Meyer Alexa R, Joice Gregory A, Allaf Mohamad E, Rowe Steven P, Gorin Michael A
The James Buchanan Brady Urological Institute and Department of Urology.
The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Curr Opin Urol. 2018 Nov;28(6):493-498. doi: 10.1097/MOU.0000000000000549.
To explore the current state of using prostate-specific membrane antigen (PSMA)-targeted PET imaging to aid in the diagnosis of clinically significant prostate cancer.
Prostate-specific antigen screening remains controversial, as it is associated with the underdetection of clinically significant prostate cancer as well as the overdetection and subsequent overtreatment of clinically insignificant disease. A diagnostic test that can accurately assess the presence of clinically significant prostate cancer and avoid detection of low-risk tumors is needed. Multiparametric magnetic resonance imaging (mpMRI) can aid in the detection of clinically significant prostate cancer and can be used with fusion-based biopsy platforms to target biopsies to specific lesions. However, there are several limitations of mpMRI including a modest negative predictive value for high-grade cancer. PSMA-targeted PET imaging has shown promise as a noninvasive test to aid in the detection of clinically significant prostate cancer while providing anatomical information to guide targeted biopsies. PSMA-targeted PET in combination with mpMRI offers a higher degree of diagnostic accuracy for imaging localized prostate cancer than either modality alone.
PSMA-targeted PET imaging can aid in the identification of men with clinically significant prostate cancer. Further research is needed to determine the full potential of PSMA-targeted imaging in both the detection and treatment of localized prostate cancer.
探讨使用前列腺特异性膜抗原（PSMA）靶向PET成像辅助诊断临床显著性前列腺癌的现状。
前列腺特异性抗原筛查仍存在争议，因为它与临床显著性前列腺癌的漏诊以及临床意义不显著疾病的过度检测和后续过度治疗相关。需要一种能够准确评估临床显著性前列腺癌的存在并避免检测低风险肿瘤的诊断测试。多参数磁共振成像（mpMRI）有助于检测临床显著性前列腺癌，并可与基于融合的活检平台结合使用，以针对特定病变进行活检。然而，mpMRI存在一些局限性，包括对高级别癌症的阴性预测价值有限。PSMA靶向PET成像已显示出作为一种无创检测手段的前景，有助于检测临床显著性前列腺癌，同时提供解剖学信息以指导靶向活检。与单独使用任何一种方式相比，PSMA靶向PET与mpMRI联合使用对局限性前列腺癌成像具有更高的诊断准确性。
PSMA靶向PET成像有助于识别患有临床显著性前列腺癌的男性。需要进一步研究以确定PSMA靶向成像在局限性前列腺癌检测和治疗中的全部潜力。
