Zhou Xing, Jiang Xiao, Liu Luzhou, Wang Xiaoxiong, Li Chuan, Yao Yutang, Kou Ying, Shen Jiaqi, Shen Taipeng, Li Zeng, Yang Shengke, Zhou Shukui, Liao Hong, Luo Zhifu, Wu Xiaoai, Chen Shirong, Cheng Zhuzhong
Radiation Oncology Key Laboratory of Sichuan Province, PET/CT Centre, Sichuan Cancer Hospital, Chengdu 610041, China; Department of Radiology, Sichuan Province Maternal and Child Health Care Hospital, Chengdu 610041, China.
Radiation Oncology Key Laboratory of Sichuan Province, PET/CT Centre, Sichuan Cancer Hospital, Chengdu 610041, China; Institute of Isotope, China Institute of Atomic Energy, Beijing 102413, China.
Transl Oncol. 2022 Jan;15(1):101292. doi: 10.1016/j.tranon.2021.101292. Epub 2021 Nov 24.
Prostate-specific membrane antigen (PSMA) ligands targeting has shown promising results in staging of prostate cancer (PCa). The aim of present study was to evaluate the value of F-PSMA-1007 PET/CT in PCa patients with biochemical recurrence.
71 patients with PCa after radical prostatectomy (RP) were included in the present study. Median prostate-specific antigen (PSA) level was 1.27 ng/mL (range 0.01-67.40 ng/mL, n = 69). All patients underwent whole-body PET/CT imaging after injection of 333±38 MBq F-PSMA-1007. The distribution of PSMA-positive lesions was assessed. The influence of PSA level, androgen deprivation therapy and primary Gleason score on PSMA-positive finding and uptake of F-PSMA-1007 were evaluated.
56 (79%) patients showed at least one pathological finding on F-PSMA-1007 PET/CT. The rates of positive scans were 50%, 80%, 100%, 100% among patients with PSA levels ≤0.5, 0.51-1.0, 1.1-2.0 and >2.0 ng/mL, respectively. The median Gleason score was 8 (range 7-10), and higher Gleason score (≤7 vs. ≥8) leads to higher detection rates (58.3% (14/24) vs. 88.9% (32/36), P = 0.006). The median SUVmax of positive findings in patients with PSA levels ≤0.5, 0.51-1.0, 1.1-2.0 and >2.0 ng/mL were 4.51, 4.27, 11.50 and 14.08, respectively. The median SUVmax in patients with PSA level >2.0 ng/mL was significantly higher than that in patients with PSA ≤2.0 ng/mL (14.08 vs. 6.13, P<0.001).
F-PSMA-1007 PET/CT demonstrated a high detection rate for patients with a raised PSA level after radical prostatectomy even in patients with extremely low PSA level (eg. PSA level ≤0.5 ng/mL), which was essential for further clinical management for PCa patients.
靶向前列腺特异性膜抗原（PSMA）在前列腺癌（PCa）分期中已显示出有前景的结果。本研究的目的是评估F-PSMA-1007 PET/CT在生化复发的PCa患者中的价值。
本研究纳入了71例前列腺癌根治术（RP）后的PCa患者。前列腺特异性抗原（PSA）水平中位数为1.27 ng/mL（范围0.01 - 67.40 ng/mL，n = 69）。所有患者在注射333±38 MBq F-PSMA-1007后接受全身PET/CT成像。评估PSMA阳性病变的分布。评估PSA水平、雄激素剥夺治疗和原发Gleason评分对PSMA阳性发现及F-PSMA-1007摄取的影响。
56例（79%）患者在F-PSMA-1007 PET/CT上显示至少一项病理发现。PSA水平≤0.5、0.51 - 1.0、1.1 - 2.0和>2.0 ng/mL的患者中，阳性扫描率分别为50%、80%、100%、100%。Gleason评分中位数为8（范围7 - 10），较高的Gleason评分（≤7 vs.≥8）导致更高的检测率（58.3%（14/24）vs. 88.9%（32/36），P = 0.006）。PSA水平≤0.5、0.51 - 1.0、1.1 - 2.0和>2.0 ng/mL患者中阳性发现的SUVmax中位数分别为4.51、4.27、11.50和14.08。PSA水平>2.0 ng/mL患者的SUVmax中位数显著高于PSA≤2.0 ng/mL的患者（14.08 vs. 6.13，P<0.001）。
F-PSMA-1007 PET/CT对前列腺癌根治术后PSA水平升高的患者显示出高检测率，即使是在PSA水平极低的患者中（例如PSA水平≤0.5 ng/mL），这对PCa患者的进一步临床管理至关重要。
