Predictive Value of Pre-treatment Ga-68 PSMA-11 PET/CT Volumetric Parameters for Toxicity in Lu-177 PSMA-617 Therapy
Nuclear Medicine and Molecular Imaging, 2026 (ESCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1007/s13139-026-01011-w
- Dergi Adı: Nuclear Medicine and Molecular Imaging
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Aerospace Database, EMBASE, Health Research Premium Collection (ProQuest), Technology Collection (ProQuest)
- Anahtar Kelimeler: Hematotoxicity, Nephrotoxicity, Prostate cancer, Ga-68 PSMA-11, PET/CT, Lu-177 PSMA-617 radioligand therapy
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Purpose: The aim of this study was to evaluate the relationship between volumetric parameters obtained from pre-treatment Gallium-68-labeled PSMA-11 (Ga-68 PSMA-11) PET/CT imaging and the development of nephrotoxicity and hematotoxicity during treatment in patients receiving Lutetium-177-labeled PSMA-617 (Lu-177 PSMA-617) radioligand therapy (RLT), and to investigate the potential of these parameters to predict toxicity. Methods: Forty-three patients diagnosed with metastatic castration-resistant prostate cancer (mCRPC) who underwent Lu-177 PSMA-617 RLT were included in the study. The patients’ baseline clinical characteristics, previous treatment history, and pre-treatment and treatment-related nephrological and hematological parameters were retrospectively recorded. Pre-RLT Ga-68 PSMA-11 PET/CT images were analyzed using LIFEx software. Regions of interest (ROIs) were created using a threshold value of 40% of the maximum Standard Uptake Value for metastatic lesions, and volumetric parameters were calculated. Organ-specific volumetric parameters for the kidneys and spleen were obtained using a similar method. Decreases in laboratory parameters were analyzed as absolute and percentage changes. Statistical analyses were performed using SPSS v25; relationships between variables were evaluated using univariate/multivariate linear regression and Spearman correlation analyses. Results: A significant relationship was found between kidney-derived volumetric PSMA parameters and absolute and percentage changes in kidney function. Volumetric parameters reflecting metastatic tumor burden showed a significant correlation with the decrease in hematological parameters. Toxicity-related changes were more limited in oligometastatic patients compared to non-oligometastatic patients. Conclusion: Volumetric parameters obtained from pre-treatment Ga-68 PSMA-11 PET/CT imaging can be used as valuable biomarkers for predicting serious nephrological and hematological toxicities that may develop during Lu-177 PSMA-617 therapy.