Gasch C, Düwel C, Kopka K, Kratochwil C, Vinsensia M, Eiber M, Maurer T, Haberkorn U, Hadaschik B, Giesel F L
Urologische Klinik, Universitätsklinikum Heidelberg, Heidelberg, Deutschland.
Urologische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Deutschland.
Urologe A. 2017 Jan;56(1):3-12. doi: 10.1007/s00120-016-0293-0.
Prostate cancer (PCa) is one of the most common malignancies of men in developed countries. To improve clinical diagnostics of PCa, Ga-PSMA-11 was recently introduced as a new PET tracer. Ga-PSMA-11 is able to specifically bind to the prostate-specific membrane antigen (PSMA), which is upregulated on the surface of prostate cancer cells in most patients.
To analyse the current significance of Ga-PSMA-11 PET imaging in prostate cancer in relation to staging of men with initial diagnosis, biochemical recurrence and metastatic disease.
Retrospective analysis of current literature (PubMed search) regarding Ga-PSMA-11 PET diagnostics in primary staging, in biochemical recurrence and in metastasized disease.
Compared to conventional imaging, Ga-PSMA-11 PET/CT reaches a higher sensitivity with an excellent specificity in the clinical diagnosis of primary staging as well as staging for recurrence and advanced, metastasized disease. In biochemical recurrence, Ga-PSMA-11 PET/CT shows significantly higher detection rates in comparison to choline PET/CT, especially in patients with low PSA values. In the clinical diagnosis of recurrent disease, therapy concepts were changed in more than a quarter of the patients due to the use of Ga-PSMA-11 PET/CT. The significance of staging with Ga-PSMA-11 PET/CT in advanced metastasized patients remains uncertain.
Due to the excellent results of Ga-PSMA-11 PET imaging, even in patients with slightly elevated PSA levels, it will continue to play an important role in clinical diagnostics of prostate cancer and, thus, its clinical utilization will become more widely spread.
前列腺癌（PCa）是发达国家男性中最常见的恶性肿瘤之一。为了改善PCa的临床诊断，Ga-PSMA-11最近作为一种新型正电子发射断层显像（PET）示踪剂被引入。Ga-PSMA-11能够特异性结合前列腺特异性膜抗原（PSMA），在大多数患者中，该抗原在前列腺癌细胞表面上调。
分析Ga-PSMA-11 PET成像在前列腺癌中对于初诊、生化复发和转移性疾病男性患者分期的当前意义。
对当前关于Ga-PSMA-11 PET在原发性分期、生化复发和转移性疾病诊断的文献（PubMed检索）进行回顾性分析。
与传统成像相比，Ga-PSMA-11 PET/CT在原发性分期以及复发和晚期转移性疾病的临床诊断中具有更高的敏感性和出色的特异性。在生化复发方面，与胆碱PET/CT相比，Ga-PSMA-11 PET/CT显示出显著更高的检出率，尤其是在前列腺特异抗原（PSA）值较低的患者中。在复发性疾病的临床诊断中，由于使用Ga-PSMA-11 PET/CT，超过四分之一的患者治疗方案发生了改变。Ga-PSMA-11 PET/CT在晚期转移性患者中的分期意义仍不确定。
由于Ga-PSMA-11 PET成像的出色结果，即使在PSA水平略有升高的患者中，它也将继续在前列腺癌的临床诊断中发挥重要作用，因此其临床应用将更加广泛。
