68Ga-PSMA PET/CT in radioactive iodine-refractory differentiated thyroid cancer and first treatment results with 177Lu-PSMA-617

被引：73
作者：
de Vries, Lisa H. [1 ]
Lodewijk, Lutske [1 ]
Braat, Arthur J. A. T. [2 ]
Krijger, Gerard C. [2 ]
Valk, Gerlof D. [3 ]
Lam, Marnix G. E. H. [2 ]
Rinkes, Inne H. M. [1 ]
Vriens, Menno R. [1 ]
de Keizer, Bart [2 ]
机构：
[1] Univ Med Ctr Utrecht, Dept Surg, Heidelberglaan 100, NL-3584 CX Utrecht, Netherlands
[2] Univ Med Ctr Utrecht, Dept Radiol & Nucl Med, Heidelberglaan 100, NL-3584 CX Utrecht, Netherlands
[3] Univ Med Ctr Utrecht, Dept Endocrine Oncol, Heidelberglaan 100, NL-3584 CX Utrecht, Netherlands
来源：
EJNMMI RESEARCH | 2020年 / 10卷 / 01期
关键词：
Radioactive iodine-refractory differentiated thyroid carcinoma; Prostate-specific membrane antigen; Theranostic; Gallium; Lutetium; PET; CT; MEMBRANE ANTIGEN-EXPRESSION; PSMA EXPRESSION; CARCINOMA; GUIDELINES; MANAGEMENT; PAPILLARY; THERAPY;
D O I：
10.1186/s13550-020-0610-x
中图分类号：
R8 [特种医学]; R445 [影像诊断学];
学科分类号：
1002 ; 100207 ; 1009 ;
摘要：
Background Differentiated thyroid carcinoma (DTC) is the most common type of thyroid cancer. Treatment with surgery, radioactive iodine (RAI), and TSH suppression is effective in most patients. Five to 15% of patients become RAI refractory and need alternative therapy; however, treatment options are limited. Ga-68-PSMA PET/CT, originally developed for prostate cancer, is also applicable to other malignancies, including thyroid carcinoma. The uptake of PSMA in thyroid carcinoma gives opportunities for imaging and therapy of RAI-refractory DTC. The aim of this study was to analyze imaging on Ga-68-PSMA PET/CT and evaluate the response to Lu-177-PSMA-617 therapy in patients with RAI-refractory DTC. Materials and methods Five patients with RAI-refractory DTC underwent Ga-68-PSMA PET/CT to determine their eligibility for Lu-177-PSMA-617 therapy. Ga-68-PSMA PET/CTs were analyzed visually and quantitatively. Response to Lu-177-PSMA-617 therapy was evaluated using imaging and thyroglobulin (Tg) values. Results Tracer uptake suspicious for distant metastases was depicted in all Ga-68-PSMA PET/CTs. Based on tracer uptake, three patients were eligible for Lu-177-PSMA-617 therapy, of whom two were treated. One patient showed disease progression on imaging 1 month later, while her Tg values gradually increased from 18 to 63 mu g/L in the months after treatment. Another patient showed partial, temporary response of lung and liver metastases. Her Tg levels initially decreased from 17 to 9 mu g/L. However, 7 months after treatment, there was disease progression on imaging and Tg levels had increased to 14 mu g/L. Imaging with Ga-68-PSMA PET/CT could be compared to (18)FDG PET/CT in three patients. Two patients showed additional lesions on Ga-68-PSMA PET/CT, and one patient showed concordant imaging. Conclusion Ga-68-PSMA PET/CT appears to have added value in patients with RAI-refractory DTC, as it is able to detect various types of lesions, some of which were not picked up by (18)FDG PET/CT. Furthermore, Ga-68-PSMA PET/CT might be used to identify patients eligible for treatment with Lu-177-PSMA-617. One of the two patients who underwent Lu-177-PSMA-617 therapy showed a modest, temporary response. To draw conclusions about the effectiveness of this therapy, more research is needed.
引用
收藏
页数：8
相关论文
共 24 条
[1]   FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0 [J].
