Chodyla Michal-Kamil, Eiber Matthias, Wetter Axel, Rauscher Isabel
Klinik für Radiologie, Universitätsklinikum Essen, Hufelandstraße 55, 45147, Essen, Deutschland.
Klinik und Poliklinik für Nuklearmedizin, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland.
Radiologe. 2020 May;60(5):386-393. doi: 10.1007/s00117-020-00642-0.
Recently, the use of prostate-specific membrane antigen (PSMA) tracers like 68Ga-PSMA-11 in positron emission tomography (PET) have shown promising results and are helping to improve care for patients with prostate cancer (PC).
In the following we review the current literature on PSMA-ligand PET, in particular with regard to the currently increasing replacement of 68Ga-PSMA ligands by 18F-labeled PSMA ligands.
PSMA-ligand PET is most frequently used for biochemical recurrence. Here, 68Ga-PSMA-11 PET/CT shows superior detection rates compared to conventional imaging modalities, especially in small, morphologically unsuspicious lesions, even at low PSA values. Furthermore, 68Ga-PSMA PET imaging seems to be an encouraging alternative for staging of high-risk patients, particularly in combination with multiparametric MRI.
The use of PSMA-ligand PET has revolutionized PC imaging. Thus, PSMA-ligand PET is expected to play an even greater role in PC diagnostics in the future, especially as 18F-labeled PSMA ligands are now increasingly used. However, simultaneous image analysis of PET and CT as well as a differentiated image evaluation (clinical context, knowledge of common pitfalls) is mandatory.
最近，正电子发射断层扫描（PET）中使用前列腺特异性膜抗原（PSMA）示踪剂，如68Ga-PSMA-11，已显示出有前景的结果，并有助于改善前列腺癌（PC）患者的护理。
在以下内容中，我们回顾了关于PSMA配体PET的当前文献，特别是关于目前18F标记的PSMA配体对68Ga-PSMA配体的替代日益增加的情况。
PSMA配体PET最常用于生化复发。在此，与传统成像方式相比，68Ga-PSMA-11 PET/CT显示出更高的检测率，尤其是在小的、形态上无可疑的病变中，即使在低PSA值时也是如此。此外，68Ga-PSMA PET成像似乎是高危患者分期的一种令人鼓舞的替代方法，特别是与多参数MRI联合使用时。
PSMA配体PET的使用彻底改变了PC成像。因此，预计PSMA配体PET在未来的PC诊断中将发挥更大的作用，特别是随着现在越来越多地使用18F标记的PSMA配体。然而，PET和CT的同步图像分析以及差异化的图像评估（临床背景、常见陷阱的知识）是必不可少的。
