镓前列腺特异性膜抗原正电子发射断层扫描计算机断层扫描在生化复发患者中对前列腺癌进行定位和再分期

Localization and restaging of carcinoma prostate by Gallium prostate-specific membrane antigen positron emission tomography computed tomography in patients with biochemical recurrence.

作者信息

Seniaray Nikhil, Verma Ritu, Khanna Sudhir, Belho Ethel, Pruthi Ankur, Mahajan Harsh

机构信息

Department of Nuclear Medicine and PET/CT, Mahajan Imaging Centre, Sir Ganga Ram Hospital, New Delhi, India.

Department of Urology, Sir Ganga Ram Hospital, New Delhi, India.

出版信息

Indian J Urol. 2020 Jul-Sep;36(3):191-199. doi: 10.4103/iju.IJU_275_19. Epub 2020 Jul 1.

DOI:10.4103/iju.IJU_275_19

PMID:33082634

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7531378/

Abstract

INTRODUCTION

Radical prostatectomy (RP) and radical radiotherapy (RT) are well established primary curative options for localized prostate cancer. Despite technical improvements, prostate-specific antigen (PSA)-recurrence after RP and RT is a common clinical scenario. We aimed to assess the role of Gallium (Ga) prostate-specific membrane antigen positron emission tomography computed tomography (PSMA PET/CT) in patients with biochemical recurrence of prostate cancer after RP or RT for the detection and localization recurrent and metastatic disease.

MATERIALS AND METHODS

We ambispectively (70 retrospective and 100 prospective) analyzed the data of men with biochemical recurrence post-RP and post-RT who were evaluated by Ga PSMA PET/CT at our institute. We aimed to assess the relationship between serum PSA levels and the probability of having a positive scan in patients with recurrent prostate cancer.

RESULTS

The study included 170 men, all had adenocarcinoma of the prostate, 124/170 had previous RP and 46/170 had prior RT. The median serum PSA in the RP group was 1.8 ng/ml and 5.2 ng/ml in the RT group. In the post-RP cohort, the detection rate of Ga PSMA PET/CT was 39.3% for PSA 0.2 to <0.5 ng/ml, 47.3% for PSA 0.5 to <1 ng/ml, 68.4% for PSA 1 to <2 ng/ml and 93.1% for PSA ≥2 ng/ml. In the post-RT group, the detection rate was 88.8% for PSA 2 to <4 ng/ml and 100% for PSA ≥4 ng/ml.

CONCLUSIONS

Ga PSMA PET/CT provides a novel imaging modality for the detection of prostate cancer recurrence and metastases at low posttreatment PSA levels, which may help in directing appropriate salvage treatments.

摘要

引言

根治性前列腺切除术（RP）和根治性放射治疗（RT）是局限性前列腺癌公认的主要根治性治疗选择。尽管技术有所改进，但RP和RT后前列腺特异性抗原（PSA）复发仍是常见的临床情况。我们旨在评估镓（Ga）前列腺特异性膜抗原正电子发射断层扫描计算机断层扫描（PSMA PET/CT）在RP或RT后前列腺癌生化复发患者中检测和定位复发及转移性疾病的作用。

材料与方法

我们对在我院接受Ga PSMA PET/CT评估的RP和RT后生化复发男性患者的数据进行了双向分析（70例回顾性和100例前瞻性）。我们旨在评估复发性前列腺癌患者血清PSA水平与扫描阳性概率之间的关系。

结果

该研究纳入了170名男性，均为前列腺腺癌，其中124/170曾接受过RP，46/170曾接受过RT。RP组血清PSA中位数为1.8 ng/ml，RT组为5.2 ng/ml。在RP后队列中，PSA 0.2至<0.5 ng/ml时Ga PSMA PET/CT的检出率为39.3%，PSA 0.5至<1 ng/ml时为47.3%，PSA 1至<2 ng/ml时为68.4%，PSA≥2 ng/ml时为93.1%。在RT后组中，PSA 2至<4 ng/ml时检出率为88.8%，PSA≥4 ng/ml时为100%。