68Ga-PSMA PET/CT for monitoring response to 177Lu-PSMA-617 radioligand therapy in patients with metastatic castration-resistant prostate cancer

  • Alexander HeinzelEmail author
  • Dima Boghos
  • Felix M. Mottaghy
  • Florian Gaertner
  • Markus Essler
  • Dirk von Mallek
  • Hojjat Ahmadzadehfar
Original Article



To evaluate the use of 68Ga-PSMA PET/CT for monitoring response to 177Lu-617 PSMA radioligand therapy in patients with metastatic castrate-resistant prostate cancer (mCRPC).


Patients from the University Hospital Bonn and the University Hospital Aachen were retrospectively reviewed for this study. We included 48 patients with mCRPC who were treated with 177Lu-PSMA-617 and whose records included 68Ga-PSMA PET/CT imaging before the first and after the third or fourth treatment cycle. A treatment response based on 68Ga-PSMA PET/CT was defined according to a modified version of the PERCIST criteria. A decline in PSA level of ≥50% was considered the reference standard. The sensitivity, specificity, positive and negative predictive values, and ROC curves were calculated, and patient survival times in relation to the PET results were also analysed.


68Ga-PSMA PET/CT had a sensitivity of about 85% and a specificity of between 55% and 65%. The negative and positive predictive values ranged between 70% and 78%. The fitted ROC area was 0.70. The survival time was about 19.6 months in patients with a treatment response, while nonresponders had a survival time of about 15.9 months. However, this difference between the groups was not statistically significant.


Our results indicate that 68Ga-PSMA PET/CT could be a useful tool for the evaluation of response to 177Lu-PSMA-617 radioligand therapy within a theranostic framework.


Prostate cancer 177Lu-PSMA-617 68Ga-PSMA PET/CT Response monitoring 



We thank Tanja Berger of The Institute of Medical Statistics of RWTH Aachen University for reviewing the data analysis.

Compliance with ethical standards

Conflicts of interest


Ethical approval

This study was approved by the Institutional Review Board of the University Hospital Aachen. Given the type of study (a retrospective analysis), the need for written informed consent was waived. All procedures were performed in accordance with the ethical standards of the institutional and/or national research committees and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Supplementary material

259_2019_4258_MOESM1_ESM.docx (35 kb)
ESM 1 (DOCX 35 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Nuclear MedicineUniversity Hospital RWTH AachenAachenGermany
  2. 2.Institute for Neuroscience and Medicine (INM-4)Research Centre JülichJülichGermany
  3. 3.Department of Radiology and Nuclear MedicineMaastricht University Medical CenterMaastrichtThe Netherlands
  4. 4.Department of Nuclear MedicineUniversity Hospital BonnBonnGermany

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