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Nuklearmedizin 2025; 64(01): 7-12
DOI: 10.1055/a-2383-2468
Original Article

Prognostic value of pretherapeutic 68Ga-PSMA-11-PET based imaging parameters in mCRPC patients treated with PSMA radioligands

Prognostischer Wert der prätherapeutischen 68Ga-PSMA-11-PET-basierten Bildgebungsparameter in mit PSMA-Radiologanden therapierten mCRPC-Patienten
Laya Rahbar Nikoukar
1   Clinic for Nuclear Medicine, University Hospital Münster, Münster, Germany (Ringgold ID: RIN39069)
,
Robert Seifert
1   Clinic for Nuclear Medicine, University Hospital Münster, Münster, Germany (Ringgold ID: RIN39069)
2   2. West German Cancer Center (WTZ), Münster site, Germany, Münster, Germany
,
David Ventura
1   Clinic for Nuclear Medicine, University Hospital Münster, Münster, Germany (Ringgold ID: RIN39069)
,
Philipp Schindler
3   Radiology, University Hospital Münster, Münster, Germany (Ringgold ID: RIN39069)
2   2. West German Cancer Center (WTZ), Münster site, Germany, Münster, Germany
,
Martin Bögemann
4   Clinic for Urology, University Hospital Münster, Münster, Germany (Ringgold ID: RIN39069)
5   West German Cancer Center (WTZ), Münster site, Germany, Münster, Germany
,
Kambiz Rahbar
1   Clinic for Nuclear Medicine, University Hospital Münster, Münster, Germany (Ringgold ID: RIN39069)
5   West German Cancer Center (WTZ), Münster site, Germany, Münster, Germany
,
Wolfgang Roll
1   Clinic for Nuclear Medicine, University Hospital Münster, Münster, Germany (Ringgold ID: RIN39069)
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Abstract

Purpose

This study aims to evaluate the prognostic significance of various previously reported PSMA-PET parameters in patients undergoing 177Lu-PSMA radioligand therapy (RLT). While individual studies have investigated the prognostic value of one or few of these factors, comprehensive analyses are rare.

Methods

Data of 82 patients undergoing 177Lu-PSMA-radiologand-therapy (RLT) were analyzed. Total tumor volume (tumor volume), average SUVmean of all tumor lesions (SUVmean) and the quotient of sum of SUVmean of all tumor lesions to SUVmean of the parotid glands (tumor-parotid-ratio; TPR) and of the kidneys (tumor-kidney-ratio; TKR) were included in analysis.

Results

This study showed that a tumor volume of <290.6 ml is associated with a better survival in patients undergoing PSMA-RLT (median PFS: 4.2, median OS: 13.2 months) compared to patients with higher tumor volume (median PFS: 3.4,median OS: 6.2 months; p-value = 0.01 for PFS and <0.001 for OS). The average SUVmean correlated inversely with survival. Patients with a SUVmean > 10.7 had a median PFS of 4.2 and OS of 11.4 months while patients with SUVmean <10.7 had a median PFS of 1.6 and OS of 5 months (p-value <0.001 for both). The assessment of TPR showed no significant difference regarding OS and PFS. TKR showed a better PFS in patients with ratio > 0.33 (p-value 0.009) but no significant difference regarding OS.

Conclusion

The present study confirms that pretherapeutic PSMA-PET before RLT with 177Lu-PSMA has a prognostic value.

Keywords

PSMA - mCRPC - Radioligand therapy


Publication History

Received: 29 April 2024

Accepted after revision: 06 August 2024

Article published online:
29 August 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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