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Exploring New Multimodal Quantitative Imaging Indices for the Assessment of Osseous Tumor Burden in Prostate Cancer Using 68Ga-PSMA PET/CT
The Journal of Nuclear Medicine ( IF 9.1 ) Pub Date : 2017-10-01 , DOI: 10.2967/jnumed.116.189050
Marie Bieth , Markus Krönke , Robert Tauber , Marielena Dahlbender , Margitta Retz , Stephan G. Nekolla , Bjoern Menze , Tobias Maurer , Matthias Eiber , Markus Schwaiger

PET combined with CT and prostate-specific membrane antigen (PSMA) ligands has gained significant interest for staging prostate cancer (PC). In this study, we propose 2 multimodal quantitative indices as imaging biomarkers for the assessment of osseous tumor burden using 68Ga-PSMA PET/CT and present preliminary clinical data. Methods: We defined 2 bone PET indices (BPIs) that incorporate anatomic information from CT and functional information from 68Ga-PSMA PET: BPIVOL is the percentage of bone volume affected by tumor and BPISUV additionally considers the level of PSMA expression. We describe a semiautomatic computation method based on segmentation of bones in CT and of lesions in PET. Data from 45 patients with castration-resistant PC and bone metastases during 223Ra-dichloride were retrospectively analyzed. We evaluated the computational stability and reproducibility of the proposed indices and explored their relation to the prostate-specific antigen blood value, the bone scan index (BSI), and disease classification using PERCIST. Results: On the technical side, BPIVOL and BPISUV showed an interobserver maximum difference of 3.5%, and their computation took only a few minutes. On the clinical side, BPIVOL and BPISUV showed significant correlations with BSI (r = 0.76 and 0.74, respectively, P < 0.001) and prostate-specific antigen values (r = 0.57 and 0.54, respectively, P < 0.01). When the proposed indices were compared against expert rating using PERCIST, BPIVOL and BPISUV showed better agreement than BSI, indicating their potential for objective response evaluation. Conclusion: We propose the evaluation of BPIVOL and BPISUV as imaging biomarkers for 68Ga-PSMA PET/CT in a prospective study exploring their potential for outcome prediction in patients with bone metastases from PC.



中文翻译:

探索使用68 Ga-PSMA PET / CT评估前列腺癌骨肿瘤负担的新的多峰定量成像指标

结合CT和前列腺特异性膜抗原(PSMA)配体的PET对分期前列腺癌(PC)引起了极大的兴趣。在这项研究中,我们提出了两种多峰定量指标作为使用68 Ga-PSMA PET / CT评估骨肿瘤负荷的影像学生物标志物,并提供了初步的临床数据。方法:我们定义了2个骨PET指数(BPI),这些指数结合了CT的解剖信息和68 Ga-PSMA PET的功能信息:BPI VOL是受肿瘤和BPI SUV影响的骨体积百分比另外考虑PSMA表达水平。我们描述了一种基于CT中的骨骼分割和PET中的病变分割的半自动计算方法。回顾性分析了223例二氯化镭治疗期间有去势抵抗性PC和骨转移的45例患者的数据。我们评估了拟议指标的计算稳定性和可重复性,并探讨了它们与前列腺特异性抗原血值,骨扫描指标(BSI)和使用PERCIST进行的疾病分类的关系。结果:在技​​术方面,BPI VOL和BPI SUV的观察者间最大差异为3.5%,而他们的计算仅花费了几分钟。在临床方面,BPI VOL和BPI SUV与BSI呈显着相关性(r分别为0.76和0.74,P <0.001)和前列腺特异性抗原值(分别为r = 0.57和0.54,P <0.01)。当使用PERCIST将提议的指标与专家评级进行比较时,BPI VOL和BPI SUV比BSI显示出更好的一致性,表明它们有可能用于客观反应评价。结论:我们建议在一项前瞻性研究中评估BPI VOL和BPI SUV作为68 Ga-PSMA PET / CT的成像生物标志物,以探讨其在PC骨转移患者中预测结局的潜力。

更新日期:2017-10-02
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