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Cancer Management and Research Volume 13, 2021 - Issue
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Original Research

Combination of 99mTc-Labeled PSMA-SPECT/CT and Diffusion-Weighted MRI in the Prediction of Early Response After Carbon Ion Therapy in Prostate Cancer: A Non-Randomized Prospective Pilot Study

Ping Li1 Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, People’s Republic of China;2 Shanghai Key Laboratory of Radiation Oncology, Shanghai, People’s Republic of China;3 Shanghai Engineering Research Center of Proton and Heavy ion Radiation Therapy, Shanghai, People’s Republic of China
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Chang Liu4 Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China;5 Key Laboratory of Nuclear Physics and Ion-Beam Application (MOE), Fudan University, Shanghai, People’s Republic of China;6 Shanghai Engineering Research Center for Molecular Imaging Probes, Shanghai, People’s Republic of China
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Shuang Wu2 Shanghai Key Laboratory of Radiation Oncology, Shanghai, People’s Republic of China;3 Shanghai Engineering Research Center of Proton and Heavy ion Radiation Therapy, Shanghai, People’s Republic of China;7 Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, People’s Republic of China
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Lin Deng2 Shanghai Key Laboratory of Radiation Oncology, Shanghai, People’s Republic of China;3 Shanghai Engineering Research Center of Proton and Heavy ion Radiation Therapy, Shanghai, People’s Republic of China;8 Department of Radiology, Shanghai Proton and Heavy Ion Center, Shanghai, People’s Republic of China
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Guangyuan Zhang2 Shanghai Key Laboratory of Radiation Oncology, Shanghai, People’s Republic of China;3 Shanghai Engineering Research Center of Proton and Heavy ion Radiation Therapy, Shanghai, People’s Republic of China;8 Department of Radiology, Shanghai Proton and Heavy Ion Center, Shanghai, People’s Republic of China
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Xin Cai1 Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, People’s Republic of China;2 Shanghai Key Laboratory of Radiation Oncology, Shanghai, People’s Republic of China;3 Shanghai Engineering Research Center of Proton and Heavy ion Radiation Therapy, Shanghai, People’s Republic of China
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Silong Hu4 Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China;5 Key Laboratory of Nuclear Physics and Ion-Beam Application (MOE), Fudan University, Shanghai, People’s Republic of China;6 Shanghai Engineering Research Center for Molecular Imaging Probes, Shanghai, People’s Republic of China
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Jingyi Cheng2 Shanghai Key Laboratory of Radiation Oncology, Shanghai, People’s Republic of China;3 Shanghai Engineering Research Center of Proton and Heavy ion Radiation Therapy, Shanghai, People’s Republic of China;6 Shanghai Engineering Research Center for Molecular Imaging Probes, Shanghai, People’s Republic of China;9 Department of Nuclear Medicine, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, People’s Republic of China
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Xiaoping Xu4 Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China;5 Key Laboratory of Nuclear Physics and Ion-Beam Application (MOE), Fudan University, Shanghai, People’s Republic of China;6 Shanghai Engineering Research Center for Molecular Imaging Probes, Shanghai, People’s Republic of ChinaORCID Iconhttps://orcid.org/0000-0001-9656-6233
ORCID Icon,
Bin Wu2 Shanghai Key Laboratory of Radiation Oncology, Shanghai, People’s Republic of China;3 Shanghai Engineering Research Center of Proton and Heavy ion Radiation Therapy, Shanghai, People’s Republic of China;10 Department of Radiology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, People’s Republic of China
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Xiaomao Guo2 Shanghai Key Laboratory of Radiation Oncology, Shanghai, People’s Republic of China;3 Shanghai Engineering Research Center of Proton and Heavy ion Radiation Therapy, Shanghai, People’s Republic of China;7 Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, People’s Republic of China
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Yingjian Zhang4 Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China;5 Key Laboratory of Nuclear Physics and Ion-Beam Application (MOE), Fudan University, Shanghai, People’s Republic of China;6 Shanghai Engineering Research Center for Molecular Imaging Probes, Shanghai, People’s Republic of China
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Shen Fu5 Key Laboratory of Nuclear Physics and Ion-Beam Application (MOE), Fudan University, Shanghai, People’s Republic of China;11 Department of Radiation Oncology, Shanghai Concord Cancer Hospital, Shanghai, People’s Republic of ChinaCorrespondence[email protected]
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Qing Zhang1 Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, People’s Republic of China;2 Shanghai Key Laboratory of Radiation Oncology, Shanghai, People’s Republic of China;3 Shanghai Engineering Research Center of Proton and Heavy ion Radiation Therapy, Shanghai, People’s Republic of ChinaCorrespondence[email protected]
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Pages 2191-2199 | Published online: 03 Mar 2021
 
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Abstract

Purpose

The purpose of this study was to assess the potential of 99mTc-labeled PSMA-SPECT/CT and diffusion-weighted image (DWI) for predicting treatment response after carbon ion radiotherapy (CIRT) in prostate cancer.

Patients and Methods

We prospectively registered 26 patients with localized prostate cancer treated with CIRT. All patients underwent 99mTc-labeled PSMA-SPECT/CT and multiparametric magnetic resonance imaging (MRI) before and after CIRT. The tumor/background ratio (TBR) and mean apparent diffusion coefficient (ADCmean) were measured on the tumor and the percentage changes before and after therapy (ΔTBR and ΔADCmean) were calculated. Patients were divided into two groups: good response and poor response according to clinical follow-up.

Results

The median follow up time was 38.3months. The TBR was significantly decreased (p=0.001), while the ADCmean was significantly increased compared with the pretreatment value (p<0.001). The ΔTBR and ΔADCmean were negatively correlated with each other (p = 0.002). On ROC curve analysis for predicting treatment response, the area under the ROC curve (AUC) of ΔTBR (0.867) for predicting good response was higher than that of ΔADCmean (0.819). The AUC of combined with ΔTBR and ΔADCmean (0.895) was higher than that of either ΔADCmean or ΔTBR alone. The combined use of ΔTBR and ΔADCmean showed 91.4% sensitivity and 95.2% specificity.

Conclusion

Our preliminary data indicate that the changes of TBR and ADCmean maybe an early bio-marker for predicting prognosis after CIRT in localized prostate cancer patients. In addition, the ΔTBR seems to be a more powerful prognostic factor than ΔADCmean in prostate cancer treated with CIRT.

Acknowledgments

We would like to thank the participating patients. This article has drawn on a program of research funded by the National Key Research and Development Program of China (2017YFC0107600), National Natural Science Foundation of China (81773225), Pudong New area science and technology development foundation (PKJ2016-Y43), Shanghai Municipal Health commission (201940121).

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Disclosure

The authors report no conflicts of interest in this work.

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