Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China.
Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Ann Nucl Med. 2022 Jun;36(6):523-532. doi: 10.1007/s12149-022-01732-w. Epub 2022 Apr 1.
Prostate-specific membrane antigen (PSMA)-PET/CT imaging has gained increasing clinical importance for the detection and staging of high-risk primary prostate cancer (PCa). However, it is unclear whether the routine practice of prostate biopsy obscures the image finding of PSMA-PET/CT. This study aimed to compare the tumor positivity rate of PSMA-PET/CT performed pre- (PSMA-PET/CT) and post-biopsy (PSMA-PET/CT) in high-risk PCa patients.
We matched 58 PSMA-PET/CT with 58 PSMA-PET/CT studies for primary detection of high-risk PCa according to clinical characteristics. Three subgroups of PSMA-PET/CT were defined by the intervals after biopsy (≤ 1 week, 1 ~ 2 weeks, and 2 ~ 5 weeks). Tumor positivity rates were determined, and SUVmax of primary tumors were compared separately for the two main groups and the related subgroups. Malignant prostate tissues from 20 of these patients were examined by immunohistochemical analysis of PSMA. In addition, the values of PSMA-PET/CT and PSMA-PET/CT in assessing seminal vesicle invasion (SVI) were evaluated in patients who underwent radical prostatectomy.
All the primary tumors were positive on PSMA-PET/CT and PSMA-PET/CT imaging, resulting in a patient-based positivity rates of 100% (58/58) in both groups. All examined IHC results (20/20) confirmed the high-level expression of PSMA. SUVmax of primary tumors did not differ between the two main groups (16.1, IQR 9.8-26.6 vs. 16.5, IQR 11.0-26.7, p > 0.05). Subgroup analysis of PSMA-PET/CT (≤ 1 week, 1 ~ 2 weeks, and 2 ~ 5 weeks) also showed no significant difference in tumor SUVmax (15.8, IQR 9.5-22.2; 17.8, IQR 9.8-29.2; and 15.4, IQR 10.1-30.3. p > 0.05). PSMA-PET/CT and PSMA-PET/CT exhibited similar value in SVI detection as well.
The tumor positivity rate was consistently high for PSMA-PET/CT pre- and post-biopsy. A prior biopsy does not seem to affect the tumor positivity rate of PSMA-PET/CT in high-risk PCa.
前列腺特异性膜抗原（PSMA）-PET/CT 成像在检测和分期高危原发性前列腺癌（PCa）方面的临床重要性日益增加。然而，目前尚不清楚前列腺活检是否会掩盖 PSMA-PET/CT 的影像学发现。本研究旨在比较高危 PCa 患者行 PSMA-PET/CT 检测（PSMA-PET/CT）和活检后（PSMA-PET/CT）的肿瘤阳性率。
我们根据临床特征将 58 例 PSMA-PET/CT 与 58 例 PSMA-PET/CT 研究进行匹配，用于高危 PCa 的初次检测。根据活检后时间间隔（≤1 周、12 周和 25 周）将 PSMA-PET/CT 分为三组。分别确定两组和相关亚组的肿瘤阳性率，并比较原发肿瘤的 SUVmax。对其中 20 例患者的恶性前列腺组织进行 PSMA 免疫组化分析。此外，评估了接受根治性前列腺切除术的患者 PSMA-PET/CT 和 PSMA-PET/CT 在评估精囊侵犯（SVI）中的价值。
两组患者的所有原发肿瘤均在 PSMA-PET/CT 和 PSMA-PET/CT 成像上呈阳性，因此患者的阳性率均为 100%（58/58）。所有免疫组化检查结果（20/20）均证实 PSMA 呈高水平表达。两组患者的原发肿瘤 SUVmax 无差异（16.1，IQR 9.8-26.6 与 16.5，IQR 11.0-26.7，p＞0.05）。PSMA-PET/CT（≤1 周、12 周和 25 周）亚组分析也显示肿瘤 SUVmax 无显著差异（15.8，IQR 9.5-22.2；17.8，IQR 9.8-29.2；和 15.4，IQR 10.1-30.3，p＞0.05）。PSMA-PET/CT 和 PSMA-PET/CT 在 SVI 检测中也具有相似的价值。
PSMA-PET/CT 检测前和检测后的肿瘤阳性率始终较高。先前的活检似乎不会影响高危 PCa 中 PSMA-PET/CT 的肿瘤阳性率。
