Paymani Zeinab, Rohringer Taryn, Vali Reza, Loidl Wolfgang, Alemohammad Nafiseh, Geinitz Hans, Langsteger Werner, Beheshti Mohsen
Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran 1411713135, Iran.
Department of Nuclear Medicine & Endocrinology, PET-CT Center LINZ, St. Vincent's Hospital, Ordensklinikum, 4020 Linz, Austria.
J Clin Med. 2020 Jul 21;9(7):2308. doi: 10.3390/jcm9072308.
The current study endeavored to closely compare the detection rate of 68-Gallium labelled prostate-specific membrane antigen ([Ga]Ga-PSMA) versus [F]Fluorocholine in men with prostate cancer (PC), to investigate the benefits and pitfalls of each modality in the setting of various patient characteristics. We retrospectively analyzed 29 biopsy-proven PC patients in two categories, staging and restaging, who underwent both scans within a maximum of 30 days of each other. Variables including patient demographics, prostate specific antigen (PSA) level, Gleason score, clinical course, and following treatments were recorded. The number and location of suspicious lesions as well as uptake values were noted. A total of 148 suspicious lesions were detected, of which 70.9% (105/148) were concordantly visualized in both imaging modalities. [Ga]Ga-PSMA positron emission tomography/computed tomography (PET/CT) revealed a higher number of metastatic lesions per patients (91% vs 78%). The mean of maximum standardized uptake value (SUV max) in concordant lesions was significantly higher in [Ga]Ga-PSMA compared to [F]Fluorocholine PET/CT (14.6 ± 8.44 vs. 6.9 ± 3.4, = 0.001). Discordant lesions were detected by both modalities, but more frequently by [Ga]Ga-PSMA PET/CT (20.3% in [Ga]Ga-PSMA versus 8.8% by [F]Fluorocholine PET/CT). In patients with PSA levels below 1.0 ng/mL and <2.0 ng/mL, [F]Fluorocholine PET/CT detection rate was half (57% and 55%, respectively) that of [Ga]Ga-PSMA PET/CT. Tumor, nodes and metastases (TNM) staging, and subsequently patient management, was only influenced in 4/29 patients (14%), particularly by [Ga]Ga-PSMA PET/CT with PSA values under 0.5 ng/mL. [Ga]Ga-PSMA PET/CT revealed superior diagnostic performance to [F]Fluorocholine PET/CT in staging and restaging of PC patients, especially in cases with low PSA levels. However, in a few hormone resistant high-risk PC patients, [F]Fluorocholine PET/CT may improve overall diagnostic accuracy.
本研究旨在密切比较68镓标记的前列腺特异性膜抗原（[Ga]Ga-PSMA）与[F]氟胆碱在前列腺癌（PC）男性患者中的检测率，以探讨在不同患者特征情况下每种方法的益处和缺陷。我们回顾性分析了29例经活检证实的PC患者，分为分期和再分期两类，他们在彼此最多30天内接受了两种扫描。记录了包括患者人口统计学、前列腺特异性抗原（PSA）水平、Gleason评分、临床病程及后续治疗等变量。记录了可疑病变的数量和位置以及摄取值。共检测到148个可疑病变，其中70.9%（105/148）在两种成像方式中均能一致显示。[Ga]Ga-PSMA正电子发射断层扫描/计算机断层扫描（PET/CT）显示每位患者的转移病变数量更多（91%对78%）。与[F]氟胆碱PET/CT相比，[Ga]Ga-PSMA中一致病变的最大标准化摄取值（SUV max）均值显著更高（14.6±8.44对6.9±3.4，P = 0.001）。两种方法均检测到了不一致的病变，但[Ga]Ga-PSMA PET/CT检测到的更频繁（[Ga]Ga-PSMA中为20.3%，[F]氟胆碱PET/CT中为8.8%）。在PSA水平低于1.0 ng/mL和<2.0 ng/mL的患者中，[F]氟胆碱PET/CT的检测率分别是[Ga]Ga-PSMA PET/CT的一半（分别为57%和55%）。肿瘤、淋巴结和转移（TNM）分期以及随后的患者管理仅在4/29例患者（14%）中受到影响，特别是PSA值低于0.5 ng/mL的患者中受[Ga]Ga-PSMA PET/CT影响更明显。在PC患者的分期和再分期中，[Ga]Ga-PSMA PET/CT显示出比[F]氟胆碱PET/CT更好的诊断性能，尤其是在PSA水平较低的情况下。然而，在少数激素抵抗的高危PC患者中，[F]氟胆碱PET/CT可能会提高总体诊断准确性。
