Quantitative imaging for 177Lu-PSMA treatment response monitoring and dosimetry

Catherine Meyer; Laszlo Szidonya; Celeste Winters; Anna Mench; Nadine Mallak; Erik Mittra

doi:10.3389/fnume.2023.1291253

Quantitative imaging for ¹⁷⁷Lu-PSMA treatment response monitoring and dosimetry

Front Nucl Med. 2023 Dec 14:3:1291253. doi: 10.3389/fnume.2023.1291253. eCollection 2023.

Authors

Catherine Meyer¹, Laszlo Szidonya¹, Celeste Winters¹, Anna Mench¹, Nadine Mallak¹, Erik Mittra¹

Affiliation

¹ Department of Diagnostic Radiology, Oregon Health & Science University, Portland, OR, United States.

Abstract

PSMA-targeted radiopharmaceutical therapy is an established treatment option for metastatic castration-resistant prostate cancer (mCRPC). However, response rates and duration using ¹⁷⁷Lu-PSMA-617 vary considerably between patients. Quantitative ¹⁷⁷Lu SPECT imaging is one approach that may be leveraged to more closely monitor inter-cycle response, as well as patient-specific absorbed doses. In this work, we describe our experience implementing quantitative imaging throughout the course of ¹⁷⁷Lu-PSMA treatment, including serial SPECT imaging to monitor response and for individualized dosimetry. We also describe our imaging protocols and dose calculation workflows for 3D voxelized patient-specific organ and tumor dosimetry, including a review of the current landscape and efforts towards harmonized dosimetry.

Keywords: PSMA; SPECT/CT; dosimetry; lutetium-177; prostate cancer.

Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.