Institute of Radiology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany. 6. Department of Urology and Pediatric Urology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
Abstract
BACKGROUND: To evaluate the role of 68Gallium prostate-specific membrane antigen-positron emission tomography/computed tomography (68Ga-PSMA-11 PET/CT) derived quantitative volumetric tumor parameters in comparison with fully diagnostic conventional CT and serum-PSA levels for classification and evaluation of therapeutic response of bone metastases in patients with metastasized prostate cancer (PC). METHODS: A total of 177 men with biochemical recurrence of prostate cancer suffering from bone metastases underwent PET/CT with [68Ga] Ga-PSMA-HBED-CC (68Ga-PSMA-11). To calculate 68Ga-PSMA-11 PET quantitative volumetric tumor parameters including whole-body total-lesion PSMA (TL-PSMA), whole-body PSMA-tumor volume (PSMA-TV), as well as the established maximum standard uptake values (SUVmax) and mean standard uptake values (SUVmean), all 443 68Ga-PSMA-11-positive bone lesions in the field of view were assessed quantitatively. Quantitative volumetric tumor parameters were correlated with CT-derived volume and bone density measurements of metastatic bone lesions, serum prostate-specific antigen (PSA) levels, and Gleason Scores. In the 20 patients suffering from bone metastases who underwent 68Ga-PSMA-11 PET/CT before and after therapy, CT-derived volume and bone density measurements of metastatic lesions were compared to biochemical response determined by serum-PSA levels. RESULTS: In 177 patients, a total of 443 68Ga-PSMA-11 PET-positive bone lesions were detected. Of these, 50 lesions (11%) were only detectable on PET but not on conventional CT. PET-positive/CT-negative bone metastases demonstrated a significantly lower PSMA uptake compared to PET-positive/CT-positive bone lesions (p < 0.05). SUVmax, SUVmean, PSMA-TV, and TL-PSMA of bone metastases were significantly higher (p < 0.05) in patients with Gleason Scores > 7 compared to those with Gleason Scores ≤ 7. In the linear regression analysis, an association was determined between SUVmean, Gleason Scores, lesion classification, and serum-PSA levels but not for CT-derived bone density measurements. No significant correlation could be found between changes of bone density and CT-derived volume measurements of metastatic bone lesions and changes of serum-PSA levels (p > 0.05) before and after therapy, while a highly significant correlation was observed for changes of PSMA-TV, TL-PSMA, and serum-PSA levels (p < 0.001). CONCLUSION: Our results suggest that 68Ga-PSMA-11 PET/CT might be a valuable tool for the detection and follow-up of bone metastases in patients with metastasized prostate cancer. 68Ga-PSMA-11 PET-derived quantitative volumetric parameters demonstrated a highly significant correlation with changes of serum-PSA levels during the course of therapy. No such correlation could be determined for bone density measurements of metastatic bone lesions. Compared to the fully diagnostic CT scan, a significantly higher proportion of bone metastases was detected on 68Ga-PSMA-11 PET.
