Value of post-therapy 177Lu PSMA images for accurate interpretation of therapy response with 68Ga-PSMA PET/CT

Publication date: Available online 24 July 2017
Source:Revista Española de Medicina Nuclear e Imagen Molecular
Author(s): M. Tuncel, T. Telli
A 54-year-old man with progressive prostate cancer underwent a ⁶⁸Ga-PSMA-PET/CT, which showed lymph node and bone metastases. After 2-cycles of ¹⁷⁷Lu-PSMA therapy, the repeated ⁶⁸Ga-PSMA PET/CT showed decreased radiotracer uptake in lymph node and bones metastases, but there were new lesions which may be compatible with progression or tumour sink-effect. A review of ¹⁷⁷Lu-PSMA-therapy images revealed that new lesions in the second PET/CT were the metastatic lesions that progressed after the first PET/CT, and subsequently showed a good response. The patient received additional cycles of ¹⁷⁷Lu-PSMA therapy, and the disease regressed further, with a PSA of 0.06ng/mL. Response evaluation of new therapeutic diagnostics (theranostic) agents needs a review of not only diagnostic PET/CT images, but also post-therapy images and laboratory results.



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