Ra-223 therapy of bone metastases of prostate cancer: Predictive diagnosis by PET and its application to treatment strategy

• Project/Area Number: 19K08120
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 52040:Radiological sciences-related
• Research Institution: Nagoya University
• Principal Investigator: Kato Katsuhiko 名古屋大学, 医学系研究科(保健), 教授 (10345895)
• Co-Investigator(Kenkyū-buntansha): 山本 誠一 名古屋大学, 医学系研究科(保健), 教授 (00290768) ; 山本 徳則 名古屋大学, 医学系研究科, 特任教授 (20182636)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Project Status: Completed (Fiscal Year 2021)
• Budget Amount: ¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000); Fiscal Year 2021: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000); Fiscal Year 2020: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000); Fiscal Year 2019: ¥2,340,000 (Direct Cost: ¥1,800,000、Indirect Cost: ¥540,000)
• Keywords: 去勢抵抗性前立腺癌骨転移 / Ra-223治療 / F-18 NaF PET/CT / F-18 FDG PET/CT / 骨シンチ/SPECT / 治療効果判定 / 腫瘍核医学 / 予後予測診断 / 去勢抵抗性前立腺癌 / PET検査 / 転移性骨腫用 / F-18 fluoride PET/CT / 機械学習 / 転移性骨腫瘍 / 18F-FDG PET/CT / 18F-fluoride PET/CT / PET / PET/CT / Ra-223内用療法

Outline of Research at the Start

私たちはC-11 cohline、F-18 fluorothymidine (FLT)/PETを使って1cm弱大の尿路上皮癌の診断が可能であることを見いだした。また、2-deoxy-2-[F-18]fluoro-D-glucose (F-18 FDG) PET、F-18 fluoride PETを使って甲状腺癌の骨転移の診断の有効性についても発表してきた。本研究では既存のPET/CTに加え、リング型超高分解能PET装置を利用する。さらにディープラーニングの技術を利用し、去勢抵抗性前立腺癌骨転移の223Ra内用療法（ゾーフィゴ治療）の治療効果の予測診断と治療戦略への応用を目指す。

Outline of Final Research Achievements

We evaluated 223Ra therapy for prostate cancer with bone metastases by 18F-fluoride PET/CT, 18F-FDG PET/CT, bone scintigraphy/SPECT, and follow-up. The reducing effect of 223Ra on bone metastases was confirmed by 18F-fluoride PET/CT, 18F-FDG PET/CT, and bone scintigraphy/SPECT in most of the patients with bone metastases of prostate cancer. Bone metastases were more efficiently detected by 18F-fluoride PET/CT than 18F-FDG PET/CT or bone scintigraphy/SPECT.

Academic Significance and Societal Importance of the Research Achievements

今回、去勢抵抗性前立腺癌骨転移のRa-223内用療法を施行した患者に焦点を当てて研究を進めた。治療効果の評価はF-18 NaF PET/CTにおいてより効果が明瞭に判定された。PSA値が上昇した症例でも画像診断により治療効果が認められた。多発骨転移が広範に進行した症例では効果が得られなかった症例があった。治療効果の予後予測診断を行うには経過観察期間が短いかったと考えられ、今後も続けて評価を行っていく予定である。

