Haran Crishan, McBean Rhiannon, Parsons Rex, Wong David
School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
Wesley Medical Imaging, The Wesley Hospital, Brisbane, Queensland, Australia.
J Med Imaging Radiat Oncol. 2019 Aug;63(4):495-499. doi: 10.1111/1754-9485.12885. Epub 2019 Apr 11.
In the last 5 years, there has been a significant focus on the use of positron emission tomography (PET) for primary and secondary staging of prostate cancer. In this study, we aim to describe the trends of use between Gallium-68 prostate-specific membrane antigen ligand (Ga-68 PSMA) PET/computed tomography (PSMA PET/CT) and nuclear medicine bone scan (NMBS) for prostate cancer staging in the first institution in Australia to offer both modalities.
We evaluated trends in prostate cancer staging/restaging imaging modalities at our facility between the time period January 2013-April 2018. Imaging logs were filtered to identify NMBS and PSMA PET/CT scans done within the time period for prostate cancer. Sub-analysis was undertaken (i) to investigate the number of patients who were imaged using both modalities, (ii) to compare the age of the patients in the NMBS group and the PSMA PET/CT group and (iii) to compare the use of PSMA PET/CT for pre-treatment staging compared to the detection of recurrence or metastatic disease (secondary staging).
A total of 3144 examinations were performed in the time period reviewed, with 546 NMBS and 2598 PSMA PET/CT scans performed. In the 6 months after PSMA PET/CT was introduced, there was a 45.7% decrease in the number of NMBS performed and 95.3% decrease across the duration of the study. In the PSMA PET/CT cohort, 1569 examinations were performed for pre-treatment staging and 1029 performed for secondary staging. There was a significant difference in the proportion of PSMA PET/CT conducted for pre-treatment staging compared with secondary staging when comparing the first and final 500 examinations (P < 0.05).
After the introduction of PSMA PET/CT there was a marked decline in the use of NMBS for prostate cancer staging. This finding is of note as it occurred before there was clinical data or guidelines supporting the use of PSMA PET/CT for prostate cancer imaging.
在过去5年中，正电子发射断层扫描（PET）在前列腺癌的原发和继发分期中的应用受到了广泛关注。在本研究中，我们旨在描述在澳大利亚第一家同时提供两种检查方式的机构中，镓-68前列腺特异性膜抗原配体（Ga-68 PSMA）PET/计算机断层扫描（PSMA PET/CT）和核医学骨扫描（NMBS）在前列腺癌分期中的使用趋势。
我们评估了2013年1月至2018年4月期间我院前列腺癌分期/再分期成像方式的趋势。对成像记录进行筛选，以确定在此期间为前列腺癌进行的NMBS和PSMA PET/CT扫描。进行了亚分析：（i）调查同时使用两种检查方式的患者数量；（ii）比较NMBS组和PSMA PET/CT组患者的年龄；（iii）比较PSMA PET/CT在治疗前分期与复发或转移性疾病检测（继发分期）中的使用情况。
在回顾的时间段内共进行了3144次检查，其中546次为NMBS，2598次为PSMA PET/CT扫描。在引入PSMA PET/CT后的6个月内，NMBS的检查次数减少了45.7%，在研究期间减少了95.3%。在PSMA PET/CT队列中，1569次检查用于治疗前分期，1029次用于继发分期。在比较最初和最后的500次检查时，PSMA PET/CT用于治疗前分期与继发分期的比例存在显著差异（P<0.05）。
引入PSMA PET/CT后，NMBS在前列腺癌分期中的使用显著下降。这一发现值得注意，因为它发生在尚无临床数据或指南支持PSMA PET/CT用于前列腺癌成像之前。
