Scopinaro Francesco, De Vincentis Giuseppe, Varvarigou Alexandra D, Laurenti Cesare, Iori Francesco, Remediani Silvia, Chiarini Stella, Stella Salvatore
Dipartimento di Scienze Radiologiche, Sezione di Medicina Nucleare, Università La Sapienza, Policlinico Umberto I, Rome, Italy.
Eur J Nucl Med Mol Imaging. 2003 Oct;30(10):1378-82. doi: 10.1007/s00259-003-1261-7. Epub 2003 Aug 21.
Biopsy is the standard method for the diagnosis of prostate cancer; however, it is inadequate for the assessment of lymph node invasion. Radionuclide imaging might be useful for both diagnosis and N staging, but it requires high uptake of radiotracers in order to overcome difficulties arising from the anatomy of the region. The aim of this study was to assess whether or not technetium-99m labelled bombesin (99mTc-BN) scan is able to detect prostate cancer and invasion of pelvic lymph nodes. Ten patients were studied with 99mTc-BN, transrectal ultrasonography, biopsy, computed tomography and magnetic resonance imaging. All the patients with cancer were operated on. Planar dynamic scintigraphy and single-photon emission tomography (SPET) were performed after administration of 185 MBq 99mTc-BN. Two patients showed benign adenoma and eight showed cancer at biopsy. The average Gleason's score was 7.5+/-1.3. 99mTc-BN dynamic planar scan showed hot spots in the prostatic fossa in two of the eight patients with cancer, both of whom had a prostate-specific antigen level higher than 20 ng/ml. In these patients, high uptake inside the prostatic fossa was detected as early as 1 min after injection, before the arrival of radioactivity in the bladder. True positive SPET scans were obtained in all eight patients with cancer. Invasion of the obturator nodes was detected by SPET in three patients, and in all three was confirmed at surgery. Our preliminary data encourage further studies on the prostate with 99mTc-BN. If the high sensitivity of 99mTc-BN SPET is confirmed, this method may play an important role in diagnosing and staging prostate cancer.
活检是诊断前列腺癌的标准方法；然而，它不足以评估淋巴结侵犯情况。放射性核素成像可能对诊断和N分期都有用，但为了克服该区域解剖结构带来的困难，它需要放射性示踪剂有高摄取。本研究的目的是评估锝-99m标记的蛙皮素（99mTc-BN）扫描能否检测前列腺癌及盆腔淋巴结侵犯情况。对10例患者进行了99mTc-BN、经直肠超声检查、活检、计算机断层扫描和磁共振成像检查。所有癌症患者均接受了手术。在给予185MBq 99mTc-BN后进行了平面动态闪烁显像和单光子发射断层扫描（SPET）。2例患者活检显示为良性腺瘤，8例显示为癌症。平均Gleason评分是7.5±1.3。在8例癌症患者中的2例，99mTc-BN动态平面扫描显示前列腺窝有热点，这2例患者的前列腺特异性抗原水平均高于20ng/ml。在这些患者中，早在注射后1分钟，在放射性到达膀胱之前，就检测到前列腺窝内有高摄取。所有8例癌症患者的SPET扫描均获得真阳性结果。3例患者通过SPET检测到闭孔淋巴结侵犯，且在手术中均得到证实。我们的初步数据鼓励对99mTc-BN用于前列腺的研究进一步开展。如果99mTc-BN SPET的高敏感性得到证实，该方法可能在前列腺癌的诊断和分期中发挥重要作用。