Research Products

• [Presentation] Evaluation of 223Ra therapy on bone metastases of prostate cancer by 18F-fluoride PET/CT, 18F-FDG PET/CT and bone scintigraphy/SPECT (2021)
  • Author(s): Katsuhiko Kato, Tetsuro Odagawa, Naotoshi Fujita, Yoshinori Tsutsumi, Shinji Abe, Shinji Naganawa.
  • Organizer: Society of Nuclear Medicine & Molecular Imaging Annual Meeting, Anaheim
• [Presentation] Evaluation of radionuclide therapy for the palliation of bone metastasis pain using 89Sr: comparison of SUV values of bone metastases measured by 99mTc bone SPECT, 18F-fluoride PET/CT, 18F-FDG PET/CT. (2021)
  • Author(s): Chinatsu Hasegawa, Naotoshi Fujita, Yoshinori Ito, Risa Ono, Tomohiro Tada, Rina Murayama, Yoshinori Tsutsumi, Tetsuro Odagawa, Mika Tamura, Shinji Abe, Katsuhiko Kato.
  • Organizer: Society of Nuclear Medicine & Molecular Imaging Annual Meeting, Anaheim
• [Presentation] Studies On Decision Of The Cut-off Standardized Uptake Values For Normal Bones In 18F-fluoride PET/CT And 18F-FDG PET/CT. (2021)
  • Author(s): Risa Ono, Naotoshi Fujita, Chinatsu Hasegawa, Yoshinori Ito, Tomohiro Tada, Rina Murayama, Yoshinori Tsutsumi, Tetsuro Odagawa, Mika Tamura, Shinji Abe, Katsuhiko Kato.
  • Organizer: Annual Congress of the European Association of Nuclear Medicine
• [Presentation] Studies on Decision of the Cut-off Standardized Uptake Values for Normal Bones and Bone Metastases in the Vertebrae in 18F-fluoride PET/CT and 18F-FDG PET/CT. (2021)
  • Author(s): Risa Ono, Naotoshi Fujita, Yoshinori Ito, Tomohiro Tada, Rina Murayama, Haruna Ikeda, Yuka Ochi, Miho Nishio, Yoshinori Tsutsumi, Tetsuro Odagawa, Mika Tamura, Shinji Abe, Katsuhiko Kato.
  • Organizer: Annual Congress of the European Association of Nuclear Medicine, Vienna
• [Presentation] 18F-NaF PET/CT、18F-FDG PET/CT、骨シンチ/SPECTによる去勢抵抗性前立腺癌骨転移223Ra治療の評価 (2021)
  • Author(s): 加藤 克彦，小田川 哲郎，藤田 尚利，堤 貴紀，田村 美香，阿部 真治，長谷川 千夏，長縄 慎二
  • Organizer: 日本核医学会学術総会
• [Presentation] Support vector machineを用いた223Ra内用療法の治療効果予測. (2021)
  • Author(s): 奥田迅一郎、藤田尚利、伊藤良典、大野里沙、多田智大、村山里奈、池田陽菜、越智優佳、西尾美穂、田村美香、小田川哲郎、山口博司、阿部真治、加藤克彦.
  • Organizer: 第191回日本核医学技術学会東海地方会
• [Presentation] Studies on Decision of the Cut-off Standardized Uptake Values for Normal Bones and Bone Metastases in the Vertebrae in 18F-fluoride PET/CT and 18F-FDG PET/CT. (2020)
  • Author(s): Risa Ono, Naotoshi Fujita, Yoshinori Ito, Tomohiro Tada, Rina Murayama, Haruna Ikeda, Yuka Ochi, Miho Nishio, Yoshinori Tsutsumi, Tetsuro Odagawa, Mika Tamura, Shinji Abe, Katsuhiko Kato.
  • Organizer: 33rd Annual Congress of the European Association of Nuclear Medicine
  • Int'l Joint Research
• [Presentation] 18F-fluoride PET/CT及び18F-FDG PET/CTにおける正常骨と骨転移のカットオフ値設定とその有用性. (2020)
  • Author(s): 大野里沙、藤田尚利、伊藤良典、多田智大、村山里奈、池田陽菜、越智優佳、西尾美穂、堤貴紀、小田川哲郎、田村美香、阿部真治、加藤克彦.
  • Organizer: 第40回日本核医学技術学会総会学術大会
• [Presentation] 18F-fluoride PET/CT及び18F-FDG PET/CTにおける正常骨と骨転移のカットオフ値の検討. (2020)
  • Author(s): 大野里沙、藤田尚利、伊藤良典、多田智大、村山里奈、池田陽菜、越智優佳、西尾美穂、堤貴紀、小田川哲郎、田村美香、阿部真治、加藤克彦.
  • Organizer: 第76回日本放射線技術学術学会総会学術大会
• [Presentation] Evaluation of 223Ra therapy on bone metastases of prostate cancer by 18F-fluoride PET/CT, 18F-FDG PET/CT and bone scintigraphy/SPECT (2019)
  • Author(s): Katsuhiko Kato, Tetsuro Odagawa, Naotoshi Fujita, Yoshinori Tsutsumi, Shinji Abe, Shinji Naganawa.
  • Organizer: Society of Nuclear Medicine & Molecular Imaging 2019 Annual Meeting
  • Int'l Joint Research
• [Presentation] 18F-NaF PET/CT、18F-FDG PET/CT、骨シンチ/SPECTによる去勢抵抗性前立腺癌骨転移223Ra治療の評価 (2019)
  • Author(s): 加藤 克彦，小田川 哲郎，藤田 尚利，堤 貴紀，田村 美香，阿部 真治，長谷川 千夏，長縄 慎二
  • Organizer: 第59回日本核医学会学術総会
• [Presentation] Evaluation of radionuclide therapy for the palliation of bone metastasis pain using 89Sr: comparison of SUV values of bone metastases measured by 99mTc bone SPECT, 18F-fluoride PET/CT, 18F-FDG PET/CT. (2019)
  • Author(s): Chinatsu Hasegawa, Naotoshi Fujita, Yoshinori Ito, Risa Ono, Tomohiro Tada, Rina Murayama, Yoshinori Tsutsumi, Tetsuro Odagawa, Mika Tamura, Shinji Abe, Katsuhiko Kato.
  • Organizer: Society of Nuclear Medicine and Molecular Imaging 2019 Annual Meeting.
• [Presentation] Studies On Decision Of The Cut-off Standardized Uptake Values For Normal Bones In 18F-fluoride PET/CT And 18F-FDG PET/CT. (2019)
  • Author(s): Risa Ono, Naotoshi Fujita, Chinatsu Hasegawa, Yoshinori Ito, Tomohiro Tada, Rina Murayama, Yoshinori Tsutsumi, Tetsuro Odagawa, Mika Tamura, Shinji Abe, Katsuhiko Kato.
  • Organizer: Annual Congress of the European Association of Nuclear Medicine