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Nuklearmedizin 2018; 57(01): 19-25
DOI: 10.3413/Nukmed-0937-17-10
Original Article
Schattauer GmbH

Relevant tumor sink effect in prostate cancer patients receiving 177Lu-PSMA-617 radioligand therapy

Relevante Senkung der Tumorlast bei Prostatakarzinom-Patienten unter der Gabe von 177Lu-PSMA-617
Christian Filss
1   Department of Nuclear Medicine, RWTH Aachen University Hospital, Aachen, Germany
2   Institute of Neuroscience and Medicine(INM-4), Forschungszentrum Jülich-Jülich, Germany
,
Alexander Heinzel
1   Department of Nuclear Medicine, RWTH Aachen University Hospital, Aachen, Germany
2   Institute of Neuroscience and Medicine(INM-4), Forschungszentrum Jülich-Jülich, Germany
,
Berthold Miiller
1   Department of Nuclear Medicine, RWTH Aachen University Hospital, Aachen, Germany
,
Andreas T. J. Vogg
1   Department of Nuclear Medicine, RWTH Aachen University Hospital, Aachen, Germany
,
Karl-Josef Langen
1   Department of Nuclear Medicine, RWTH Aachen University Hospital, Aachen, Germany
2   Institute of Neuroscience and Medicine(INM-4), Forschungszentrum Jülich-Jülich, Germany
3   JARA — Jülich Aachen Research Alliance, Germany
,
Felix M. Mottaghy
1   Department of Nuclear Medicine, RWTH Aachen University Hospital, Aachen, Germany
3   JARA — Jülich Aachen Research Alliance, Germany
4   Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
› Author Affiliations
Further Information

Publication History

received: 19 October 2017

in revised form: 15 December 2017

Publication Date:
21 February 2018 (online)

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Summary

Aim: In metastatic prostate cancer patients PSMA targeting radioligands have gained significant impact as theranostic probes. In this study a correlation between total tumor volume (TTV) and measured kidney dose as well as salivary glands (SG) uptake in 177Lu-PSMA-617 therapy was evaluated.

Methods: Eleven consecutive prostate cancer patients receiving a first cylcle of 177Lu-PSMA-617 (administered activity of approximately 6GBq) were included. The 68Ga-PSMA-11 PET/CT scan previous to therapy was used to determine TTV and SG uptake (glandulae submandibularis) employing PMOD version 3.403 with different 68Ga-PSMA-11 thresholds based on the standardized uptake value (SUV).The kidney dose was estimated with the software ULMDOS using planar whole-body scintigrams.

Results: Kidney dose and SG uptake was inversely correlated to TTV, indicating high kidney dose and high SG uptake in case of low tumor load and low kidney dose and low SG uptake in case of high tumor load.

Conclusion: Our data support the hypothesis that in 177Lu-PSMA-617 therapy an individualized treatment activity based on total tumor volume could be beneficiary.

Zusammenfassung

Aim: Bei Patienten mit metastasiertem Prostatakarzinom haben PSMA-Radioliganden als theranostische Sonden zunehmenden Im-pakt. In dieser Studie wurde die Korrelation von totalem Tumorvolumen (TTV) und be-rechneter Dosis für Nieren- als auch Speichel-drüsen-Aufnahme (SG) bei der 177Lu-PSMA-617-Therapie evaluiert.

Methoden: Elf konsekutive Prostatakarzinom-Patienten mit einer Gabe von 177Lu-PSMA-617 (applizierte Aktivität von ca. 6GBq) wurden inkludiert. Eine 68Ga-PSMA-11 PET/CT-Untersuchung vor der Therapie wurde herangezogen urn TTV und SG-Aufnahme (glandulae submandibularis) unterVerwendung von PMOD (Version 3403) mit unterschiedlichen auf dem standardisierten Aufnahmewert (SUV) basie-renden 68Ga-PSMA-11 Schwellenwerten zu bestimmen. Die Nierendosis wurde mit der Software ULMDOS bei den planaren Ganz-körper-Szintigrammen berechnet.

Ergebnisse: Nierendosis und SG-Aufnahme korrelierten umgekehrt proportional zu TTV. In anderen Worten zeigte sich eine hohe Nieren-Dosis und hohe SG-Aufnahme bei niedriger Tumor-last und niedrige Nierendosis und niedrige SG-Aufnahme bei hoher Tumorlast.

Schluss-folgerung: Unsere Daten unterstuützen die Hy-pothese, dass bei der 177Lu-PSMA-617-Therapie eine individuelle aktivitätsadaptierte Be-handlung unter Berücksichtigung des Ge-samt-Tumorvolumens von Vorteil ware.

Keywords

Prostate Cancer - Dosimetry - Therapy - PSMA - Scintigraphy

Schlüssel-Wörter

Prostatakarzinom - Dosimetrie - Therapie - PSMA - Szintigrafie
 

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