PDF(Pubmed)
Abstract：
Performing 2-[18F]FDG PET/CT in addition to a PSMA-ligand PET/CT can assist in the detection of lesions with low PSMA expression and may help in prognostication and identification of patients who likely benefit from PSMA-radioligand therapy (PSMA-RLT). However, the cost and time needed for a separate PET/CT examination might hinder its routine implementation. In this communication, we present our initial experiences with additional low-dose 2-[18F]FDG PET/CT as part of a dual-tracer and same-day imaging protocol which exploits the higher sensitivity exhibited by long-axial field-of-view (LAFOV) and total-body PET/CT systems and demonstrates its feasibility.
Fourteen patients referred for evaluation for PSMA-RLT received [68 Ga]Ga-PSMA-11 PET/CT at 1 h p.i. with a standard activity of 150 MBq and an additional low-dose 2-[18F]FDG PET/CT with 40 MBq 1 h thereafter using a long-axial field-of-view PET/CT system in a single sitting and as per institutional protocol. Scans were scrutinized by two experienced nuclear medicine physicians for mismatch findings.
The combined protocol identified additional lesions with low or absent PSMA-expression but high FDG-avidity in 1/14 (7%) patients. The protocol was easily implemented and well tolerated by all patients.
Additional low-dose 2-[18F]FDG-PET/CT is feasible as part of a same-day imaging protocol and can help reveal lesions of low PSMA avidity as part of therapy assessment for [177Lu]-PSMA radioligand therapy and demonstrates higher sensitivity compared to [68 Ga]Ga-PSMA-11 PET/CT alone in some patients.
Fourteen patients referred for evaluation for PSMA-RLT received [68 Ga]Ga-PSMA-11 PET/CT at 1 h p.i. with a standard activity of 150 MBq and an additional low-dose 2-[18F]FDG PET/CT with 40 MBq 1 h thereafter using a long-axial field-of-view PET/CT system in a single sitting and as per institutional protocol. Scans were scrutinized by two experienced nuclear medicine physicians for mismatch findings.
The combined protocol identified additional lesions with low or absent PSMA-expression but high FDG-avidity in 1/14 (7%) patients. The protocol was easily implemented and well tolerated by all patients.
Additional low-dose 2-[18F]FDG-PET/CT is feasible as part of a same-day imaging protocol and can help reveal lesions of low PSMA avidity as part of therapy assessment for [177Lu]-PSMA radioligand therapy and demonstrates higher sensitivity compared to [68 Ga]Ga-PSMA-11 PET/CT alone in some patients.
摘要：
目的：除了PSMA-配体PET/CT外，还进行2-[18F]FDGPET/CT可以帮助检测PSMA低表达的病变，并可能有助于预测和鉴定可能受益于PSMA放射性配体治疗（PSMA-RLT）的患者。然而,单独PET/CT检查所需的成本和时间可能会阻碍其常规实施.在这份通讯中,我们介绍了我们在双示踪剂和当日成像方案中使用额外的低剂量2-[18F]FDGPET/CT的初步经验,该方案利用了长轴向视场(LAFOV)和全身PET/CT系统所表现出的更高灵敏度,并证明了其可行性.
方法：接受PSMA-RLT评估的14例患者在1hp.i.时接受了[68Ga]Ga-PSMA-11PET/CT，标准活性为150MBq，然后在1h后使用长轴视野PET/CT系统并根据机构方案进行了40MBq的低剂量2-[18F]FDGPET/CT。扫描由两名经验丰富的核医学医生仔细检查，以发现不匹配的结果。
结果：联合方案在1/14（7％）患者中发现了PSMA表达低或缺失但FDG代谢高的其他病变。该方案很容易实施，所有患者都能很好地耐受。
结论：作为当天成像方案的一部分，额外的低剂量2-[18F]FDG-PET/CT是可行的，并且可以帮助揭示低PSMA亲和力的病变，作为[177Lu]-PSMA放射性配体治疗的治疗评估的一部分，并且在某些患者中与单独的[68]Ga-PSMA-11PET/CT相比显示出更高的敏感性。
方法：接受PSMA-RLT评估的14例患者在1hp.i.时接受了[68Ga]Ga-PSMA-11PET/CT，标准活性为150MBq，然后在1h后使用长轴视野PET/CT系统并根据机构方案进行了40MBq的低剂量2-[18F]FDGPET/CT。扫描由两名经验丰富的核医学医生仔细检查，以发现不匹配的结果。
结果：联合方案在1/14（7％）患者中发现了PSMA表达低或缺失但FDG代谢高的其他病变。该方案很容易实施，所有患者都能很好地耐受。
结论：作为当天成像方案的一部分，额外的低剂量2-[18F]FDG-PET/CT是可行的，并且可以帮助揭示低PSMA亲和力的病变，作为[177Lu]-PSMA放射性配体治疗的治疗评估的一部分，并且在某些患者中与单独的[68]Ga-PSMA-11PET/CT相比显示出更高的敏感性。
