8th Baltic Congress of Radiology

08.10.2022 Tallinn, Estonia

177Lu-PSMA radioligand therapy of mCRPC - the experience of East Tallinn Central Hospital

Eve Kelk (Estonia)

Chief physician in Radionuclide Terapy, Nuclear Medicine Centre, Clinic of Diagnostics, East Tallinn Central Hospital

Biography: Member of Estonian Society of Nuclear Medicine, European Association of Nuclear Medicine (EANM), World Association of Radiopharmaceutical Therapy (WARMTH), Estonian Society of Endocrinology (board member 1997 – 2017), Estonian delegate in World Federation of Nuclear Medicine and Biology (WFNMB) and in Section of Nuclear Medicine of UEMS, Deputy delegate in Section of Endocrinology of UEMS. Has led introduction of I-131 therapy, PRRT and RLT to clinical practice of East Tallinn Central Hospital and Estonia. Main topics of interest: Theragnostics, with special emphasis on oncology and endocrinology.

Presentation

Small Hall

Synopsis: As prostate specific membrane antigen (PSMA) is highly upregulated in prostate cancer, demonstrating the stronger expression the more aggressive the cancer is, it is an ideal marker to target prostate cancer cells both for visualization and therapy. The last decade has brought promising PSMA related therapeutic agents. Although several large and well-designed studies have been conducted on radioligand therapy (RLT) of metastatic castration resistant prostate cancer (mCRPC) with 177Lu-PSMA ligands – including prospective multicenter randomized phase 3 study of 177Lu-PSMA-617 in mCRPC (VISION), that clearly confirmed the benefits of RLT – this therapeutic option has not received standard therapy status so far.
In East Tallinn Central Hospital (ETCH) RLT is performed since 2018. We have witnessed very different patterns of clinical effectiveness of RLT, what has made us seek for an optimal quantitative tool to assess the distribution of radioactivity which could aid to predict the outcome of RLT, preferably already after the first cycle of RLT. As part of this process, voxel-based dosimetry, not commonly used in RLT, was introduced, and its results analyzed in comparison with standardized uptake values (SUV) gained on contemporary quantitative SPECT/CT system.

This agenda item is presented in the following session: S5-2 Prostata Imaging

Plenary session

08.10.2022 09:00 - 10:30