Prognostic Value of Tumor Volume Assessment on PSMA PET After 177Lu-PSMA Radioligand Therapy Evaluated by PSMA PET/CT Consensus Statement and RECIP 1.0

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FIGURE 1.
Maximum-intensity projections of ⁶⁸Ga-PSMA-11 (A) and ¹⁸F-PSMA-1007 (B) PET scans of patients with metastasized prostate cancer before PSMA RLT. PSMA-positive prostate cancer lesions were delineated semiautomatically and highlighted in blue. Lesion-specific threshold of 50% was used. Intensity-scale bar is SUV.
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FIGURE 2.
Kaplan–Meier curves of OS of all patients (n = 70) classified by PSMA PET/CT consensus statement (A) and RECIP 1.0 (B).

TABLE 1.

Response Assessment According to PSMA PET/CT Consensus Statement (10) and RECIP 1.0

Response	PSMA PET/CT consensus statement	RECIP 1.0
PR	Decline in tumor volume > 30%	No new lesions^* and decline in tumor volume > 30%
SD	Change in tumor volume ≤ ±30%	Change in tumor volume of −30% to +20%, or ≥1 new lesion^* and decline in tumor volume ≥ 30%, or no new lesions^* and increase in tumor volume ≥ 20%
PD	Polymetastatic prostate cancer: increase in tumor volume > 30%	≥1 new lesion^* and increase in tumor volume > 20%

TABLE 2.

Patient Characteristics at Baseline (n = 70)

Characteristic	All patients (n = 70)	Patients with ⁶⁸Ga-PSMA-11 PET/CT (n = 33)	Patients with ¹⁸F-PSMA-1007 PET/CT (n = 37)	P^*
Age (y)	73 (53–90)	72 (53–88)	74 (57–90)	0.383
Time since initial diagnosis (y)	9.0 (0.7–26.9)	9.4 (0.7–22.2)	8.3 (1.2–26.9)	0.609
Prostate-specific antigen (ng/mL)	338.3 (0.1–3,129)	416.1 (0.1–3,129)	269.0 (5.8–2,980)	0.348
Gleason score				0.695
<8	25 (36)	11 (44)	14 (56)
≥8	45 (64)	22 (49)	23 (51)
Previous treatment^†
Prostatectomy	38 (54)	22 (66)	16 (43)	0.059
Radiotherapy to prostate/prostate bed	50 (71)	26 (79)	24 (6)	0.449
Androgen deprivation therapy	70 (100)	33 (100)	37 (100)	0.935
Abiraterone	42 (60)	16 (48)	26 (70)	0.063
Enzalutamide	24 (34)	11 (33)	13 (35)	0.874
Docetaxel	40 (57)	18 (54)	22 (59)	0.678
Cabazitaxel	9 (13)	2 (6)	7 (19)	0.109
²²³Ra-dichloride	9 (13)	8 (24)	1 (3)	0.007^‡
Sites of metastatic disease^†
Lymph node	56 (80)	30 (91)	26 (70)	0.062
Bone	61 (87)	30 (9)	31 (84)	0.374
Liver	2 (3)	1 (3)	1 (3)	0.935
Lung	15 (21)	9 (27)	6 (16)	0.26
Local recurrence	22 (31)	9 (27)	13 (35)	0.479
Other	13 (19)	3 (9)	10 (27)	0.054

↵* Difference between patients with ⁶⁸Ga-PSMA-11 PET/CT and ¹⁸F-PSMA-1007 PET/CT according to independent t test or χ² test.
↵† Multiple namings possible.
↵‡ Statistically significant.
Nominal data are presented as number and percentage; continuous data are presented as mean and range.