Dual-Tracer 18F-FDG and 68Ga-PSMA PET/CT Imaging of Heterogeneous Phenotypes of Metastatic Castration-Resistant Prostate Cancer for Predicting Response to Novel Hormone Therapy

作者：Linjie Bian, Panli Li, Xiangwei Wang, Yan Zuo, Xuwei Liu, Liyan Bai, Jialiang Lei, Haoyao Guo, Silong Hu, Chang Liu, Shaoli Song · 发表于：Clinical Nuclear Medicine · 年份：2024 · DOI：10.1097/rlu.0000000000005587 · 被引用次数：11 · 研究领域：Prostate Cancer Treatment and Research、Prostate Cancer Diagnosis and Treatment、Radiopharmaceutical Chemistry and Applications

PURPOSE: This study evaluated interlesion heterogeneity in prostate cancer using dual-tracer imaging (PSMA and FDG) and explored its predictive value for novel hormone therapy (NHT). PATIENTS AND METHODS: A total of 205 prostate cancer patients (23 biochemical recurrences, 68 metastatic castration-sensitive prostate cancers, 114 metastatic castration-resistant prostate cancers [mCRPC]) who underwent dual 18 F-FDG and 68 Ga-PSMA PET/CT imaging were retrospectively analyzed. Among them, 62 mCRPC patients received NHT. Patients were classified into 3 groups: PSMA+FDG-, PSMA+FDG+, and PSMA-FDG+. SUV ratio , the ratio of PSMA-SUV max to FDG-SUV max , was evaluated for its predictive value on progression-free survival (PFS). RESULTS: The proportion of PSMA+FDG- patients decreased from biochemical recurrence to mCRPC stages, whereas FDG+ cases increased significantly ( P = 0.001). In the NHT cohort, group 3 (PSMA-FDG+) had significantly shorter median PFS than group 1 (133 vs 497 days; P = 0.027). In group 2, patients with a high SUV ratio had better median PFS than those with a low SUV ratio (368 vs 147 days; P = 0.031). CONCLUSIONS: Dual-tracer imaging reveals interlesion heterogeneity in prostate cancer, and SUV ratio may help predict early response to NHT.