18F-fluoride PET: changes in uptake as a method to assess response in bone metastases from castrate-resistant prostate cancer patients treated with 223Ra-chloride (Alpharadin).
18F-fluoride PET: changes in uptake as a method to assess response in bone metastases from castrate-resistant prostate cancer patients treated with 223Ra-chloride (Alpharadin).
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DOI：
10.1186/2191-219x-1-4
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发表时间：
2011-06-07
期刊：
影响因子：
3.2
通讯作者：
Lewington VJ
中科院分区：
文献类型：
--
作者：
Cook G Jr;Parker C;Chua S;Johnson B;Aksnes AK;Lewington VJ
~(99m)Tc-亚甲基二磷酸核素骨显像的定性评价被认为是监测骨转移瘤治疗反应的一种不敏感的方法，我们推测半定量18F-氟化物正电子发射断层扫描(PET)可能是一种合适的替代治疗反应的生物标志物。5例抗去势前列腺癌和骨转移患者在0周和6周接受100kBq/kg的~223(223Ra)-氯(Alpharadin)治疗，并在基线、6周和12周进行18F-氟化物正电子发射计算机断层扫描，同时测定前列腺特异性抗原(PSA)和碱性磷酸酶(ALP)。在不考虑PSA和ALP结果的情况下，对PET扫描进行定性比较。通过测量每个患者五个骨转移瘤的最大标准摄取值(SUVmax)进行半定量比较。每个受试者的五个SUVmax测量的平均值被用来作为每个时间点的全球转移活动性的定量测量。3例患者在12周时PSA下降(-44%、-31%、-27%)，2例患者PSA升高(+10%、+17%)。所有五名患者的碱性磷酸酶均有超过25%的下降。对18F-氟化物扫描的定性评估在每个病例中记录了一种稳定的疾病。然而，半定量评估显示，3名患者的PSA下降(-52%，-75%，-49%)与12周后PSA升高的两名患者的微小变化(+12%，-16%)一致。4名患者在12周时表现出类似的平均SUVmax和ALP下降。半定量~(18)F-氟-正电子发射计算机断层显像在评价骨转移瘤疗效方面较定性比较准确，与PSA反应和ALP活性相关，为监测223Ra-氯治疗后骨转移瘤的治疗反应提供了一种潜在的影像生物标志物。
A qualitative assessment of conventional bone scintigraphy with 99mTc methylene diphosphonate is perceived as an insensitive method for monitoring the treatment response of bone metastases, and we postulated that semi-quantitative 18F-fluoride positron emission tomography (PET) might serve as a suitable alternative biomarker of the treatment response. Five patients with castrate-resistant prostate cancer and bone metastases with no known soft tissue disease received 100 kBq/kg of radium-223 (223Ra)-chloride (Alpharadin) therapy at 0 and 6 weeks and had whole body 18F-fluoride PET scans at baseline, 6 and 12 weeks with concurrent prostatic-specific antigen (PSA) and alkaline phosphatase (ALP) measurements. A qualitative comparison of the PET scans was performed blinded to the PSA and ALP results. A semi-quantitative comparison was made by measuring the maximum standardised uptake values (SUVmax) in five bone metastases in each patient. The means of the five SUVmax measurements in each subject were used as a quantitative measure of global metastatic activity at each time point. Three patients showed a PSA decline at 12 weeks (-44%, -31%, -27% reduction) whilst two patients showed PSA increases (+10%, +17%). All five patients showed a reduction in ALP of greater than 25%. The qualitative assessment of the 18F-fluoride scans recorded a stable disease in each case. However, the semi-quantitative assessment showed agreement with the PSA decline in three patients (-52%, -75%, -49%) and minimal change (+12%, -16%) in two patients with increased PSA at 12 weeks. Four patients showed similar reductions in mean SUVmax and ALP at 12 weeks. The semi-quantitative 18F-fluoride PET is more accurate than the qualitative comparison of scans in assessing response in bone metastases, correlating with the PSA response and ALP activity and offering a potential imaging biomarker for monitoring treatment response in bone metastases following treatment with 223Ra-chloride.