Teyateeti Ajalaya, Teyateeti Achiraya, Ravizzini Gregory C, Xu Guofan, Tang Chad, Tu Shi-Ming, Macapinlac Homer A, Lu Yang
Department of Nuclear Medicine, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center Houston, TX, USA.
Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University Bangkok, Thailand.
Am J Nucl Med Mol Imaging. 2021 Apr 15;11(2):87-98. eCollection 2021.
This retrospective study is to assess the performance of F-Fluciclovine PET/CT in prostate cancer (PC) patients with multiple treatment failures and prostate-specific antigen (PSA) ≤ 0.5 ng/mL. PC patients with multiple treatment failures who had PSA level within 2-week interval of F-Fluciclovine PET/CT (PSA) ≤ 0.5 ng/mL were identified in retrospective review of our institution's database (n=28). Patient, tumor, treatment, PSA and castration characteristics as well as findings on F-Fluciclovine PET/CT were collected and compared between positive and negative F-Fluciclovine PET/CT subgroups by using Fisher's exact test. The overall detection rate of F-Fluciclovine PET/CT was 7 of 28 studies (25%). PSA > 0.2 ng/mL was associated with higher detection rates in all (33.3 vs 10%, =0.172), castration-resistant (CR) (50 vs 20%, =0.343) and castration-sensitive (CS) (28.6 vs 0%, =0.179) patients. Sites of recurrence were local 42.9% (3/7), nodal 42.9% (3/7) and bone metastases 14.3% (1/7). Higher Gleason score (GS 8-10) (33.3 vs 14.5%, =0.396), advanced tumor stage (T3-T4) (35.7 vs 20%, =0.653), second-line androgen deprivation therapy (ADT) uses (66.7 vs 20%, =0.145), chemotherapy uses (50 vs 23.1%, =0.444) and CRPC (33.3 vs 21.1%, =0.483) related to positivity of F-Fluciclovine PET/CT but none reached statistical significance. Performance of F-Fluciclovine PET/CT in prostate cancer patients with multiple treatment failures and PSA ≤ 0.5 ng/mL was acceptable particularly in patients with PSA ≥ 0.3 ng/mL, CRPC, initial GS ≥ 8 or T3-T4.
本回顾性研究旨在评估F-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-Fluciclovine PET/CT）在多次治疗失败且前列腺特异性抗原（PSA）≤0.5 ng/mL的前列腺癌（PC）患者中的表现。通过回顾本机构数据库，确定了多次治疗失败且在F-Fluciclovine PET/CT检查前2周内PSA≤0.5 ng/mL的PC患者（n = 28）。收集患者、肿瘤、治疗、PSA和去势特征以及F-Fluciclovine PET/CT检查结果，并使用Fisher精确检验对F-Fluciclovine PET/CT阳性和阴性亚组进行比较。在28项研究中，F-Fluciclovine PET/CT的总体检出率为7例（25%）。在所有患者（33.3%对10%，P = 0.172）、去势抵抗性（CR）患者（50%对20%，P = 0.343）和去势敏感性（CS）患者（28.6%对0%，P = 0.179）中，PSA>0.2 ng/mL与更高的检出率相关。复发部位为局部占42.9%（3/7）、淋巴结占42.9%（3/7）和骨转移占14.3%（1/7）。更高的Gleason评分（GS 8 - 10）（33.3%对14.5%，P = 0.396）、晚期肿瘤分期（T3 - T4）（35.7%对20%，P = 0.653）、二线雄激素剥夺治疗（ADT）的使用（66.7%对20%，P = 0.145）、化疗的使用（50%对23.1%，P = 0.444）和去势抵抗性前列腺癌（CRPC）（33.3%对21.1%，P = 0.483）与F-Fluciclovine PET/CT阳性相关，但均未达到统计学意义。F-Fluciclovine PET/CT在多次治疗失败且PSA≤0.5 ng/mL的前列腺癌患者中的表现是可接受的，特别是在PSA≥0.3 ng/mL、CRPC、初始GS≥8或T3 - T4的患者中。
