The use of molecular volumetric parameters for the evaluation of Lu-177 PSMA I&amp;T therapy response and survival

Acar, Emine; Özdoğan, Özhan; Aksu, Ayşegül; Derebek, Erkan; Bekiş, Recep; Kaya, Gamze Çapa

doi:10.1007/s12149-019-01376-3

Cited by 28 publications

(38 citation statements)

References 26 publications

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“…We were able to show significant correlations between serum PSA values and PSMA-TV as well as TL-PSMA at baseline and follow-up in accordance to previous studies [10,11,14,24]. These earlier publications showed correlations between relative ∆PSMA-TV and ∆PSMA-TL with relative changes in serum PSA-levels in patients undergoing androgen deprivation, radiotherapy and radioligand therapy [10,12,24]. To our knowledge, our data are the first revealing significant correlations of ∆PSMA-TV, ∆TL-PSMA and ∆PSA for a cohort of patients undergoing taxane-based chemotherapy.…”

Section: Clinical Agreement Of Psma-tv and Tl-psma Determined With Sysupporting

confidence: 90%

“…Going one step back, it is also unknown whether choosing different software solutions for determining metabolic tumour volume influences outcome. For calculation of PSMA-TV and TL-PSMA, different authors used different software (Syngo.via, METAVOL, LifeX or custom-made programs) and currently it is unclear whether their results are seamlessly comparable [11][12][13][14]. To address these issues, we analysed pre-and post-therapeutic 68 Ga-PSMA PET/CT scans of PCa patients receiving chemotherapy -first, with Syngo.via and afterwards with the FIJI algorithm.…”

Section: Discussionmentioning

confidence: 99%

“…However, a variety of software algorithms delivers metabolic tumour volume markers such as PSMA-TV and TL-PSMA. Accordingly, studies examining metabolic tumour volume derived from PSMA PET/CT used different software tools [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Metabolic Tumour Volume from PSMA PET/CT Scans of Prostate Cancer Patients during Chemotherapy—Do Different Software Solutions Deliver Comparable Results?

Hartrampf

Heinrich

Seitz

et al. 2020

JCM

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(1) Background: Prostate-specific membrane antigen (PSMA)-derived tumour volume (PSMA-TV) and total lesion PSMA (TL-PSMA) from PSMA PET/CT scans are promising biomarkers for assessing treatment response in prostate cancer (PCa). Currently, it is unclear whether different software tools for assessing PSMA-TV and TL-PSMA produce comparable results. (2) Methods: 68Ga-PSMA PET/CT scans from n = 21 patients with castration-resistant PCa (CRPC) receiving chemotherapy were identified from our single-centre database. PSMA-TV and TL-PSMA were calculated with Syngo.via (Siemens) as well as the freely available Beth Israel plugin for FIJI (Fiji Is Just ImageJ) before and after chemotherapy. While statistical comparability was illustrated and quantified via Bland-Altman diagrams, the clinical agreement was estimated by matching PSMA-TV, TL-PSMA and relative changes of both variables during chemotherapy with changes in serum PSA (ΔPSA) and PERCIST (Positron Emission Response Criteria in Solid Tumors). (3) Results: Comparing absolute PSMA-TV and TL-PSMA as well as Bland–Altman plotting revealed a good statistical comparability of both software algorithms. For clinical agreement, classifying therapy response did not differ between PSMA-TV and TL-PSMA for both software solutions and showed highly positive correlations with BR. (4) Conclusions: due to the high levels of statistical and clinical agreement in our CRPC patient cohort undergoing taxane chemotherapy, comparing PSMA-TV and TL-PSMA determined by Syngo.via and FIJI appears feasible.

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Section: Clinical Agreement Of Psma-tv and Tl-psma Determined With Sysupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Metabolic Tumour Volume from PSMA PET/CT Scans of Prostate Cancer Patients during Chemotherapy—Do Different Software Solutions Deliver Comparable Results?

Hartrampf

Heinrich

Seitz

et al. 2020

JCM

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“…This is a difference to a study published before, where we found a correlation of PSA levels and TTV with OS after undergoing PSMA 617 radioligand therapy 13. A recently published study found similar results for response assessment in patients undergoing PSMA 617 radioligand therapy 22. Here, the molecular and volumetric PSMA parameters were also associated with OS.…”

contrasting

confidence: 91%

Response assessment using [⁶⁸Ga]Ga‐PSMA ligand PET in patients undergoing systemic therapy for metastatic castration‐resistant prostate cancer

