A pilot study of 68 Ga-PSMA-617 PET/CT imaging and 177Lu-EB-PSMA-617 radioligand therapy in patients with adenoid cystic carcinoma

• Published in: EJNMMI research Vol. 12; no. 1; pp. 52 - 13
• Main Authors: Wang, Guochang, Zhou, Mengjiao, Zang, Jie, Jiang, Yuanyuan, Chen, Xiaohong, Zhu, Zhaohui, Chen, Xiaoyuan
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 19.08.2022; Springer Nature B.V; SpringerOpen
• Subjects: 177Lu-EB-PSMA-617; 18F-FDG PET/CT; 68 Ga-PSMA-617 PET/CT; Adenoid cystic carcinoma; Cancer; Cardiac Imaging; Computed tomography; Fluorine isotopes; Imaging; Lesions; Lutetium isotopes; Medical imaging; Medicine; Medicine & Public Health; Metastasis; NCT; NCT04801264; Nuclear Medicine; Oncology; Original Research; Orthopedics; Positron emission; Pulmonary lesions; Radiology; Therapy; Tomography; Tumors; Lu-EB-PSMA-617; Ga-PSMA-617 PET/CT; F-FDG PET/CT; Adenoid cystic carcinoma
• ISSN: 2191-219X; 2191-219X
• DOI: 10.1186/s13550-022-00922-x

Background This pilot study was designed to evaluate the diagnostic value of 68  Ga-PSMA-617 and 18 F-FDG PET/CT in adenoid cystic carcinoma (ACC) and to assess the safety and therapeutic response to PSMA radioligand therapy (RLT) in ACC patients. Methods Thirty patients pathologically diagnosed with ACC were recruited into the cohort. Each patient underwent 68  Ga-PSMA-617 and 18 F-FDG PET/CT within 1 week. The number and SUVmax of PET-positive lesions were recorded and compared. Four patients accepted RLT using 177 Lu-EB-PSMA-617, in a dosage of approximately 1.85 GBq (50 mCi) per cycle for up to 3 cycles. Results Compared with 18 F-FDG, 68  Ga-PSMA-617 revealed more PET-positive extrapulmonary tumors (157 vs. 141, P  = 0.016) and higher SUVmax (8.8 ± 3.6 vs. 6.4 ± 4.2, P  = 0.027). However, 68  Ga-PSMA-617 revealed less PET-positive pulmonary lesions (202 vs. 301, P  < 0.001) and lower SUVmax of tumors (3.1 ± 3.0 vs. 4.2 ± 3.9, P  < 0.001) than 18 F-FDG. The combination of 68  Ga-PSMA-617 and 18 F-FDG can detect 469 PET-positive lesions, which was superior to each alone (469 vs. 359 vs. 442, P  < 0.001). Two patients achieved remarkable response after PSMA RLT, while the other two patients showed reduced tumor uptake of recurrent foci, lung and liver metastases, whereas increased SUVmax of bone metastases. Conclusions 68  Ga-PSMA-617 PET/CT is a valuable imaging modality for the detection of ACC and combining with 18 F-FDG PET/CT will achieve a higher detection efficiency. PSMA RLT may be a promising treatment for ACC and is worth of further investigation. Trial registration : Diagnosis of Adenoid Cystic Carcinoma on 68  Ga-PSMA-617 PET-CT and Therapy With 177 Lu-EB-PSMA-617 (NCT04801264, Registered 16 March 2021, retrospectively registered). URL of registry : https://clinicaltrials.gov/ct2/show/NCT04801264 .