Value of post-therapy 177Lu-PSMA images for accurate interpretation of therapy response with 68Ga-PSMA PET/CT
Rev Esp Med Nucl Imagen Mol (Engl Ed). 2018 Mar-Apr;37(2):114-117.
doi: 10.1016/j.remn.2017.05.004.
Epub 2017 Jul 24.
[Article in
English,
Spanish]
Affiliations
- 1 Department of Nuclear Medicine, Hacettepe University, Faculty of Medicine, Ankara, Turkey. Electronic address: muratmtx@yahoo.com.
- 2 Department of Nuclear Medicine, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
Abstract
A 54-year-old man with progressive prostate cancer underwent a 68Ga-PSMA PET/CT, which showed lymph node and bone metastases. After 2-cycles of 177Lu-PSMA therapy, the repeated 68Ga-PSMA PET/CT showed decreased radiotracer uptake in lymph node and bones metastases, but there were new lesions which may be compatible with progression or tumour sink-effect. A review of 177Lu-PSMA-therapy images revealed that new lesions in the second PET/CT were the metastatic lesions that progressed after the first PET/CT, and subsequently showed a good response. The patient received additional cycles of 177Lu-PSMA therapy, and the disease regressed further, with a PSA of 0.06ng/ml. Response evaluation of new therapeutic diagnostics (theranostic) agents needs a review of not only diagnostic PET/CT images, but also post-therapy images and laboratory results.
Keywords:
(177)Lu- PSMA; (68)Ga-PSMA; Regresión tumoral; Respuesta a la terapia; Therapeutic response; Tumor sink effect.
Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.
MeSH terms
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Adenocarcinoma / blood
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Adenocarcinoma / diagnostic imaging*
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Adenocarcinoma / radiotherapy
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Adenocarcinoma / secondary*
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Bone Neoplasms / blood
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Bone Neoplasms / diagnostic imaging*
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Bone Neoplasms / radiotherapy
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Bone Neoplasms / secondary*
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Dipeptides / analysis
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Dipeptides / therapeutic use*
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Drug Monitoring
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Edetic Acid / analogs & derivatives
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Edetic Acid / analysis
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Gallium Isotopes
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Gallium Radioisotopes / analysis
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Heterocyclic Compounds, 1-Ring / analysis
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Heterocyclic Compounds, 1-Ring / therapeutic use*
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Humans
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Lutetium / analysis
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Lutetium / therapeutic use*
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Lymphatic Metastasis / diagnostic imaging*
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Lymphatic Metastasis / radiotherapy
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Male
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Middle Aged
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Oligopeptides / analysis
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Positron Emission Tomography Computed Tomography*
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Prostate-Specific Antigen / blood
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Prostatic Neoplasms / blood
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Prostatic Neoplasms / diagnostic imaging*
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Prostatic Neoplasms / radiotherapy
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Radioisotopes / analysis
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Radioisotopes / therapeutic use*
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Radiopharmaceuticals / analysis
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Radiopharmaceuticals / therapeutic use*
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Sensitivity and Specificity
Substances
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177Lu-PSMA-617
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Dipeptides
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Gallium Isotopes
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Gallium Radioisotopes
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Heterocyclic Compounds, 1-Ring
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Oligopeptides
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Radioisotopes
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Radiopharmaceuticals
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gallium 68 PSMA-11
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Lutetium
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Gallium-68
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Edetic Acid
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Lutetium-177
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Prostate-Specific Antigen