L. Djaileb , N. De Leiris , M. Chanchou , E. Paquet , C. Margail , D. Clément , F. Andrea , B. Francesco , A.L. Giraudet , C. Merlin
{"title":"[68Ga]-Ga-PSMA-11、[18F]F-FDG和[18F]- f胆碱PET/CT对mCRPC [177Lu]-PSMA放射配体治疗资格的影像学筛查","authors":"L. Djaileb , N. De Leiris , M. Chanchou , E. Paquet , C. Margail , D. Clément , F. Andrea , B. Francesco , A.L. Giraudet , C. Merlin","doi":"10.1016/j.mednuc.2025.01.162","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To assess [18F]F-FDG (FDG) and [18F]-Fcholine (Fcholine) performance for discordant lesion detection with [68Ga]-Ga-PSMA-11 (PSMA) PET/CT for [177Lu]-PSMA (LuPSMA) radioligand therapy eligibility in metastatic castration-resistant prostate (mCRPC).</div></div><div><h3>Method</h3><div>This multicenter retrospective study included adults who performed FDG, FCholine and PSMA PET/CT before LuPSMA (I&T or 617) radioligand therapy in mCRPC. PSMA and FDG PET/CT were performed within 30 days and FDG and FCholine within 45 days. During this time, the French regulatory agency required the use of Fcholine prior to performing a PSMA PET/CT. Imaging analysis on a lesion-based level was performed by two groups of readers with different imaging reading order (Group 1: PSMA, FDG and Fcholine. / Group 2: PSMA, Fcholine and FDG). The primary outcome was the percentage rate of patients with discordant findings between PSMA- and FDG-PET (PSMA-FDG) and between PSMA- and Fcholine-PET (PSMA-Fcholine). The secondary outcome was the concordance and discordance rate between FDG and Fcholine PET.</div></div><div><h3>Results</h3><div>A total of 60 patients (median age, 74 years [IQR, 68–79 years]) were included between May 2021 and June 2022. 57/60 (95%), 35/60 (57%), 20/60 (33%) patients had bone, lymph node, and visceral disease on PSMA PET/CT. PSMA-FDG discordance was found in 16/60 (26%) patients and discordant lesions were detected in viscera, lymph nodes and bone in 5/16 (31%), 8/16 (50%), 9/16 (56%) patients, respectively. PSMA-Fcholine discordance was found in 18/60 (30%) patients. None of the patients had discrepant visceral lesions (0/18), while 8/18 (44%), 13/18 (72%) patients presented discordant findings for lymph nodes and bone metastases on Fcholine. Among patients with PSMA-FDG discordance, 8/16 (50%) also showed discordance in PSMA-Fcholine analysis. PSMA-Fcholine discordance not detected by PSMA-FDG analysis was observed only in bone in 8/18 (44%) patients and in lymph nodes in 2/18 (11%) patients.</div></div><div><h3>Conclusion</h3><div>Compared to FDG, Fcholine PET/CT did not detect discordant visceral lesions in patients with mCRPC being considered for LuPSMA radioligand therapy. Prognostic significance of bone-only lesions detected by Fcholine PET/CT requires further evaluation.</div></div>","PeriodicalId":49841,"journal":{"name":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","volume":"49 2","pages":"Page 99"},"PeriodicalIF":0.2000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Imaging screening with [68Ga]-Ga-PSMA-11, [18F]F-FDG, and [18F]-FCholine PET/CT for [177Lu]-PSMA radioligand therapy eligibility in mCRPC\",\"authors\":\"L. Djaileb , N. De Leiris , M. Chanchou , E. Paquet , C. Margail , D. Clément , F. Andrea , B. Francesco , A.L. Giraudet , C. Merlin\",\"doi\":\"10.1016/j.mednuc.2025.01.162\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>To assess [18F]F-FDG (FDG) and [18F]-Fcholine (Fcholine) performance for discordant lesion detection with [68Ga]-Ga-PSMA-11 (PSMA) PET/CT for [177Lu]-PSMA (LuPSMA) radioligand therapy eligibility in metastatic castration-resistant prostate (mCRPC).</div></div><div><h3>Method</h3><div>This multicenter retrospective study included adults who performed FDG, FCholine and PSMA PET/CT before LuPSMA (I&T or 617) radioligand therapy in mCRPC. PSMA and FDG PET/CT were performed within 30 days and FDG and FCholine within 45 days. During this time, the French regulatory agency required the use of Fcholine prior to performing a PSMA PET/CT. Imaging analysis on a lesion-based level was performed by two groups of readers with different imaging reading order (Group 1: PSMA, FDG and Fcholine. / Group 2: PSMA, Fcholine and FDG). The primary outcome was the percentage rate of patients with discordant findings between PSMA- and FDG-PET (PSMA-FDG) and between PSMA- and Fcholine-PET (PSMA-Fcholine). The secondary outcome was the concordance and discordance rate between FDG and Fcholine PET.