Ćwikła Jarosław B, Roslan Marek, Skoneczna Iwona, Kempińska-Wróbel Monika, Maurin Michał, Rogowski Wojciech, Janota Barbara, Szarowicz Anna, Garnuszek Piotr
Department of Cardiology and Internal Medicine, School of Medicine, University of Warmia and Mazury, 11-041 Olsztyn, Poland.
Diagnostic and Therapy Center-Gammed, 02-351 Warsaw, Poland.
Pharmaceuticals (Basel). 2021 Oct 29;14(11):1107. doi: 10.3390/ph14111107.
Numerous different molecules of prostate-specific membrane antigen (PSMA) ligands are used to detect prostate cancer (PCa); most approaches utilize gallium PET and a few reports describe the role of SPECT/CT. [Tc]Tc-PSMA-T4 is a new radiopharmaceutical designed for the diagnosis of patients with PCa. We conducted a single site, prospective, preliminary case series study that included 31 patients with PCa; all had undergone clinical, biochemical or imaging examination and exhibited clear or suspicious active disease or clinical/biochemical recurrence of PCa. Whole-body (WB) SPECT/CT after i.v. administration of [Tc]Tc-PSMA-T4 was utilized; acquisition images were obtained at three time points. The clinical value of the images was assessed in regard to the evaluation of tumor extent in patients with confirmed PC that qualified for initial therapy and the evaluation of tumor recurrence; both provided encouraging results. The late acquisition of WB-SPECT resulted in better lesions delineation. The results of the analysis of the sensitivity/specificity were: 92%/100% in cases of primary cancer, 83%/100% in terms of pelvic lymph nodes disease, 100%/95% in other lymph nodes and soft tissue involvement, respectively, and bone mets were both 100%. An oncotropic SPECT [Tc]Tc-PSMA-T4 can help in selecting a rational therapeutic strategy for a patient with an initial diagnosis of PCa by assessing the extent of cancer and also after complex radical or palliative therapy in case of biochemical recurrence for re-staging.
许多不同的前列腺特异性膜抗原（PSMA）配体分子被用于检测前列腺癌（PCa）；大多数方法采用镓PET，少数报告描述了SPECT/CT的作用。[锝]Tc-PSMA-T4是一种用于诊断前列腺癌患者的新型放射性药物。我们进行了一项单中心、前瞻性、初步病例系列研究，纳入了31例前列腺癌患者；所有患者均接受了临床、生化或影像学检查，且表现出明确或可疑的活动性疾病或前列腺癌的临床/生化复发。静脉注射[锝]Tc-PSMA-T4后进行全身（WB）SPECT/CT检查；在三个时间点采集图像。评估了这些图像在评估符合初始治疗条件的确诊前列腺癌患者的肿瘤范围以及肿瘤复发方面的临床价值；两者均取得了令人鼓舞的结果。WB-SPECT的延迟采集能更好地勾勒病变。敏感性/特异性分析结果分别为：原发性癌症病例中为92%/100%，盆腔淋巴结疾病方面为83%/100%，其他淋巴结及软组织受累情况方面均为100%/95%，骨转移方面均为100%。一种亲肿瘤性SPECT[锝]Tc-PSMA-T4可通过评估癌症范围，在对初诊前列腺癌患者进行初始诊断时，以及在生化复发进行重新分期的复杂根治性或姑息性治疗后，帮助为患者选择合理的治疗策略。
