Marwa Abdallah Hassan Abdallah,  <br/><br/>
Role of psma pet/ct in evaluation of therapy response in patients with metastatic prostate cancer /  
 دور المسح الذري البوزيترونى المقطعي المدمج بالأشعة المقطعية بروابط المستضد الغشائي البروستاتي النوعي في تقييم العلاج لمرضي سرطان البروستاتا المصحوبه بثانويات  
by Marwa Abdallah Hassan Abdallah ; under supervision of Prof. Dr. Sherif Mohamed El-Refaei, Ass. Prof. Dr. Maha Abd-El Kareem, Ass. Prof. Mohamed Mohamed Houseni, Dr. Ahmed Mohamed Badawy Ali. 
 - 177 pages :   illustrations ;  25 cm. +   CD. 
<br/><br/>Thesis (Ph.D)-Cairo University, 2023. 
<br/><br/>Bibliography: pages 161-176.  
<br/><br/> Prostate cancer is the first most common cancer among men. The<br/>evaluation of metastatic prostate cancer under distinct therapies presents several<br/>well-known limitations which may be overcome by PSMA PET/CT.<br/>The aim of this study is to evaluate the role of PSMA ligands PET-CT in the<br/>metastatic prostate cancer after therapy.<br/>Patients and methods:<br/>Our prospective study included total of 53 male patients who were referred to<br/>our center from March 2020 till March 2022 with metastatic prostatic<br/>adenocarcinoma. The study was performed in Nuclear Medicine and Radiation<br/>Oncology department, Kasr El-Ainy hospital, Cairo University after the<br/>approval of the departmental and the university’s ethical review board. The<br/>patients’ data and images were analyzed, PSMA-PET/CT studies were<br/>performed before and after treatment with post-therapy assessment according to<br/>PERCIST and RECIST criteria. Also, correlation between post-therapy serum<br/>PSA level and imaging response is done.<br/>Results: Total 53 patients with metastatic prostate cancer, 33 (62.3%) patients<br/>were with bone metastases, 39 (73.6%) patients were with lymph nodal<br/>metastatic lesions and 5 (9.4%) patient were with visceral deposits. All patients<br/>received interval therapy. Initial and post-therapy assessment was done by<br/>PSMA-PET study using PERCIST criteria (≥ 30% increase of tracer uptake or<br/>new lesions detected were considered as progressive disease, ≥ 30% decrease in<br/>tracer uptake was considered partial response and change in-between partial<br/>response and progressive disease (less than − 30% and less than + 30%) was<br/>considered as stable). Also, assessment of CT changes was done by RECIST<br/>criteria (≥30% decrease in size was considered as partial response, while ≥20% <br/>increase was considered as progressive disease, change in-between less than<br/>−30% and less than+20% was considered as stable disease). Biochemical<br/>response was also assessed as complete response, partial response (if there is ≥<br/>50% decrease in PSA value), progressive disease (if there is ≥ 25% increase in<br/>PSA value) and a change in PSA after therapy between −49% and +24% was<br/>defined as stable disease. Correlation between PET parameters, CT and<br/>biochemical response were done. There is good agreement (kappa value 0.88)<br/>between PERCIST and RECIST criteria. There is moderate agreement (kappa<br/>value 0.57) between PERCIST and post-therapy PSA level response. Also, there<br/>is moderate agreement (kappa value 0.57) between RECIST and post-therapy<br/>PSA level response. There is moderate agreement (kappa value 0.60) between<br/>total lesion PSMA and biochemical response.<br/>Conclusion: PSMA PET/CT has a pivotal role in post-therapy<br/>assessment of patients with metastatic prostate cancer.  تعد أورام البروستاتا الخبيثة أكثر الأورام حدوثاً بين الرجال، و يعد تقييم مرضي سرطان البروستاتا المصاحب بثانويات بعد العلاج من اهم الخطوات المتبعه في علاج المريض. <br/>أجريت دراستنا في الفترة بين مارس 2020 و مارس 2022 حيث تضمنت الرسالة 53 مريضاً بورم سرطاني مع ثانويات منتشره بالجسم تتراوح أعمارهم بين 61-77 عاماً بمتوسط 69 عاماً.<br/>تم عمل فحص الماسح الذري البوزيتروني بالمادة المشار إليها في الرسالة قبل بدء العلاج و بعد الانتهاء منه وايضا تم عمل تحاليل المستضد البروستاتا النوعي قبل و بعد العلاج.<br/>وقد تم إثبات علاقة مباشرة بين إيجابية الفحص وتحليل المستضد البروستاتا النوعي حيث وجد أن نسبة العلاقه بين نتيجه كل منهما بعد العلاج بدرجه متوسطه. <br/>من أهم القيود في هذه الرسالة هو صعوبه الحصول علي عدد اكبر لمرضي سرطان البروستاتا المصاحب بثانويات موافيه لجميع البيانات العلاجيه و تحاليل  المستضد البروستاتا النوعي و ايضا صعوبه الحصول علي ابحاث بصدد هذه الدراسه بالرغم من تلك القيود توصلنا إلي أهمية الفحص المذكور في تقييم المرضي بعد العلاج لمعرفه مدي استجابه المريض للعلاج المحدد.<br/> <br/>و في النهاية نوصي بمتابعة المرضي من حيث تأثير المسح الذري البوزيتروني على قرار العلاج فيما بعد<br/> 
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<br/><br/><br/>Text in English and abstract in Arabic & English. 
<br/><br/><label>Subjects--Topical Terms: </label><br/>Nuclear medicine.
<br/><br/><label>Subjects--Index Terms: </label>PSMA PET/CT  biochemical response 
<br/><br/><label>Dewey Class. No.: </label>616.075075