</div></div><div><h3>Results</h3><div>A total of 60 patients (median age, 74 years [IQR, 68–79 years]) were included between May 2021 and June 2022. 57/60 (95%), 35/60 (57%), 20/60 (33%) patients had bone, lymph node, and visceral disease on PSMA PET/CT. PSMA-FDG discordance was found in 16/60 (26%) patients and discordant lesions were detected in viscera, lymph nodes and bone in 5/16 (31%), 8/16 (50%), 9/16 (56%) patients, respectively. PSMA-Fcholine discordance was found in 18/60 (30%) patients. None of the patients had discrepant visceral lesions (0/18), while 8/18 (44%), 13/18 (72%) patients presented discordant findings for lymph nodes and bone metastases on Fcholine. Among patients with PSMA-FDG discordance, 8/16 (50%) also showed discordance in PSMA-Fcholine analysis. PSMA-Fcholine discordance not detected by PSMA-FDG analysis was observed only in bone in 8/18 (44%) patients and in lymph nodes in 2/18 (11%) patients.</div></div><div><h3>Conclusion</h3><div>Compared to FDG, Fcholine PET/CT did not detect discordant visceral lesions in patients with mCRPC being considered for LuPSMA radioligand therapy. Prognostic significance of bone-only lesions detected by Fcholine PET/CT requires further evaluation.</div></div>\",\"PeriodicalId\":49841,\"journal\":{\"name\":\"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique\",\"volume\":\"49 2\",\"pages\":\"Page 99\"},\"PeriodicalIF\":0.2000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0928125825001627\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PATHOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medecine Nucleaire-Imagerie Fonctionnelle et Metabolique","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0928125825001627","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PATHOLOGY","Score":null,"Total":0}
Imaging screening with [68Ga]-Ga-PSMA-11, [18F]F-FDG, and [18F]-FCholine PET/CT for [177Lu]-PSMA radioligand therapy eligibility in mCRPC
Objective
To assess [18F]F-FDG (FDG) and [18F]-Fcholine (Fcholine) performance for discordant lesion detection with [68Ga]-Ga-PSMA-11 (PSMA) PET/CT for [177Lu]-PSMA (LuPSMA) radioligand therapy eligibility in metastatic castration-resistant prostate (mCRPC).
Method
This multicenter retrospective study included adults who performed FDG, FCholine and PSMA PET/CT before LuPSMA (I&T or 617) radioligand therapy in mCRPC. PSMA and FDG PET/CT were performed within 30 days and FDG and FCholine within 45 days. During this time, the French regulatory agency required the use of Fcholine prior to performing a PSMA PET/CT. Imaging analysis on a lesion-based level was performed by two groups of readers with different imaging reading order (Group 1: PSMA, FDG and Fcholine. / Group 2: PSMA, Fcholine and FDG). The primary outcome was the percentage rate of patients with discordant findings between PSMA- and FDG-PET (PSMA-FDG) and between PSMA- and Fcholine-PET (PSMA-Fcholine). The secondary outcome was the concordance and discordance rate between FDG and Fcholine PET.
Results
A total of 60 patients (median age, 74 years [IQR, 68–79 years]) were included between May 2021 and June 2022. 57/60 (95%), 35/60 (57%), 20/60 (33%) patients had bone, lymph node, and visceral disease on PSMA PET/CT. PSMA-FDG discordance was found in 16/60 (26%) patients and discordant lesions were detected in viscera, lymph nodes and bone in 5/16 (31%), 8/16 (50%), 9/16 (56%) patients, respectively. PSMA-Fcholine discordance was found in 18/60 (30%) patients. None of the patients had discrepant visceral lesions (0/18), while 8/18 (44%), 13/18 (72%) patients presented discordant findings for lymph nodes and bone metastases on Fcholine. Among patients with PSMA-FDG discordance, 8/16 (50%) also showed discordance in PSMA-Fcholine analysis. PSMA-Fcholine discordance not detected by PSMA-FDG analysis was observed only in bone in 8/18 (44%) patients and in lymph nodes in 2/18 (11%) patients.
Conclusion
Compared to FDG, Fcholine PET/CT did not detect discordant visceral lesions in patients with mCRPC being considered for LuPSMA radioligand therapy. Prognostic significance of bone-only lesions detected by Fcholine PET/CT requires further evaluation.
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