Kjölhede Henrik, Ahlgren Göran, Almquist Helen, Liedberg Fredrik, Lyttkens Kerstin, Ohlsson Thomas, Bratt Ola
Section of Urology, Department of Surgery, Växjö Hospital, Lund University, 351 85, Växjö, Sweden.
Department of Urology, Skåne University Hospital, Lund University, Malmö, Sweden.
World J Urol. 2015 Nov;33(11):1749-52. doi: 10.1007/s00345-015-1547-y. Epub 2015 Apr 1.
Salvage radiotherapy (SRT) for biochemical recurrence (BCR) following radical prostatectomy (RP) should if possible be added at a prostate-specific antigen (PSA) level of <1-2 ng/mL. The value of positron emission tomography combined with computed tomography (PET/CT) at such low PSA values is not defined. The purpose was to determine what proportion of a well-defined cohort of hormone-naïve patients who were candidates for early salvage radiotherapy had (18)F-choline PET/CT findings suggesting metastases.
Patients with untreated BCR following RP, PSA <2 ng/mL, and Gleason score ≥7 or PSA doubling time ≤6 months underwent (18)F-choline PET/CT. Focal choline uptake in lymph nodes or skeletal sites was recorded.
PET/CT indicated metastases in 16 (28 %) of 58 patients. In five (9 %) patients, the scans suggested bone metastases, and in 11 (19 %) patients, the scans suggested regional lymph node metastases only. For patients with PSA levels <1.0 ng/mL, the PET/CT scans indicated metastatic recurrence in 25 %.
(18)F-choline PET/CT may be valuable for selecting patients with BCR following RP for SRT or experimental treatment of oligometastases, even at low PSA values.
根治性前列腺切除术后生化复发（BCR）患者进行挽救性放疗（SRT）时，若可能，应在前列腺特异性抗原（PSA）水平<1 - 2 ng/mL时进行。在如此低的PSA值下，正电子发射断层扫描联合计算机断层扫描（PET/CT）的价值尚不明确。本研究旨在确定在明确的一组初治且适合早期挽救性放疗的患者中，有多少比例的患者（18）F - 胆碱PET/CT检查结果提示有转移。
根治性前列腺切除术后未经治疗的BCR患者，PSA<2 ng/mL，Gleason评分≥7或PSA倍增时间≤6个月，接受（18）F - 胆碱PET/CT检查。记录淋巴结或骨骼部位的局灶性胆碱摄取情况。
58例患者中，16例（28%）PET/CT显示有转移。5例（9%）患者扫描提示有骨转移，11例（19%）患者扫描仅提示有区域淋巴结转移。对于PSA水平<1.0 ng/mL的患者，PET/CT扫描显示转移复发的比例为25%。
即使在低PSA值情况下，（18）F - 胆碱PET/CT对于选择根治性前列腺切除术后BCR患者进行SRT或寡转移灶的实验性治疗可能有价值。