Boellaard, Ronald ;
Delgado-Bolton, Roberto ;
Oyen, Wim J. G. ;
Giammarile, Francesco ;
Tatsch, Klaus ;
Eschner, Wolfgang ;
Verzijlbergen, Fred J. ;
Barrington, Sally F. ;
Pike, Lucy C. ;
Weber, Wolfgang A. ;
Stroobants, Sigrid ;
Delbeke, Dominique ;
Donohoe, Kevin J. ;
Holbrook, Scott ;
Graham, Michael M. ;
Testanera, Giorgio ;
Hoekstra, Otto S. ;
Zijlstra, Josee ;
Visser, Eric ;
Hoekstra, Corneline J. ;
Pruim, Jan ;
Willemsen, Antoon ;
Arends, Bertjan ;
Kotzerke, Joerg ;
Bockisch, Andreas ;
Beyer, Thomas ;
Chiti, Arturo ;
Krause, Bernd J. .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2015, 42 (02) :328-354
[2]   PSMA PET and Radionuclide Therapy in Prostate Cancer [J].
Bouchelouche, Kirsten ;
Turkbey, Baris ;
Choyke, Peter L. .
SEMINARS IN NUCLEAR MEDICINE, 2016, 46 (06) :522-535
[3]   PSMA expression by microvasculature of thyroid tumors - Potential implications for PSMA theranostics [J].
Bychkov, Andrey ;
Vutrapongwatana, Usanee ;
Tepmongkol, Supatporn ;
Keelawat, Somboon .
SCIENTIFIC REPORTS, 2017, 7
[4]   Multidose formulation of ready-to-use 177Lu-PSMA-617 in a centralized radiopharmacy set-up [J].
Chakraborty, Sudipta ;
Vimalnath, K. V. ;
Chakravarty, Rubel ;
Sarma, H. D. ;
Dash, Ashutosh .
APPLIED RADIATION AND ISOTOPES, 2018, 139 :91-97
[5]   Long-term outcome of 444 patients with distant metastases from papillary and follicular thyroid carcinoma: Benefits and limits of radioiodine therapy [J].
Durante, C. ;
Haddy, N. ;
Baudin, E. ;
Leboulleux, S. ;
Hartl, D. ;
Travagli, J. P. ;
Caillou, B. ;
Ricard, M. ;
Lumbroso, J. D. ;
De Vathaire, F. ;
Schlumberger, M. .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2006, 91 (08) :2892-2899
[6]   Novel Preclinical and Radiopharmaceutical Aspects of [Ga-68]Ga-PSMA-HBED-CC: A New PET Tracer for Imaging of Prostate Cancer [J].
Eder, Matthias ;
Neels, Oliver ;
Mueller, Miriam ;
Bauder-Wust, Ulrike ;
Remde, Yvonne ;
Schaefer, Martin ;
Hennrich, Ute ;
Eisenhut, Michael ;
Afshar-Oromieh, Ali ;
Haberkorn, Uwe ;
Kopka, Klaus .
PHARMACEUTICALS, 2014, 7 (07) :779-796
[7]   Prostate-specific membrane antigen expression in regeneration and repair [J].
Gordon, Ilyssa O. ;
Tretiakova, Maria S. ;
Noffsinger, Amy E. ;
Hart, John ;
Reuter, Victor E. ;
Al-Ahmadie, Hikmat A. .
MODERN PATHOLOGY, 2008, 21 (12) :1421-1427
[8]   Prostate-specific membrane antigen expression in the neovasculature of gastric and colorectal cancers [J].
Haffner, Michael C. ;
Kronberger, Irmgard E. ;
Ross, Jeffrey S. ;
Sheehan, Christine E. ;
Zitt, Matthias ;
Muehlmann, Gilbert ;
Oefner, Dietmar ;
Zelger, Bettina ;
Ensinger, Christian ;
Yang, Ximing J. ;
Geley, Stephan ;
Margreiter, Raimund ;
Bander, Neil H. .
HUMAN PATHOLOGY, 2009, 40 (12) :1754-1761
[9]   2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer [J].
Haugen, Bryan R. ;
Alexander, Erik K. ;
Bible, Keith C. ;
Doherty, Gerard M. ;
Mandel, Susan J. ;
Nikiforov, Yuri E. ;
Pacini, Furio ;
Randolph, Gregory W. ;
Sawka, Anna M. ;
Schlumberger, Martin ;
Schuff, Kathryn G. ;
Sherman, Steven I. ;
Sosa, Julie Ann ;
Steward, David L. ;
Tuttle, R. Michael ;
Wartofsky, Leonard .
THYROID, 2016, 26 (01) :1-133
[10]  
Heitkotter Birthe, 2018, Oncotarget, V9, P9867, DOI 10.18632/oncotarget.23984
123