Article Figures & Data
Figures
- FIGURE 1.
CONSORT (Consolidated Standards of Reporting Trials) diagram describing SGM patient selection for PSMA-directed imaging and PSMA RLT.
- FIGURE 2.
Pie charts demonstrating additional detection of diseased regions by PSMA PET/CT (orange) when compared with standalone CT (blue). Charts demonstrate percentage positive patients among 28 patients, separately for each region.
- FIGURE 3.
68Ga-PSMA PET/CT of 69-y-old man with adenoid-cystic carcinoma of right submandibular gland after primary resection. Maximum-intensity projection (A) and axial slices (B–E) of 68Ga-PSMA PET/CT reveal bone metastases in sixth left rib (white arrow) and sacral bone (black arrow) without CT correlate (F and G), confirmed by follow-up imaging 6 mo later.
- FIGURE 4.
PSMA expression score by PROMISE criteria for 27 patients. One patient without any detected lesion was excluded.
Tables
Characteristic Data Sex Male 11 (39%) Female 17 (61%) Age (y) Median 59 Range 30–75 Primary location Major salivary gland 18 (64%) Parotid gland 8 (29%) Submandibular gland 7 (25%) Sublingual gland 3 (11%) Minor salivary gland 10 (36%) Clinical indications Staging 2 (7%) Restaging 12 (43%) Evaluation for RLT 14 (50%) Previous treatments Primary surgery 25 (89%) Multiple surgeries 12 (43%) Radiotherapy 24 (86%) Chemotherapy 7 (25%) Metastasectomy 9 (32%) Palliative radiotherapy 6 (21%) Disease sites at 68Ga-PSMA PET/CT Local tumor 8 (29%) Locoregional lymph node metastases 5 (18%) Nonlocoregional lymph node metastases 4 (14%) Lung metastases 14 (50%) Bone metastases 10 (36%) Other metastases 10 (36%) Data are number and percentage, except for age.
Characteristic Patient 1 Patient 2 Patient 3 Patient 4 Patient 5 Age (y) 50 42 40 56 65 Sex M F F F M Histology ACC ACC ACC ACC Acinic cell carcinoma Initial diagnosis to RLT (y) 8 2 4 3 16 Prior treatments Surgery*; radiotherapy; axitinib; chemotherapy Surgery; radiotherapy Surgery; radiotherapy*; metastasectomy Surgery; radiotherapy Surgery*; radiotherapy*; denosumab Primary location Paranasal sinus (minor salivary gland) Parotid gland Upper jaw (minor salivary gland) Parotid gland Parotid gland Metastatic sites Local; lung Lung Bone Lung; soft tissue Locoregional LN; bone PSMA expression score 3 2 3 2 3 RECIST 1.1 response PD NA† NA† SD SD TTP after PSMA RLT 3 mo 12 mo† 6 mo† Lost to follow-up 12 mo PSMA CT No disease Unifocal Oligometastatic Multifocal Disseminated No disease 1 (4%) 0 1 (4%)* 0 1 (4%)* Unifocal 0 2 (7%) 1 (4%)* 0 0 Oligometastatic 0 0 7 (25%) 2 (7%)* 1 (4%)* Multifocal 0 0 0 1 (4%) 0 Disseminated 0 0 0 0 11 (39%) ↵* Upstaging.
Data are number. Extent shifted toward higher disease burden in 6 of 28 (21%) patients after PSMA PET (oligometastatic disease, 2–5 metastases; multifocal disease, 6–10; disseminated disease, ≥11.
- TABLE 4.
Comparison of SUVmax for Sex, Primary Location at Initial Diagnosis, Bone Metastasis vs. Lung Metastasis, and Subtype
Parameter n Average SUVmax P Total patients 28 (100%) 10.7 (SD, 7.8) Sex Male 11 (39%) 15.8 (SD, 9.8) Female 17 (61%) 8.5 (SD, 4.9) 0.001* Primary location at primary diagnosis Major salivary glands 18 (64%) 9 (SD, 4.4) Minor salivary glands 10 (36%) 12.8 (SD, 8.4) 0.308 Metastasis sites Bone 14 (50%) 14.2 (SD, 10.2) Lung 16 (57%) 6.4 (SD, 4.2) Other 7 (25%) 8.8 (SD, 2.8) 0.006* Subtype ACC 24 (86%) 10.1 (SD, 5.9) Other 4 (14%) 14.2 (SD, 16) 0.352 ↵* P < 0.05, assessed by Student t test.
Patient no. Cycle no. Activity (GBq) Lesion 1 Lesion 2 Renal AD (Gy/GBq) Type AD (Gy/GBq) SUVmax SUVmean Type AD (Gy/GBq) SUVmax SUVmean 1 1 7.6 Lung 0.06 11.9 6.1 Recurrent 0.42 22.9 14.6 0.35 2 7.5 Lung 0.08 11.9 6.1 Recurrent 0.23 22.9 14.6 0.32 2 1 7.5 Lung 0.26 9 5 3 1 6.1 Bone 0.68 11.2 7.7 Bone 0.22 16.4 10.4 0.38 4 1 5.8 Lung 0.42 7.2 4 Lung 0.65 13.7 7 5 1 6.1 Bone 0.41 27.1 14.9 Bone 0.49 30 17.4 0.39 2 7.5 Bone 0.17 27.1 14.9 Bone 0.25 30 17.4 0.34 AD = absorbed dose.
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