BACKGROUND: To evaluate the role of 68Gallium prostate-specific membrane antigen-positron emission tomography/computed tomography (68Ga-PSMA-11 PET/CT) derived quantitative volumetric tumor parameters in comparison with fully diagnostic conventional CT and serum-PSA levels for classification and evaluation of therapeutic response of bone metastases in patients with metastasized prostate cancer (PC). METHODS: A total of 177 men with biochemical recurrence of prostate cancer suffering from bone metastases underwent PET/CT with [68Ga] Ga-PSMA-HBED-CC (68Ga-PSMA-11). To calculate 68Ga-PSMA-11 PET quantitative volumetric tumor parameters including whole-body total-lesion PSMA (TL-PSMA), whole-body PSMA-tumor volume (PSMA-TV), as well as the established maximum standard uptake values (SUVmax) and mean standard uptake values (SUVmean), all 443 68Ga-PSMA-11-positive bone lesions in the field of view were assessed quantitatively. Quantitative volumetric tumor parameters were correlated with CT-derived volume and bone density measurements of metastatic bone lesions, serum prostate-specific antigen (PSA) levels, and Gleason Scores. In the 20 patients suffering from bone metastases who underwent 68Ga-PSMA-11 PET/CT before and after therapy, CT-derived volume and bone density measurements of metastatic lesions were compared to biochemical response determined by serum-PSA levels. RESULTS: In 177 patients, a total of 443 68Ga-PSMA-11 PET-positive bone lesions were detected. Of these, 50 lesions (11%) were only detectable on PET but not on conventional CT. PET-positive/CT-negative bone metastases demonstrated a significantly lower PSMA uptake compared to PET-positive/CT-positive bone lesions (p < 0.05). SUVmax, SUVmean, PSMA-TV, and TL-PSMA of bone metastases were significantly higher (p < 0.05) in patients with Gleason Scores > 7 compared to those with Gleason Scores ≤ 7. In the linear regression analysis, an association was determined between SUVmean, Gleason Scores, lesion classification, and serum-PSA levels but not for CT-derived bone density measurements. No significant correlation could be found between changes of bone density and CT-derived volume measurements of metastatic bone lesions and changes of serum-PSA levels (p > 0.05) before and after therapy, while a highly significant correlation was observed for changes of PSMA-TV, TL-PSMA, and serum-PSA levels (p < 0.001). CONCLUSION: Our results suggest that 68Ga-PSMA-11 PET/CT might be a valuable tool for the detection and follow-up of bone metastases in patients with metastasized prostate cancer. 68Ga-PSMA-11 PET-derived quantitative volumetric parameters demonstrated a highly significant correlation with changes of serum-PSA levels during the course of therapy. No such correlation could be determined for bone density measurements of metastatic bone lesions. Compared to the fully diagnostic CT scan, a significantly higher proportion of bone metastases was detected on 68Ga-PSMA-11 PET.
Entities:
Keywords:
68Ga-PSMA-11 PET/CT; Bone metastases; Quantitative tumor parameters; Treatment response
Authors: Sebastian Zschaeck; Stephanie Bela Andela; Holger Amthauer; Christian Furth; Julian M Rogasch; Marcus Beck; Frank Hofheinz; Kai Huang Journal: Front Oncol Date: 2022-04-22 Impact factor: 5.738
Authors: Philipp E Hartrampf; Markus Krebs; Lea Peter; Marieke Heinrich; Julia Ruffing; Charis Kalogirou; Maximilian Weinke; Joachim Brumberg; Hubert Kübler; Andreas K Buck; Rudolf A Werner; Anna Katharina Seitz Journal: Biology (Basel) Date: 2022-04-26
Authors: Kerstin Michalski; Claudius Klein; Tonio Brueggemann; Philipp T Meyer; Cordula Annette Jilg; Juri Ruf Journal: J Nucl Med Date: 2021-03-31 Impact factor: 11.082
Authors: Laure Fournier; Lioe-Fee de Geus-Oei; Daniele Regge; Daniela-Elena Oprea-Lager; Melvin D'Anastasi; Luc Bidaut; Tobias Bäuerle; Egesta Lopci; Giovanni Cappello; Frederic Lecouvet; Marius Mayerhoefer; Wolfgang G Kunz; Joost J C Verhoeff; Damiano Caruso; Marion Smits; Ralf-Thorsten Hoffmann; Sofia Gourtsoyianni; Regina Beets-Tan; Emanuele Neri; Nandita M deSouza; Christophe M Deroose; Caroline Caramella Journal: Front Oncol Date: 2022-01-10 Impact factor: 6.244
Authors: J Orcajo-Rincon; J Muñoz-Langa; J M Sepúlveda-Sánchez; G C Fernández-Pérez; M Martínez; E Noriega-Álvarez; S Sanz-Viedma; J C Vilanova; A Luna Journal: Clin Transl Oncol Date: 2022-02-13 Impact factor: 3.340