PURPOSE To evaluate the effect of neoadjuvant androgen deprivation treatment (ADT) on prostate-specific membrane antigen (PSMA) tracer uptake demonstrated in 68Ga-PSMA-positron emission tomography (PET/CT) in non-metastatic hormone-naïve prostate cancer (PC) patients. MATERIALS AND METHODS The clinical data of 108 PC patients who received neoadjuvant ADT were retrospectively analyzed. All patients had a baseline 68Ga-PSMA-PET/CT scan, and a second scan was delivered median of 2.9 months after the initiation of ADT. The maximum standardized uptake value (SUVmax) of primary tumor (SUVp) and metastatic lymph nodes (SUVln) as well as PSA response were assessed between pre- and post-ADT 68Ga-PSMA-PET/CT scans. RESULTS There were significant decreases in posttreatment serum PSA, SUVp, and SUVln. A decrease in SUVp was seen in 91 patients (84%) with a median value of 66% (range, 5-100%), while 17 patients (16%) had no change in or an increase in PSMA tracer uptake with a median value of 24% (range, 0-198%). Patients with Gleason score (GS) of 7 had significantly higher metabolic response rates compared to other patients. The disease progression was significantly higher only in patients with GS > 7 disease compared to GS 7 disease. The PSA response to ADT was the lowest in patients with ISUP high-grade tumors. A total of 16 patients (15%) had progressive disease, and in 9 patients (8%), radiotherapy decisions were modified according to posttreatment 68Ga-PSMA-PET/CT scans. CONCLUSIONS The current study includes the largest number of patients analyzed to date and demonstrates that ADT causes a significant decrease in serum PSA values and SUVp and SUVln. The authors demonstrate that 68Ga-PSMA-PET/CT may be used as a quantitative imaging modality after neoadjuvant ADT in hormone-naïve non-metastatic PC patients.

中文翻译：

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雄激素剥夺疗法对非转移性前列腺癌患者68Ga-PSMA示踪剂摄取的影响。

目的评估68Ga-PSMA-正电子发射断层扫描（PET / CT）在非转移性初治激素的前列腺癌（PC）中证明的新辅助雄激素剥夺治疗（ADT）对前列腺特异性膜抗原（PSMA）示踪剂摄取的影响耐心。材料与方法回顾性分析了108例接受新辅助ADT的PC患者的临床资料。所有患者均进行了基线68Ga-PSMA-PET / CT扫描，并且在开始ADT后中值2.9个月进行了第二次扫描。在ADT 68Ga-PSMA-PET / CT扫描前后，评估了原发肿瘤（SUVp）和转移淋巴结（SUVln）的最大标准化摄取值（SUVmax）以及PSA反应。结果治疗后血清PSA，SUVp和SUVln显着降低。SUVp降低了91位患者（84％），中位值为66％（范围5-100％），而17位患者（16％）的PSMA示踪剂摄取无变化或增加，中位值值的24％（​​范围为0-198％）。与其他患者相比，格里森评分（GS）为7的患者具有更高的代谢反应率。与GS 7疾病相比，仅GS> 7疾病的患者的疾病进展显着更高。PSUP对ADT的反应在ISUP高度肿瘤患者中最低。共有16例患者（占15％）患有进行性疾病，而9例患者（占8％）根据放疗后68Ga-PSMA-PET / CT扫描修改了放疗决策。结论当前的研究包括迄今为止最多的患者分析，并证明ADT导致血清PSA值和SUVp和SUVln的显着降低。作者证明68Ga-PSMA-PET / CT可以用作初治荷尔蒙的非转移性PC患者新辅助ADT后的定量影像学检查方法。