PSMA-Directed Imaging and Therapy of Salivary Gland Tumors: A Single-Center Retrospective Study.

Autor: Civan C; Department of Nuclear Medicine, University Hospital Essen, Essen, Germany.; German Cancer Consortium, partner site Essen, Essen, Germany., Kasper S; German Cancer Consortium, partner site Essen, Essen, Germany.; Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany., Berliner C; Department of Nuclear Medicine, University Hospital Essen, Essen, Germany.; German Cancer Consortium, partner site Essen, Essen, Germany., Fragoso-Costa P; Department of Nuclear Medicine, University Hospital Essen, Essen, Germany.; German Cancer Consortium, partner site Essen, Essen, Germany., Grünwald V; German Cancer Consortium, partner site Essen, Essen, Germany.; Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany., Pogorzelski M; German Cancer Consortium, partner site Essen, Essen, Germany.; Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany., Schaarschmidt BM; German Cancer Consortium, partner site Essen, Essen, Germany.; Institute of Diagnostic and Interventional Radiology and Neuroradiology, University of Duisburg-Essen, Essen, Germany; and., Lang S; German Cancer Consortium, partner site Essen, Essen, Germany.; Head and Neck Surgery, Department of Otorhinolaryngology, University Hospital Essen, University Duisburg-Essen, Essen, Germany., Kersting D; Department of Nuclear Medicine, University Hospital Essen, Essen, Germany.; German Cancer Consortium, partner site Essen, Essen, Germany., Nader M; Department of Nuclear Medicine, University Hospital Essen, Essen, Germany., Lückerath K; Department of Nuclear Medicine, University Hospital Essen, Essen, Germany.; German Cancer Consortium, partner site Essen, Essen, Germany., Herrmann K; Department of Nuclear Medicine, University Hospital Essen, Essen, Germany.; German Cancer Consortium, partner site Essen, Essen, Germany., Fendler WP; Department of Nuclear Medicine, University Hospital Essen, Essen, Germany.; German Cancer Consortium, partner site Essen, Essen, Germany., Weber M; Department of Nuclear Medicine, University Hospital Essen, Essen, Germany; manuel.weber@uk-essen.de.; German Cancer Consortium, partner site Essen, Essen, Germany.
Jazyk: angličtina
Zdroj: Journal of nuclear medicine : official publication, Society of Nuclear Medicine [J Nucl Med] 2023 Mar; Vol. 64 (3), pp. 372-378. Date of Electronic Publication: 2022 Sep 22.
DOI: 10.2967/jnumed.122.264342
Abstrakt: We analyzed the diagnostic performance of prostate-specific membrane antigen (PSMA) PET/CT and the dosimetry, efficacy, and safety of 177 Lu-PSMA-617 radioligand therapy (RLT) in salivary gland malignancies (SGMs). Methods: We identified 28 SGM patients with PSMA PET/CT from our database. CT and PSMA PET/CT images were evaluated separately by 3 masked readers in joint reading sessions. Pathologic findings were grouped into 6 TNM regions, and lesion-based disease extent was classified as no disease ( n  = 1, 4%), unifocal ( n  = 2, 7%), oligometastatic ( n  = 9, 32%), multifocal ( n  = 3, 11%), or disseminated ( n  = 13, 47%). For each region, the SUV max of the lesion with the highest uptake was measured and the visual PSMA expression score was evaluated on a per-patient basis using PROMISE criteria. The association between PSMA expression and clinical and histopathologic markers was tested using the Student t test. Five patients underwent PSMA RLT with intratherapeutic dosimetry. Response was assessed using RECIST 1.1, and adverse events were graded according to version 5.0 of the Common Terminology Criteria for Adverse Events. Results: Compared with CT, PSMA PET/CT demonstrated additional metastatic lesions in 11 of 28 (39%) patients, leading to upstaging of TNM and lesion-based disease extent in 3 (11%) and 6 (21%) patients, respectively. PSMA PET/CT detected CT-occult local tumor, regional lymph nodes, nonregional lymph nodes, and bone metastases in 1 (4%), 4 (14%), 2 (7%), and 4 (14%) patients, respectively; no additional lesions were detected in the other predefined regions. PSMA expression level was higher than liver in 6 patients (25%). A significantly higher SUV max was observed in male than female patients (15.8 vs. 8.5, P  = 0.007) and in bone than lung lesions (14.2 vs. 6.4, P  = 0.006). PSMA RLT was discontinued after 1 cycle in 3 of 5 patients because of insufficient tumor doses. No adverse events of grade 4 or higher occurred. Conclusion: In SGMs, PSMA PET/CT demonstrated a superior detection rate and led to upstaging in about one third of patients when compared with CT. The male sex and the presence of bone metastases were associated with significantly higher PSMA expression. PSMA RLT was well tolerated, but most patients did not have more than 1 cycle because of insufficient tumor doses.
(© 2023 by the Society of Nuclear Medicine and Molecular Imaging.)
Databáze: MEDLINE
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