The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Can J Urol. 2023 Feb;30(1):11432-11437.
Prostate-specific membrane antigen (PSMA)-targeted positron emission tomography (PET) is rapidly becoming widely accepted as the standard-of-care for imaging of men with prostate cancer. Labeled indications for regulatoryapproved agents include primary staging and recurrent disease in men at risk of metastases. The first commercial PSMA PET agent to become available was 18F-DCFPyL (piflufolastat F 18), a radiofluorinated small molecule with high-affinity for PSMA. The regulatory approval of 18F-DCFPyL hinged upon two key, multi-center, registration trials, OSPREY (patient population: highrisk primary staging) and CONDOR (patient population: biochemical recurrence). In this manuscript, we will (1) review key findings from the OSPREY and CONDOR trials, (2) discuss the clinical acquisition protocol we use for 18F-DCFPyL PET scanning, (3) present information on important pearls and pitfalls, (4) provide an overview of the PSMA reporting and data system (PSMA-RADS) interpretive framework, and (5) posit important future directions for research in PSMA PET. Our overall goal is to provide a brief introduction for practices and academic groups that are adopting 18F-DCFPyL PET scans for use in their patients with prostate cancer.
前列腺特异性膜抗原（PSMA）靶向正电子发射断层扫描（PET）正迅速被广泛接受为前列腺癌男性患者的影像学标准。经监管部门批准的放射性配体药物的适应证包括有转移风险的男性的原发分期和复发性疾病。第一种商业化的 PSMA PET 药物是 18F-DCFPyL（培氟拉滨 F 18），这是一种放射性氟标记的小分子，与 PSMA 具有高亲和力。18F-DCFPyL 的监管批准取决于两项关键的多中心注册试验，OSPREY（患者人群：高危原发分期）和 CONDOR（患者人群：生化复发）。在本文中，我们将：（1）回顾 OSPREY 和 CONDOR 试验的关键发现；（2）讨论我们用于 18F-DCFPyL PET 扫描的临床采集方案；（3）介绍重要的要点和陷阱；（4）概述 PSMA 报告和数据系统（PSMA-RADS）解释框架；（5）对 PSMA PET 的未来研究方向提出重要看法。我们的总体目标是为采用 18F-DCFPyL PET 扫描的实践和学术团体提供简要介绍，以便在他们的前列腺癌患者中使用。
