Hofer C, Laubenbacher C, Block T, Breul J, Hartung R, Schwaiger M
Department of Urology, Technische Universität München, Germany.
Eur Urol. 1999;36(1):31-5. doi: 10.1159/000019923.
After radical retropubic prostatectomy a rise of the prostate-specific antigen (PSA) indicates a local recurrent or metastatic disease. If the bone scan shows no apparent bone metastasis, morphological imaging methods like x-ray computed tomography, magnetic resonance imaging or transrectal ultrasound often cannot distinguish between postoperative scar and local recurrence. Therefore we investigated the feasibility of fluorine-18-fluorodeoxyglucose positron emission tomography (F-18 FDG PET) for metabolic characterization of prostatic cancer, especially for differentiation of scar or recurrent prostate cancer after radical prostatectomy.
Dynamic PET with 370 MBq F-18 deoxyglucose (F-18 FDG) up to 60 min p.i. was performed in 2 patients with biopsy-proven benign prostatic hyperplasia, in 11 patients with a histologically proven prostate cancer prior to radical retropubic prostatectomy (RRP) and 7 patients with suspected local recurrence (with negative bone scan) after RRP prior to biopsy of anastomosis (3 local recurrence, 4 postoperative scar).
Prostate cancer showed a very low F-18 FDG uptake. The placement of regions of interest was only possible by the use of other imaging methods. There was not difference between the F-18 FDG uptake of benign prostate hyperplasia, prostate carcinoma, postoperative scar or local recurrence after radical prostatectomy.
F-18 FDG seems not to be useful to distinguish between postoperative scar and local recurrence after radical prostatectomy.
耻骨后前列腺癌根治术后前列腺特异性抗原（PSA）升高提示局部复发或转移。如果骨扫描未显示明显骨转移，X线计算机断层扫描、磁共振成像或经直肠超声等形态学成像方法通常无法区分术后瘢痕与局部复发。因此，我们研究了氟-18-氟脱氧葡萄糖正电子发射断层扫描（F-18 FDG PET）对前列腺癌进行代谢特征分析的可行性，特别是用于区分前列腺癌根治术后的瘢痕或复发性前列腺癌。
对2例经活检证实为良性前列腺增生的患者、11例在耻骨后前列腺癌根治术（RRP）前经组织学证实为前列腺癌的患者以及7例RRP后怀疑局部复发（骨扫描阴性）且在吻合口活检前（3例局部复发，4例术后瘢痕）的患者进行了静脉注射370 MBq F-18脱氧葡萄糖（F-18 FDG）后长达60分钟的动态PET检查。
前列腺癌显示F-18 FDG摄取非常低。仅通过使用其他成像方法才能确定感兴趣区域。良性前列腺增生、前列腺癌、术后瘢痕或前列腺癌根治术后局部复发的F-18 FDG摄取之间没有差异。
F-18 FDG似乎无助于区分前列腺癌根治术后的术后瘢痕与局部复发。
