Department of Urology, Rabin Medical Center, Petach Tikva, Israel
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Nucl Med. 2021 Jun 1;62(6):773-778. doi: 10.2967/jnumed.120.251272. Epub 2020 Oct 23.
The potential role of prostate-specific membrane antigen (PSMA) PET/CT in non-prostate cancer tumors has shown promising results. We examined the performance of dynamic Ga-PSMA-11 PET/CT (DPSMA) for the evaluation of localized renal mass. A prospective case series of patients with a newly diagnosed renal mass who were referred for surgery was examined. DPSMA was performed in a standardized manner before surgery. The final surgical histology served as the standard of reference. PSMA expression in the tumor vasculature was assessed and staining intensity was scored. Tracer uptake and PSMA expression were compared between benign and malignant tissue. Of 29 enhancing renal masses evaluated in 27 patients, 24 (83%) were malignant lesions. The median SUV of benign and malignant lesions was 2.3 (interquartile range [IQR], 2.2-2.7) and 6.8 (IQR, 4.2-10.1), respectively ( = 0.009). Median SUV of benign and malignant lesions was 3.8 (IQR, 3.3-4.5) and 9.4 (IQR, 5.4-15.8), respectively ( = 0.015). The median washout coefficient () was significantly lower in malignant lesions than in benign lesions (0.17 vs. 0.70, = 0.02). Positive PSMA staining was found in 20 of 24 malignant lesions and in 2 of 5 benign lesions ( = 0.04). This pilot study demonstrated DPSMA uptake and kinetics in localized renal masses. Increased Ga-PSMA-11 tracer uptake and intratumoral retention correlate with PSMA expression in malignant renal tumors compared with benign renal masses, supporting further assessment of DPSMA as a potential tool for evaluating localized renal masses.
前列腺特异性膜抗原（PSMA）PET/CT 在非前列腺癌肿瘤中的潜在作用已经显示出良好的结果。我们检查了动态 Ga-PSMA-11 PET/CT（DPSMA）在评估局部肾肿块中的性能。对因新诊断的肾肿块而接受手术的患者进行了前瞻性病例系列研究。在手术前以标准化方式进行 DPSMA。最终的手术组织学作为参考标准。评估肿瘤血管中的 PSMA 表达并评分染色强度。比较良性和恶性组织之间的示踪剂摄取和 PSMA 表达。在 27 名患者的 29 个增强性肾肿块中，24 个（83%）为恶性病变。良性和恶性病变的 SUV 中位数分别为 2.3（四分位距 [IQR]，2.2-2.7）和 6.8（IQR，4.2-10.1）（=0.009）。良性和恶性病变的 SUV 中位数分别为 3.8（IQR，3.3-4.5）和 9.4（IQR，5.4-15.8）（=0.015）。恶性病变的洗脱系数（）明显低于良性病变（0.17 对 0.70，=0.02）。24 个恶性病变中有 20 个和 5 个良性病变中有 2 个存在 PSMA 阳性染色（=0.04）。这项初步研究表明，在局部肾肿块中存在 DPSMA 摄取和动力学。与良性肾肿块相比，恶性肾肿瘤中的 Ga-PSMA-11 示踪剂摄取增加和肿瘤内保留与 PSMA 表达相关，支持进一步评估 DPSMA 作为评估局部肾肿块的潜在工具。
