68Ga-PSMA-11 PET/CT-derived metabolic parameters for determination of whole-body tumor burden and treatment response in prostate cancer

Journal article


Publication Details

Author(s): Schmidkonz C, Cordes M, Schmidt D, Bäuerle T, Goetz TI, Beck M, Prante O, Cavallaro A, Uder M, Wullich B, Goebell P, Kuwert T, Ritt P
Journal: European Journal of Nuclear Medicine and Molecular Imaging
Publication year: 2018
ISSN: 1619-7070


Abstract

PURPOSE: We aimed at evaluating the role of 68Ga-PSMA-11 PET/CT-derived metabolic parameters for assessment of whole-body tumor burden and its capability to determine therapeutic response in patients with prostate cancer.
METHODS: A total of 142 patients with biochemical recurrence of prostate cancer underwent PET/CT with [68Ga]Ga-PSMA-HBED-CC (68Ga-PSMA-11). Quantitative assessment of all 641 68Ga-PSMA-11-positive lesions in the field of view was performed to calculate PSMA-derived parameters, including whole-body PSMA tumor volume (PSMA-TV) and whole-body total lesion PSMA (TL-PSMA), as well as the established SUVmax and SUVmean values. All PET-derived parameters were tested for correlation with serum PSA levels and for association with Gleason scores. In 23 patients who underwent 68Ga-PSMA-11 PET/CT before and after therapy with either external beam radiation, androgen deprivation, or docetaxel chemotherapy, SUVmax and TL-PSMA were compared to radiographic response assessment of CT images based on RECIST 1.1 criteria and to biochemical response determined by changes of serum PSA levels.
RESULTS: PSMA-TV and TL-PSMA demonstrated a significant correlation with serum PSA levels (P < 0.0001) and TL-PSMA was significantly different for different Gleason scores. The agreement rate between TL-PSMA derived from PET and biochemical response was 87% (95% confidence interval, 0.66-0.97; Cohen's κ = 0.78; P < 0.01) and, thus, higher than for SUVmax, which was 74% (95% CI, 0.52-0.90; κ = 0.55; P < 0.01). Furthermore, agreement with PSA was higher for TL-PSMA and SUVmax than for CT-based response evaluation. Discordant findings between PET and CT were most likely due to limitations of CT and RECIST in rating small lymph nodes as metastases, as well as bone involvement, which was sometimes not detectable in CT.
CONCLUSION: 68Ga-PSMA-11 PET/CT-derived metabolic tumor parameters showed promising results for evaluation of treatment response. Especially, TL-PSMA demonstrated higher agreement rates with biochemical response compared to SUVmax. Larger, ideally prospective trials are needed to help to reveal the full potential of metabolic parameters derived from PET imaging with 68Ga-PSMA-11.


FAU Authors / FAU Editors

Bäuerle, Tobias Prof. Dr.
Professur für Multimodale Bildgebung in der präklinischen Forschung
Beck, Michael
Lehrstuhl für Klinische Nuklearmedizin
Cordes, Michael Prof. Dr.
Medizinische Fakultät
Medizinische Fakultät
Goebell, Peter Prof. Dr.
Urologische Klinik
Kuwert, Torsten Prof. Dr.
Lehrstuhl für Klinische Nuklearmedizin
Lehrstuhl für Urologie
Prante, Olaf Prof. Dr.
Medizinische Fakultät
Ritt, Philipp Dr.-Ing.
Nuklearmedizinische Klinik
Schmidkonz, Christian Dr.
Medizinische Fakultät
Schmidt, Daniela PD Dr.
Uder, Michael Prof. Dr.
Lehrstuhl für Diagnostische Radiologie
Wullich, Bernd Prof. Dr.


How to cite

APA:
Schmidkonz, C., Cordes, M., Schmidt, D., Bäuerle, T., Goetz, T.I., Beck, M.,... Ritt, P. (2018). 68Ga-PSMA-11 PET/CT-derived metabolic parameters for determination of whole-body tumor burden and treatment response in prostate cancer. European Journal of Nuclear Medicine and Molecular Imaging. https://dx.doi.org/10.1007/s00259-018-4042-z

MLA:
Schmidkonz, Christian, et al. "68Ga-PSMA-11 PET/CT-derived metabolic parameters for determination of whole-body tumor burden and treatment response in prostate cancer." European Journal of Nuclear Medicine and Molecular Imaging (2018).

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Last updated on 2018-05-10 at 13:08