Department of Nuclear Medicine & PET Centre, Aarhus University Hospital, Aarhus, Denmark.
Chief, Molecular Imaging Program, Center for Cancer Research, National Cancer Institute (NCI), Bethesda, Maryland, USA.
Curr Opin Oncol. 2018 May;30(3):189-196. doi: 10.1097/CCO.0000000000000439.
In recent years, a large number of reports have been published on prostate-specific membrane antigen (PSMA)/PET in prostate cancer (PCa). This review highlights advances in PSMA PET in PCa during the past year.
PSMA PET/computed tomography (CT) is useful in detection of biochemical recurrence, especially at low prostate-specific antigen (PSA) values. The detection rate of PSMA PET is influenced by PSA level. For primary PCa, PSMA PET/CT shows promise for tumour localization in the prostate, especially in combination with multiparametric MRI (mpMRI). For primary staging, PSMA PET/CT can be used in intermediate and high-risk PCa. Intraoperative PSMA radioligand guidance seems promising for detection of malignant lymph nodes. While the use of PSMA PET/MRI in primary localized disease is limited to high and intermediate-risk patients and localized staging, in the recurrence setting, PET/MRI can be particularly helpful when the lesions are subtle. PSMA PET/CT is superior to choline PET/CT and other conventional imaging modalities.
Molecular imaging with PSMA PET continues to pave the way for personalized medicine in PCa.However, large prospective clinical studies are still needed to fully evaluate the role of PSMA PET/CT and PET/MRI in the clinical workflow of PCa.
近年来，大量关于前列腺特异性膜抗原（PSMA）/PET 在前列腺癌（PCa）中的报告发表。本文重点介绍了过去一年中 PSMA PET 在 PCa 中的研究进展。
PSMA PET/计算机断层扫描（CT）有助于检测生化复发，尤其是在前列腺特异性抗原（PSA）值较低时。PSMA PET 的检出率受 PSA 水平的影响。对于原发性 PCa，PSMA PET/CT 显示出在前列腺中定位肿瘤的潜力，特别是与多参数 MRI（mpMRI）结合时。对于原发分期，PSMA PET/CT 可用于中高危 PCa。PSMA 放射性配体引导的术中检测恶性淋巴结似乎很有前景。虽然 PSMA PET/MRI 在原发性局限性疾病中的应用仅限于高危和中危患者以及局限性分期，但在复发情况下，当病变较细微时，PET/MRI 可能特别有帮助。PSMA PET/CT 优于胆碱 PET/CT 和其他常规成像方式。
PSMA PET 的分子成像继续为 PCa 的个体化医学铺平道路。然而，仍需要进行大型前瞻性临床研究，以充分评估 PSMA PET/CT 和 PET/MRI 在 PCa 临床工作流程中的作用。
