Identifying the Role of ¹⁸F-FDG-PET in ¹⁷⁷Lu-PSMA Therapy Eligibility

Objective: To reanalyze all patients who underwent both 18 F-FDG (fluorodeoxyglucose) and prostate-specific membrane antigen (PSMA) PET for PSMA-targeted therapy eligibility assessment using the VISION trial criteria. Design: Retrospective study. Methods: The authors included 89 men with metastatic castration-resistant prostate cancer (mCRPC) who were referred to 177 Lu-PSMA therapy from June 2019 to October 2021 and underwent both 18 F-FDG and PSMA PET (using either 68 Ga-PSMA-11 or 18 F-PSMA-1007) examinations within 2 weeks. Eligibility status was determined in accordance with either knowledge of both 18 F-FDG and PSMA PET (clinical routine) or VISION criteria with PSMA PET–only (study reassessment, done twice with liver only for PSMA-11 and liver/spleen as reference for PSMA-1007). A metastasis seen on 18 F-FDG PET or CT but not on PSMA PET was considered as a mismatch that led to exclusion from 177 Lu-PSMA therapy. On the basis of clinical assessment, 52 patients received 177 Lu more...