锝- MIP - 1404用于早期生化复发前列腺癌的SPECT/CT成像及后续PSMA放射性引导手术的可行性：9例患者的病例系列
Feasibility of Tc-MIP-1404 for SPECT/CT Imaging and Subsequent PSMA-Radioguided Surgery in Early Biochemically Recurrent Prostate Cancer: A Case Series of 9 Patients.
作者信息
Koehler Daniel, Sauer Markus, Klutmann Susanne, Apostolova Ivayla, Lehnert Wencke, Budäus Lars, Knipper Sophie, Maurer Tobias
机构信息
Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;
Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
出版信息
J Nucl Med. 2023 Jan;64(1):59-62. doi: 10.2967/jnumed.122.263892. Epub 2022 Jul 14.
This case series evaluated the feasibility of prostate-specific membrane antigen (PSMA)-radioguided surgery (RGS) with Tc-MIP-1404 in recurrent prostate cancer. Nine patients with PSMA-positive lesions on PET/CT received Tc-MIP-1404 (median, 747 MBq; interquartile range [IQR], 710-764 MBq) 17.2 h (IQR, 16.9-17.5 h) before SPECT/CT and 22.3 h (IQR, 20.8-24.0 h) before RGS. Seventeen PSMA-positive lesions were detected on PET/CT (median short-axis diameter, 4 mm; IQR, 3-6 mm; median SUV, 8.9; IQR, 5.2-12.6). Nine of 17 (52.9%) were visible on SPECT/CT (median SUV, 13.8; IQR, 8.0-17.9). Except for 2 foci, all PET/CT-positive findings demonstrated intraoperative count rates above the background level (median count, 31; IQR, 17-89) and were lymph node metastases. Moreover, PSMA-RGS identified 2 additional metastases compared with PET/CT. Prostate-specific antigen values decreased after RGS in 6 of 9 patients (67%). PSMA-RGS with Tc-MIP-1404 identified lymph node metastases in all patients, including 2 additional lesions compared with PET/CT.
本病例系列评估了使用锝[Tc]MIP-1404进行前列腺特异性膜抗原（PSMA）放射性引导手术（RGS）在复发性前列腺癌中的可行性。9例在PET/CT上有PSMA阳性病变的患者在SPECT/CT前17.2小时（四分位间距[IQR]，16.9 - 17.5小时）和RGS前22.3小时（IQR，20.8 - 24.0小时）接受了锝[Tc]MIP-1404（中位数，747 MBq；IQR，710 - 764 MBq）。在PET/CT上检测到17个PSMA阳性病变（短轴直径中位数，4 mm；IQR，3 - 6 mm；SUV中位数，8.9；IQR，5.2 - 12.6）。17个病变中有9个（52.9%）在SPECT/CT上可见（SUV中位数，13.8；IQR，8.0 - 17.9）。除2个病灶外，所有PET/CT阳性发现的术中计数率均高于背景水平（计数中位数，31；IQR，17 - 89），且均为淋巴结转移。此外，与PET/CT相比，PSMA-RGS还发现了另外2处转移灶。9例患者中有6例（67%）在RGS后前列腺特异性抗原值下降。使用锝[Tc]MIP-1404的PSMA-RGS在所有患者中均发现了淋巴结转移，包括比PET/CT多发现的2个病灶。
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