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The present communication details the imaging characteristics, peculiarities, and response to 177 Lu-labeled prostate-specific membrane antigen (PSMA)-617-targeted radioligand therapy (PRLT) in accordance with Gleason score and use of dual-tracer PET ( 68 Ga-PSMA-11 and 18 F-FDG) in patients with urinary bladder invasion or metastasis by prostate cancer, including the prognostic value of 18 F-FDG PET in predicting response to treatment. The CT attenuation units (Hounsfield units) correlated with the prostate primary in the case of direct tumor extension from the prostate, whereas in hematogenous metastatic seeding the Hounsfield units were lower than in the primary prostatic tumor. A favorable outcome to 177 Lu-PSMA-617 PRLT was observed in patients with low or no baseline 18 F-FDG uptake despite a high Gleason score and a high-risk National Comprehensive Cancer Network prognostic category and did not correlate with the latter alone, whereas a high SUV max on 18 F-FDG PET/CT was associated with an adverse outcome. These findings suggest a promising role for 18 F-FDG PET/CT in predicting therapeutic outcomes more confidently, and hence the concept of dual-tracer PET appears to hold good in prostate adenocarcinoma theranostics.

journal of nuclear medicine technology

Comparison of Dual-Tracer PET and CT Features to Conventional Risk Categories in Assessing Response to <sup>177</sup>Lu-PSMA-617 Therapy for Metastatic Prostate Adenocarcinoma with Urinary Bladder Involvement

Comparison of Dual-Tracer PET and CT Features to Conventional Risk Categories in Assessing Response to 177Lu-PSMA-617 Therapy for Metastatic Prostate Adenocarcinoma with Urinary Bladder Involvement

Comparison of Dual-Tracer PET and CT Features to Conventional Risk Categories in Assessing Response to ¹⁷⁷Lu-PSMA-617 Therapy for Metastatic Prostate Adenocarcinoma with Urinary Bladder Involvement