Abstract：
177Lu can be imaged after administration using SPECT/CT. Most work to date has focused on using posttreatment imaging to measure normal organ and tumor dose. We aimed to assess the impact of posttreatment SPECT/CT on the management of patients undergoing 177Lu-prostate-specific membrane antigen (PSMA) radiopharmaceutical therapy (RPT). Methods: In this retrospective study, 122 patients underwent PSMA RPT with subsequent SPECT/CT 24 h after treatment. We determined a qualitative response at each cycle and reviewed patient charts to assess the impact that posttreatment SPECT/CT had on patient management. Changes in patient management were classified as changes on the basis of progression and response, and specific cycles when they occurred were noted. Miscellaneous changes in patient management were also evaluated. Results: Among the 122 consecutive patients examined, 42%-56% exhibited stable disease, whereas 19%-39% of patients exhibited response on visual assessment across treatment cycles. In total, 49% (n = 60) of patients experienced changes in management, of which 57% (n = 34) were due to progression, 40% (n = 24) were due to response, and 3% (n = 2) were due to miscellaneous changes. Changes due to disease progression were observed mostly after cycles 2 and 4. Changes due to response to RPT occurred mostly after cycles 3 and 4. Conclusion: At our center, 49% of patients experienced changes in management based on posttreatment SPECT/CT, and most of these changes occurred at cycles 2 and 4. Integrating posttreatment SPECT/CT into routine PSMA RPT protocols can aid in patient management.
摘要：
177Lu可在给药后使用SPECT/CT成像。迄今为止，大多数工作都集中在使用后处理成像来测量正常器官和肿瘤剂量。我们旨在评估治疗后SPECT/CT对接受177Lu-前列腺特异性膜抗原（PSMA）放射性药物治疗（RPT）的患者管理的影响。方法：在这项回顾性研究中，122例患者在治疗后24小时接受PSMARPT和随后的SPECT/CT。我们确定了每个周期的定性反应，并回顾了患者图表，以评估治疗后SPECT/CT对患者管理的影响。患者管理的变化根据进展和反应分为变化，并记录了它们发生时的具体周期。还评估了患者管理中的其他变化。结果：在122例连续检查的患者中，42％-56％表现出稳定的疾病，而19%-39%的患者在整个治疗周期中对视觉评估有反应.总的来说,49%(n=60)的患者经历了管理方面的变化，其中57%(n=34)是由于进展，40%(n=24)是由于反应，3%(n=2)是由于其他变化。主要在周期2和4之后观察到由于疾病进展引起的变化。由于对RPT的反应而引起的变化主要发生在第3和第4周期之后。结论：在我们的中心，49%的患者经历了基于治疗后SPECT/CT的管理变化，这些变化大多发生在第2和第4周期。将治疗后SPECT/CT整合到常规PSMARPT方案中可以帮助患者管理。
