Nuclear Medicine Division, Policlinico S Orsola, University of Bologna, Bologna, Italy.
Department of Nuclear Medicine and Molecular Imaging, University Hospital Leuven and KU Leuven, Leuven, Belgium.
Eur J Nucl Med Mol Imaging. 2021 Feb;48(2):469-476. doi: 10.1007/s00259-020-04934-4. Epub 2020 Jul 2.
Prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) is used for (re)staging prostate cancer (PCa) and as a biomarker for evaluating response to therapy, but lacks established response criteria. A panel of PCa experts in nuclear medicine, radiology, and/or urology met on February 21, 2020, in Amsterdam, The Netherlands, to formulate criteria for PSMA PET/CT-based response in patients treated for metastatic PCa and optimal timing to use it.
Panelists received thematic topics and relevant literature prior to the meeting. Statements on how to interpret response and progression on therapy in PCa with PSMA PET/CT and when to use it were developed. Panelists voted anonymously on a nine-point scale, ranging from strongly disagree (1) to strongly agree (9). Median scores described agreement and consensus.
PSMA PET/CT consensus statements concerned utility, best timing for performing, criteria for evaluation of response, patients who could benefit, and handling of radiolabeled PSMA PET tracers. Consensus was reached on all statements. PSMA PET/CT can be used before and after any local and systemic treatment in patients with metastatic disease to evaluate response to treatment. Ideally, PSMA PET/CT imaging criteria should categorize patients as responders, patients with stable disease, partial response, and complete response, or as non-responders. Specific clinical scenarios such as oligometastatic or polymetastatic disease deserve special consideration.
Adoption of PSMA PET/CT should be supported by indication for appropriate use and precise criteria for interpretation. PSMA PET/CT criteria should categorize patients as responders or non-responders. Specific clinical scenarios deserve special consideration.
前列腺特异性膜抗原（PSMA）正电子发射断层扫描（PET）/计算机断层扫描（CT）用于（重新）分期前列腺癌（PCa），并作为评估治疗反应的生物标志物，但缺乏既定的反应标准。一组核医学、放射学和/或泌尿科的 PCa 专家于 2020 年 2 月 21 日在荷兰阿姆斯特丹举行会议，制定了用于转移性 PCa 治疗患者的 PSMA PET/CT 基础反应标准和最佳使用时机。
小组成员在会议前收到了主题和相关文献。制定了关于如何解释 PSMA PET/CT 治疗 PCa 中反应和进展以及何时使用 PSMA PET/CT 的声明。小组成员对 9 分制的声明进行匿名投票，范围从强烈不同意（1）到强烈同意（9）。中位数分数描述了一致性和共识程度。
PSMA PET/CT 共识声明涉及效用、最佳执行时间、反应评估标准、可能受益的患者以及放射性标记 PSMA PET 示踪剂的处理。所有声明都达成了共识。PSMA PET/CT 可用于转移性疾病患者的任何局部和全身治疗前后，以评估治疗反应。理想情况下，PSMA PET/CT 成像标准应将患者分为反应者、稳定疾病患者、部分反应者、完全反应者或无反应者。特定的临床情况，如寡转移或多转移疾病，值得特别考虑。
应根据适当使用的指征和解释的精确标准来支持 PSMA PET/CT 的采用。PSMA PET/CT 标准应将患者分为反应者或无反应者。特定的临床情况值得特别考虑。