et al. 2019

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Background To assess which parameters of [68Ga]Ga‐PSMA‐11 positron emission tomography (PSMA‐PET) predict response to systemic therapies in metastatic (m) castration‐resistant prostate cancer (CRPC). In addition, to investigate which of these factors are associated with overall survival (OS). Methods We retrospectively assessed the following PSMA‐PET parameters in 43 patients before and after systemic therapies for mCRPC: PSMA total tumor volume (TTV), mean standardized uptake value (SUVmean), SUVmax, and SUVpeak. prostate‐specific antigen (PSA) levels and PSMA‐PET/CT(magnetic resonance imaging [MRI]) imaging were both performed within 8 weeks before and 6 weeks after systemic therapy. PSMA‐PET and CT (MRI) images were reviewed according to the modified PET Response Criteria in Solid Tumors (PERCIST) and Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. Results were compared to PSA response. Univariable survival analyses were performed. Results Overall, 43 patients undergoing 67 systemic therapies were included (9 patients radium‐223, 12 cabazitaxel, 22 docetaxel, 6 abiraterone, and 18 enzalutamide). Median serum PSA level before any therapy was 11.3 ng/mL (interquartile range [IQR] = 3.3, 30.1). Delta (d) PSA after systemic therapies was −41%, dTTV 10.5%, dSUVmean −7.5%, dSUVmax −13.3%, dSUVpeak −12%, and dRECIST −13.3%. Overall, 31 patients had dPSA response (46.3%), 12 stable disease (17.9%), and 24 progressive disease (35.8%). All observed PET parameters, as well as the RECIST evaluation, were significantly associated with PSA response (dTTV P = .003, dSUVmean P = .003, dSUVmax P = .011, dSUVpeak P < 0001, dRECIST P = .012), while RECIST assessment was applicable in 37 out of 67 patients (55.2%). Within a median follow‐up of 33 months (IQR = 26, 38), 10 patients (23.3%) died of PC. On univariable survival analyses, neither the investigated PET parameters nor PSA level or RECIST criteria were associated with OS. Conclusion PSMA‐PET provides reliable parameters for prediction of response to systemic therapies for mCRPC. These parameters, if confirmed, could enhance RECIST criteria, specifically concerning its limitations for sclerotic bone lesions.

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“…In a first evaluation of [ 68 Ga]PSMA-11 PET derived parameters in patients after PSMA RLT, changes of PSMA-TV were significantly associated with overall survival [14]. Another recently published study also evaluated volumetric parameters in patients with mCRPC undergoing PSMA RLT and their impact to overall survival [15]. In their analysis a significant correlation between a higher survival rate and any decrease of PSMA-TV or TL-PSMA was observed whereas response assessment to therapy showed no significant relations between the changes of PSA and TV-PSMA or TL-PSMA [15].…”

Section: Introductionmentioning

confidence: 99%

Determination of whole-body tumour burden on [68Ga]PSMA-11 PET/CT for response assessment of [177Lu]PSMA-617 radioligand therapy: a retrospective analysis of serum PSA level and imaging derived parameters before and after two cycles of therapy

et al. 2019

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Aim In patients with metastasized castration-resistant prostate cancer a reliable imaging-based therapy response assessment in addition to PSA kinetics is desirable. Recently, measurements of whole-body tumour burden by [68Ga]PSMA-11 PET/CT have been reported for response assessment in oligometastasic patients. The present study investigated the association of PSMA PET derived parameters and serum PSA level before and after [177Lu]PSMA-617 radioligand therapy (RLT). Methods This retrospective study assessed whole-body PSMA tumour volume (PSMA-TV) in 10 patients with multifocal to diffuse metastases before and after 2 cycles of RLT using volume of interest (VOI) analysis. A standardized uptake value (SUV) threshold-based approach was used to semi-automatically delineate all voxels with a SUV ≥ 2.0 g/ml using the software ROVER® (ABX Radeberg, Germany). Voxels with physiological tracer uptake (e. g. kidneys) were excluded manually. Correlations between PSMA-TV and serum PSA level before and after two cycles of RLT as well as changes thereof (ΔPSMA-TV and ΔPSA, respectively) were calculated. Results Changes of ΔPSMA-TV and ΔPSA were concordant in 7 of 10 patients. Whereas a good correlation was found between PSMA-TV and PSA before RLT (ρ = 0.81, p = 0.0049), this correlation was attenuated after RLT (ρ = 0.64, p = 0.0479). Consequently, no association was found between ΔPSMA-TV and ΔPSA (ρ = 0.39, p = 0.26). Conclusion The attenuation of the correlation of PSA and PSMA-TV after RLT suggests that in patients with advanced disease the comparison of imaging based parameters such as PSMA-TV and PSA level might be useful for an adequate monitoring of treatment response.

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The use of molecular volumetric parameters for the evaluation of Lu-177 PSMA I&T therapy response and survival

Cited by 28 publications

References 26 publications

Metabolic Tumour Volume from PSMA PET/CT Scans of Prostate Cancer Patients during Chemotherapy—Do Different Software Solutions Deliver Comparable Results?

Metabolic Tumour Volume from PSMA PET/CT Scans of Prostate Cancer Patients during Chemotherapy—Do Different Software Solutions Deliver Comparable Results?

Response assessment using [⁶⁸Ga]Ga‐PSMA ligand PET in patients undergoing systemic therapy for metastatic castration‐resistant prostate cancer

Determination of whole-body tumour burden on [68Ga]PSMA-11 PET/CT for response assessment of [177Lu]PSMA-617 radioligand therapy: a retrospective analysis of serum PSA level and imaging derived parameters before and after two cycles of therapy

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The use of molecular volumetric parameters for the evaluation of Lu-177 PSMA I&T therapy response and survival

Cited by 28 publications

References 26 publications

Metabolic Tumour Volume from PSMA PET/CT Scans of Prostate Cancer Patients during Chemotherapy—Do Different Software Solutions Deliver Comparable Results?

Metabolic Tumour Volume from PSMA PET/CT Scans of Prostate Cancer Patients during Chemotherapy—Do Different Software Solutions Deliver Comparable Results?

Response assessment using [68Ga]Ga‐PSMA ligand PET in patients undergoing systemic therapy for metastatic castration‐resistant prostate cancer

Determination of whole-body tumour burden on [68Ga]PSMA-11 PET/CT for response assessment of [177Lu]PSMA-617 radioligand therapy: a retrospective analysis of serum PSA level and imaging derived parameters before and after two cycles of therapy

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Response assessment using [⁶⁸Ga]Ga‐PSMA ligand PET in patients undergoing systemic therapy for metastatic castration‐resistant prostate cancer