Klein Nulent Thomas J W, van Es Robert J J, Krijger Gerard C, de Bree Remco, Willems Stefan M, de Keizer Bart
Department of Head and Neck Surgical Oncology, Utrecht Cancer Center, University Medical Center Utrecht, P.O. Box 85500, Heidelberglaan 100, Utrecht, 3508 GA, The Netherlands.
Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Eur J Nucl Med Mol Imaging. 2017 Sep;44(10):1614-1621. doi: 10.1007/s00259-017-3737-x. Epub 2017 Jun 7.
Adenoid cystic carcinoma (AdCC) of the head and neck is an uncommon malignant epithelial tumour of the secretory glands. Many patients develop slowly growing local recurrence and/or distant metastasis, for which treatment options are limited. A retrospective analysis of 9 AdCC patients was conducted to analyse the visualization of AdCC on PSMA PET/CT and to investigate the expression of PSMA on primary, recurrent and metastatic AdCC tumour tissue using immunohistochemistry.
Local recurrence occurred in six patients and eight developed distant metastasis. All PET/CTs depicted PSMA-ligand uptake. Four PSMA PET/CTs showed suspected residual disease, eight scans depicted uptake in areas suspected of distant metastasis. Median Maximum Standardized Uptake Value (SUV) in local recurrent and distant metastatic AdCC was 2.52 (IQR 2.41-5.95) and 4.01 (IQR 2.66-8.71), respectively. All primary tumours showed PSMA expression on immunohistochemistry (5-90% expression), as well as all available specimens of local recurrence and distant metastases.
PSMA PET/CT is able to detect and visualize local recurrent and distant metastatic AdCC. PSMA-specific targeting is supported by PSMA expression on immunohistochemistry.
头颈部腺样囊性癌(AdCC)是一种罕见的分泌腺恶性上皮肿瘤。许多患者会出现生长缓慢的局部复发和/或远处转移,而针对这些情况的治疗选择有限。对9例AdCC患者进行了回顾性分析,以分析AdCC在PSMA PET/CT上的显影情况,并使用免疫组织化学研究PSMA在原发性、复发性和转移性AdCC肿瘤组织中的表达。
6例患者出现局部复发,8例发生远处转移。所有PET/CT均显示PSMA配体摄取。4例PSMA PET/CT显示可疑残留病灶,8次扫描显示在怀疑远处转移的区域有摄取。局部复发和远处转移的AdCC的最大标准化摄取值(SUV)中位数分别为2.52(四分位间距2.41 - 5.95)和4.01(四分位间距2.66 - 8.71)。所有原发性肿瘤在免疫组织化学上均显示PSMA表达(表达率5 - 90%),局部复发和远处转移的所有可用标本也均如此。
PSMA PET/CT能够检测并显影局部复发和远处转移的AdCC。免疫组织化学上PSMA的表达支持PSMA特异性靶向。