Division of Nuclear Medicine, Department of Radiology, Keck School of Medicine, University of Southern California, 2250 Alcazar Street, CSC 102, Los Angeles, CA, 90033, USA.
Mol Imaging Biol. 2022 Dec;24(6):920-927. doi: 10.1007/s11307-022-01742-0. Epub 2022 May 23.
We assessed the incidence rate and management impact of oligometastatic disease detected on F-fluciclovine (Axumin™) PET/CT in men with first biochemical recurrence (BCR) of prostate cancer (PCA) after definitive primary therapy.
We retrospectively reviewed our clinical database for men with PCA who underwent F-fluciclovine PET/CT for imaging evaluation of BCR with negative or equivocal findings on conventional imaging. We included patients with up to and including 5 metastases (oligometastases) regardless of imaging evidence for local recurrence in the treated prostate bed. We examined the association between mean serum prostate specific antigen (PSA) levels with the number of oligometastases (non-parametric ANOVA) and between patients with or without local recurrence (Student t-test). The management impact of oligometastatic disease was tabulated.
We identified 21 patients with oligometastases upon first BCR (PSA 0.2-56.8 ng/mL) out of 89 eligible patients. There was a significant difference (p = 0.04) in the mean PSA levels between patients with local recurrence (n = 12) and those without local recurrence (n = 9). In the subgroup of analysis of patients without local recurrence, there was no significant association between mean PSA level and number of oligometastases (p = 0.83). Distribution of oligometastases included 66.7% isolated nodal disease and 33.3% bone only. Twelve (57.1%) patients had change in management to include change in ADT, salvage therapy, or both. Treatment change was initiated in 62.5%, 28.6%, 66.7%, 100%, and 100% of patients with 1, 2, 3, 4, and 5 oligometastatic lesions, respectively.
The incidence rate of oligometastatic disease in men with first BCR of PCA undergoing F-fluciclovine PET/CT for imaging evaluation of BCR was 23.6% in our eligible patient population. There was no significant association between serum PSA level and the number of oligometastases. Treatment management was affected in 57.1% of patients with oligometastases.
我们评估了在接受根治性原发治疗后首次出现生化复发（BCR）的前列腺癌（PCA）男性中，氟[18F]脱氧葡萄糖（Axumin™）PET/CT 检测到寡转移疾病的发生率和管理影响。
我们回顾性地审查了我们的临床数据库，其中包括接受氟[18F]脱氧葡萄糖 PET/CT 进行 BCR 影像学评估的 PCA 男性，这些患者在常规影像学检查中呈阴性或不确定结果。我们纳入了最多有 5 个转移灶（寡转移灶）的患者，无论治疗前列腺床的局部复发是否有影像学证据。我们检查了平均血清前列腺特异性抗原（PSA）水平与寡转移灶数量之间的关系（非参数 ANOVA）以及有或没有局部复发的患者之间的关系（Student t 检验）。列出了寡转移疾病的管理影响。
我们在 89 名符合条件的患者中发现了 21 名在首次 BCR 时发生寡转移的患者（PSA 0.2-56.8ng/mL）。有局部复发的患者（n=12）与无局部复发的患者（n=9）之间的平均 PSA 水平有显著差异（p=0.04）。在无局部复发患者的亚组分析中，平均 PSA 水平与寡转移灶数量之间没有显著关联（p=0.83）。寡转移灶的分布包括 66.7%的孤立淋巴结疾病和 33.3%的单纯骨转移。12 名（57.1%）患者的管理发生变化，包括 ADT 改变、挽救性治疗或两者兼而有之。在分别有 1、2、3、4 和 5 个寡转移灶的患者中，治疗改变的起始率分别为 62.5%、28.6%、66.7%、100%和 100%。
在接受氟[18F]脱氧葡萄糖 PET/CT 进行 BCR 影像学评估的首次 BCR 的 PCA 男性中，寡转移疾病的发生率为 23.6%，这是我们符合条件的患者人群中的发生率。血清 PSA 水平与寡转移灶数量之间没有显著关联。57.1%的寡转移患者的治疗管理受到影响。
