Brunocilla Eugenio, Schiavina Riccardo, Nanni Cristina, Borghesi Marco, Cevenini Matteo, Molinaroli Enrico, Vagnoni Valerio, Castellucci Paolo, Ceci Francesco, Fanti Stefano, Gaudiano Caterina, Golfieri Rita, Martorana Giuseppe
Department of Urology, University of Bologna, S. Orsola-Malpighi Hospital, Bologna.
Arch Ital Urol Androl. 2014 Sep 30;86(3):239-40. doi: 10.4081/aiua.2014.3.239.
We present the first case of salvage radiotherapy based on the results of 18F-FACBC PET/CT performed for a PSA relapse after radical prostatectomy. The patients underwent 11CCholine PET/CT and multiparametric MRI that were negative while 18F-FACBC PET/CT visualized a suspected local relapse confirmed by transrectal ultrasound-guided biopsy. No distant relapse was detected. Thus the patient was submitted to salvage radiotherapy in the prostatic fossa. After 20 months of follow-up, the PSA was undetectable and 18F-FACBC PET/CT was negative. Salvage radiotherapy after surgery, provided that it is administered at the earliest evidence of the biochemical relapse, may improve cancer control and favourably influence the course of disease as well as the adjuvant approach. New imaging techniques may increase the efficacy of the salvage radiotherapy thus helping in the selection of the patients. Preliminary clinical reports showed an improvement in the detection rate of 20-40% of 18F-FACBC in comparison with 11C-Choline for the detection of disease relapse after radical prostatecomy, rendering the 18F-FACBC the potential radiotracer of the future for prostate cancer.
我们报告了首例基于18F-FACBC PET/CT结果进行挽救性放疗的病例，该检查是针对前列腺癌根治术后前列腺特异性抗原（PSA）复发进行的。患者接受了11C-胆碱PET/CT和多参数磁共振成像（MRI）检查，结果均为阴性，而18F-FACBC PET/CT显示出疑似局部复发，经直肠超声引导下活检得以证实。未检测到远处转移。因此，该患者接受了前列腺窝挽救性放疗。经过20个月的随访，PSA检测不到，18F-FACBC PET/CT结果为阴性。手术后进行挽救性放疗，前提是在生化复发的最早迹象出现时进行，可能会改善癌症控制，并对疾病进程以及辅助治疗方法产生有利影响。新的成像技术可能会提高挽救性放疗的疗效，从而有助于患者的选择。初步临床报告显示，与11C-胆碱相比，18F-FACBC在检测前列腺癌根治术后疾病复发方面的检出率提高了20%-40%[1-4]，使18F-FACBC成为未来前列腺癌潜在的放射性示踪剂。
