使用 68Ga-HBED-CC-PSMA PET/CT 对转移性分化型甲状腺癌中前列腺特异性膜抗原表达进行成像。

Imaging of Prostate-Specific Membrane Antigen Expression in Metastatic Differentiated Thyroid Cancer Using 68Ga-HBED-CC-PSMA PET/CT.

机构信息

From the *Clinic for Nuclear Medicine, University Hospital Essen, Essen, Germany; †Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands; and ‡Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany.

出版信息

Clin Nucl Med. 2017 Jan;42(1):20-25. doi: 10.1097/RLU.0000000000001454.

DOI:10.1097/RLU.0000000000001454

PMID:27846003

Abstract

PURPOSE

The prostate-specific membrane antigen (PSMA) was shown to be overexpressed on the neovasculature of several malignancies. Here, the role of Ga-HBED-CC-PSMA PET/CT for the detection of PSMA expression in patients with metastasized differentiated thyroid cancer (DTC) was evaluated.

METHODS

Six patients with iodine-negative and F-FDG-positive metastasized DTC (mean TG, 1616 ng/mL) received 71-93 MBq of the Ga-labeled PSMA ligand and underwent PET/CT at 62 ± 7 minutes p.i.. Tumor accumulation capacity of the tracer and the detection rate of local recurrences and metastases were compared with F-FDG. Tracer uptake was quantified in terms of the SUVmax.

RESULTS

In 5 of 6 patients, sites of putative metastatic disease could be identified using Ga-HBED-CC-PSMA PET/CT. All lesions detected with Ga-HBED-CC-PSMA PET/CT (n = 42) were confirmed by F-FDG PET/CT or conventional CT imaging. Using Ga-HBED-CC-PSMA PET/CT, all tumor lesions identified with F-FDG PET/CT imaging could be visualized in 3 of 5 patients. In 2 patients, only the most prominent lesions detected with F-FDG PET/CT imaging were visualized by Ga-HBED-CC-PSMA PET/CT. Ga-HBED-CC-PSMA uptake ranged from low in 1 patient (mean SUVmax 3.3) to intermediate (1 patient; mean SUVmax, 6.1) to intense (3 patients; mean SUVmax, 12.8, 16.2, and 18.3). The highest SUVmax values were observed for a bone lesion, reaching 39.7.

CONCLUSIONS

These preliminary results indicate that Ga-HBED-CC-PSMA PET/CT might be suitable for staging of patients with metastasized DTC. Ga-HBED-CC-PSMA PET/CT could be useful for the identification of patients who might qualify for PSMA-targeted radionuclide therapy because of high PSMA uptake.

摘要

目的

前列腺特异性膜抗原（PSMA）在多种恶性肿瘤的新生血管中过度表达。在此，评估 Ga-HBED-CC-PSMA PET/CT 检测转移性分化型甲状腺癌（DTC）患者 PSMA 表达的作用。

方法

6 名碘阴性、F-FDG 阳性转移性 DTC 患者（平均 TG 为 1616ng/ml）接受 71-93MBq Ga 标记的 PSMA 配体，并在注射后 62±7 分钟行 PET/CT。比较示踪剂的肿瘤摄取能力和局部复发及转移的检出率与 F-FDG 的差异。以 SUVmax 定量示踪剂摄取。

结果

在 6 名患者中的 5 名中，使用 Ga-HBED-CC-PSMA PET/CT 可识别疑似转移病灶。使用 Ga-HBED-CC-PSMA PET/CT 检测到的所有病变（n=42）均通过 F-FDG PET/CT 或常规 CT 成像得到证实。在 5 名患者中，使用 Ga-HBED-CC-PSMA PET/CT 可以看到 F-FDG PET/CT 成像检测到的所有肿瘤病变。在 2 名患者中，Ga-HBED-CC-PSMA PET/CT 仅显示 F-FDG PET/CT 成像检测到的最显著病变。Ga-HBED-CC-PSMA 摄取范围从 1 名患者的低摄取（平均 SUVmax 为 3.3）到中等摄取（1 名患者；平均 SUVmax 为 6.1）到高摄取（3 名患者；平均 SUVmax 分别为 12.8、16.2 和 18.3）。SUVmax 值最高的病变为骨病变，达到 39.7。