Dual-Tracer 18F-FDG and 68Ga-PSMA PET/CT Imaging of Heterogeneous Phenotypes of Metastatic Castration-Resistant Prostate Cancer for Predicting Response to Novel Hormone Therapy
Linjie Bian, Panli Li, Xiangwei Wang, Yan Zuo, Xuwei Liu, Liyan Bai, Jialiang Lei, Haoyao Guo, Silong Hu, Chang Liu, Shaoli SongPurpose
This study evaluated interlesion heterogeneity in prostate cancer using dual-tracer imaging (PSMA and FDG) and explored its predictive value for novel hormone therapy (NHT).
Patients and Methods
A total of 205 prostate cancer patients (23 biochemical recurrences, 68 metastatic castration-sensitive prostate cancers, 114 metastatic castration-resistant prostate cancers [mCRPC]) who underwent dual 18F-FDG and 68Ga-PSMA PET/CT imaging were retrospectively analyzed. Among them, 62 mCRPC patients received NHT. Patients were classified into 3 groups: PSMA+FDG−, PSMA+FDG+, and PSMA-FDG+. SUVratio, the ratio of PSMA-SUVmax to FDG-SUVmax, was evaluated for its predictive value on progression-free survival (PFS).
Results
The proportion of PSMA+FDG− patients decreased from biochemical recurrence to mCRPC stages, whereas FDG+ cases increased significantly (
Conclusions
Dual-tracer imaging reveals interlesion heterogeneity in prostate cancer, and SUVratio may help predict early response to NHT.