From the Department of Radiology, Hospital Sírio-Libanês, Rua Dona Adma Jafet 115, CEP 01308-060, São Paulo, SP, Brazil; and Department of Radiology and Oncology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil (M.A.Q., P.C.C.V., J.F.G.M., G.G.C., C.A.B.).
Radiographics. 2019 Jan-Feb;39(1):186-212. doi: 10.1148/rg.2019180079.
The introduction of prostate-specific membrane antigen (PSMA) in clinical practice has revolutionized evaluation of biochemical recurrence of prostate cancer after curative-intent treatment. The high expression of this glycoprotein in prostate cancer cells makes PSMA imaging superior to the current conventional staging methods, namely bone scanning and CT. The high capability of PSMA imaging for identifying very small previously undetected lesions has been widely demonstrated in the literature, leading to a rethinking of patient management by oncologists, urologists, and radiation oncologists. The typical and predictable patterns of spread in prostate cancer are still more prevalent, such as spread to pelvic lymph nodes and bone metastasis, but different patterns of disease spread are becoming more commonly recognized with higher reliability because PSMA imaging allows detection of more typical and atypical lesions than conventional imaging. Furthermore, it is important for the reading physician to recognize and understand the typical disease spread and the most prevalent atypical prostate cancer relapses, not only to heighten the relevancy of reports but also to improve imaging consultancy in multispecialty oncologic practice. RSNA, 2019.
前列腺特异性膜抗原（PSMA）在临床实践中的引入彻底改变了根治性治疗后前列腺癌生化复发的评估方式。这种糖蛋白在前列腺癌细胞中的高表达使得 PSMA 成像优于当前的常规分期方法，即骨扫描和 CT。文献广泛证明了 PSMA 成像在识别以前未检测到的非常小的病变方面的高能力，这导致肿瘤学家、泌尿科医生和放射肿瘤学家重新思考患者的管理方式。前列腺癌的典型和可预测的扩散模式仍然更为普遍，例如扩散到盆腔淋巴结和骨转移，但随着 PSMA 成像能够检测到比传统成像更多的典型和非典型病变，不同的疾病扩散模式越来越被广泛认可，而且具有更高的可靠性。此外，阅读医生识别和理解典型的疾病扩散和最常见的非典型前列腺癌复发非常重要，这不仅可以提高报告的相关性，还可以改善多学科肿瘤学实践中的影像学咨询。RSNA，2019 年。
