Shin Dongho, Yoon Chang Eil, Kwon Hyeok Jae, Moon Hyong Woo, Park Yong Hyun, Cho Hyuk Jin, Ha U-Syn, Hong Sung-Hoo, Park Sonya Youngju, Ha Seunggyun, Hyun O Joo, Yoo Ie Ryung, Park Chansoo, Chi Dae Yoon, Lee Ji Youl
Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Nuclear Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Prostate Int. 2023 Mar;11(1):40-45. doi: 10.1016/j.prnil.2022.08.004. Epub 2022 Sep 5.
To demonstrate the clinical usefulness of prostate-specific membrane antigen (PSMA) positron emission tomography (PET) computerized tomography (CT) for irreversible electroporation (IRE) in prostate cancer patients.
From January to May 2021, 17 men were diagnosed with localized prostate cancer through preoperative mpMRI and [F] florastamin PSMA PET-CT imaging, followed by transperineal MRI-ultrasound fusion-guided biopsy. The patients underwent IRE focal therapy at the target lesions under general anesthesia. To evaluate the treatment outcome, serum prostate-specific antigen (PSA) levels were followed up in the 1st, 3rd, 6th, 9th, 12th months, and mpMRI was taken in the 1st and 12th months, followed by MR fusion biopsy in the 12th month post-IRE.
The mean age of the patients was 66.1 ± 9.3 with a median PSA of 7.5 ng/ml. After the treatment, PSA nadir was 4.06 ± 3.4, and 11 (64.7%) achieved decline of PSA more than 50% from the baseline. Rate of negative biopsy for prostate cancer is 88% (15/17) at 12 months MR fusion biopsy after the IRE treatment. Among the relapsed cases, 1 (6.9%) patient recurred at margin of treated area, and 1 (6.9%) patient was from outfield recurrence. When excluding initial four patients, none of the patients had cancer recur.
When treating with IRE focal therapy, PSMA-PET CT is a potentially valuable diagnostic approach for localizing prostate cancer; it supports the detection of lesions with conventional mpMRI, enabling to perform the procedure more completely.
证明前列腺特异性膜抗原（PSMA）正电子发射断层扫描（PET）计算机断层扫描（CT）在前列腺癌患者不可逆电穿孔（IRE）治疗中的临床应用价值。
2021年1月至5月，17名男性患者通过术前多参数磁共振成像（mpMRI）和[F]氟代司他明PSMA PET-CT成像被诊断为局限性前列腺癌，随后接受经会阴MRI-超声融合引导下活检。患者在全身麻醉下于目标病灶处接受IRE局部治疗。为评估治疗效果，在第1、3、6、9、12个月随访血清前列腺特异性抗原（PSA）水平，并在第1和12个月进行mpMRI检查，在IRE治疗后第12个月进行MR融合活检。
患者的平均年龄为66.1±9.3岁，PSA中位数为7.5 ng/ml。治疗后，PSA最低点为4.06±3.4，11名（64.7%）患者的PSA较基线下降超过50%。IRE治疗后12个月MR融合活检时前列腺癌活检阴性率为88%（15/17）。在复发病例中，1名（6.9%）患者在治疗区域边缘复发，1名（6.9%）患者为远处复发。排除最初的4名患者后，无患者癌症复发。
在进行IRE局部治疗时，PSMA-PET CT是一种潜在有价值的前列腺癌定位诊断方法；它有助于传统mpMRI检测病变，使手术能够更彻底地进行。
