Vierasu Irina, Van Simaeys Gaetan, Trotta Nicola, Lacroix Simon, Bormans Guy, Albisinni Simone, Quackels Thierry, Roumeguère Thierry, Goldman Serge
Nuclear Medicine Department & PET/Biomedical Cyclotron Unit, Hôpital Erasme, Université libre de Bruxelles (ULB), Route de Lennik 808, 1070, Brussels, Belgium.
Center for Microscopy and Molecular Imaging (CMMI), Université libre de Bruxelles (ULB), Charleroi, Gosselies, Belgium.
Eur J Hybrid Imaging. 2023 Jan 23;7(1):2. doi: 10.1186/s41824-022-00161-2.
Positron emission tomography/computed tomography (PET/CT) using radiotracers that bind to the prostate-specific membrane antigen (PSMA) is mainly used in biochemical recurring prostate cancer. The aim of our study was to assess the usefulness of F-JK-PSMA-7 PET/CT for local and nodal staging in patients with intermediate- and high-risk prostate cancer (PCa) prior to radical prostatectomy, as compared to conventional imaging techniques.
We enrolled a total of 10 patients with intermediate- and high-risk PCa diagnosed by multiparametric-MRI followed by systematic and targeted biopsies, eligible for radical prostatectomy with extended lymph node dissection. Clinical team was blind to the results of the pre-surgery F-JK-PSMA-7 PET/CT at times of clinical decision and surgery. One month post-surgery, 18F-JK-PSMA-7 PET/CT was repeated and the results of both scans were unblinded. A third F-JK-PSMA-7 PET/CT could be acquired at a later time point depending on PSA progression.
All pre-surgery F-JK-PSMA-7 PET/CT was positive in the prostatic region, while MRI was negative in the prostate in one patient. We also detected positive pelvic lymph nodes in two patients (one high-risk, one intermediate-risk PCa) on pre-surgery and post-surgery F-JK-PSMA-7 PET/CT. No positive pelvic lymph nodes were reported on pre-surgical CT and MRI. F-JK-PSMA-7 PET/CT detected bladder involvement in one patient and seminal vesicles involvement in two patients; this malignant extension was undetected by the conventional imaging techniques. SUVmax in prostate lesions had an average value of 11.51 (range 6.90-21.49). SUVmean in prostate lesions had an average value of 7.59 (range 5.26-14.02).
This pilot study indicates that pre-surgery F-JK-PSMA-7 PET/CT provides valuable information in intermediate- and high-risk PCa, for surgery planning with curative intent.
使用与前列腺特异性膜抗原（PSMA）结合的放射性示踪剂的正电子发射断层扫描/计算机断层扫描（PET/CT）主要用于生化复发的前列腺癌。我们研究的目的是评估F-JK-PSMA-7 PET/CT在根治性前列腺切除术之前对中高危前列腺癌（PCa）患者进行局部和淋巴结分期的有效性，并与传统成像技术进行比较。
我们共纳入了10例经多参数MRI诊断为中高危PCa的患者，随后进行了系统和靶向活检，符合根治性前列腺切除术及扩大淋巴结清扫术的条件。临床团队在临床决策和手术时对术前F-JK-PSMA-7 PET/CT的结果不知情。术后1个月，重复进行18F-JK-PSMA-7 PET/CT检查，并对两次扫描结果进行解密。根据前列腺特异性抗原（PSA）进展情况，可在稍后时间点进行第三次F-JK-PSMA-7 PET/CT检查。
所有术前F-JK-PSMA-7 PET/CT在前列腺区域均为阳性，而1例患者的MRI在前列腺区域为阴性。我们还在2例患者（1例高危、1例中危PCa）的术前和术后F-JK-PSMA-7 PET/CT上检测到盆腔淋巴结阳性。术前CT和MRI未报告盆腔淋巴结阳性。F-JK-PSMA-7 PET/CT检测到1例患者膀胱受累，2例患者精囊受累；传统成像技术未检测到这种恶性扩展。前列腺病变的SUVmax平均值为11.51（范围6.90-21.49）。前列腺病变的SUVmean平均值为7.59（范围5.26-14.02）。
这项初步研究表明，术前F-JK-PSMA-7 PET/CT可为中高危PCa提供有价值的信息，用于以治愈为目的的手术规划。
