Hoberück Sebastian, Wunderlich Gerd, Michler Enrico, Hölscher Tobias, Walther Martin, Seppelt Danilo, Platzek Ivan, Zöphel Klaus, Kotzerke Jörg
Department of Nuclear Medicine, Faculty of Medicine, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany.
Department of Radiotherapy and Radiation Oncology, Faculty of Medicine, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany.
J Labelled Comp Radiopharm. 2019 Jun 30;62(8):523-532. doi: 10.1002/jlcr.3745. Epub 2019 Jun 17.
Regardless of its high positron energy, Ga-labeled PSMA ligands have become standard of care in metabolic prostate cancer imaging. Cu, a radionuclide with a much longer half-life (12.7 h), is available for PSMA labeling allowing imaging much later than Ga. In this study, the diagnostic performance of Cu-labeled PSMA was compared between early and late scans. Sixteen men (median age: 70 y) with prostate cancer in different stages underwent Cu-PSMA-617-PET/CT 2 and 22 hours post tracer injection. Pathologic and physiologic uptakes were analyzed for both points of time. Pathologic tracer accumulations occurred in 12 patients. Five patients presented with pathologic uptake in 17 different lymph nodes, two patients showed pathologic bone uptake in nine lesions, and seven patients had pathologic PSMA uptake in eight prostatic lesions. Physiologic uptake of the renal parenchyma, urine bladder, and salivary glands decreased over time, while the physiologic uptake of liver and bowel increased. In the present study, Cu-PSMA-617-PET demonstrated to be feasible for imaging prostate cancer for both the primary tumor site and metastases. Later imaging showed no additional, clinically relevant benefit compared with the early scans. At least the investigated time points we chose did not vindicate the additional expenditure.
尽管镓标记的前列腺特异性膜抗原（PSMA）配体具有较高的正电子能量，但已成为代谢性前列腺癌成像的标准治疗方法。铜是一种半衰期长得多（12.7小时）的放射性核素，可用于PSMA标记，从而允许比镓标记的成像时间晚得多。在本研究中，比较了铜标记的PSMA在早期和晚期扫描中的诊断性能。16名处于不同阶段的前列腺癌男性（中位年龄：70岁）在注射示踪剂后2小时和22小时接受了铜-PSMA-617-PET/CT检查。分析了两个时间点的病理和生理摄取情况。12例患者出现病理示踪剂积聚。5例患者在17个不同的淋巴结中出现病理摄取，2例患者在9个病变中出现病理骨摄取，7例患者在8个前列腺病变中出现病理PSMA摄取。肾实质、膀胱和唾液腺的生理摄取随时间减少，而肝脏和肠道的生理摄取增加。在本研究中，铜-PSMA-617-PET被证明对原发性肿瘤部位和转移灶的前列腺癌成像均可行。与早期扫描相比，晚期成像未显示出额外的临床相关益处。至少我们选择的研究时间点没有证明额外的花费是合理的。
