Division of Nuclear Medicine, Department of Radiology, Medical University of Graz, Auenbruggerplatz 9A, 8036, Graz, Austria.
Institute for Medical Informatics, Statics and Documentation, Medical University of Graz, Auenbruggerplatz 2, 8036, Graz, Austria.
Sci Rep. 2023 May 22;13(1):8297. doi: 10.1038/s41598-023-35628-0.
The emerging PET tracer [Ga]Ga-PSMA-11 has been established for staging in prostate cancer (PCa). Aim was to determine the value of early static imaging in two-phase PET/CT. 100 men with newly diagnosed histopathologically confirmed untreated PCa who underwent [Ga]Ga-PSMA-11 PET/CT from January 2017 to October 2019 were included. The two-phase imaging protocol consisted of an early static scan of the pelvis (6 min p.i.) and a late total-body scan (60 min p.i). Associations of semi-quantitative parameters derived via volumes of interest (VOI) with Gleason grade group and PSA were investigated. In 94/100 patients (94%) the primary tumor was detected in both phases. In 29/100 patients (29%) metastases were detected at a median PSA level of 32.2 ng/ml (0.41-503 ng/ml). In 71/100 patients (71%) without metastasis a median PSA level of 10.1 ng/ml (0.57-103 ng/ml) was observed (p = < 0.001). Primary tumors demonstrated a median standard uptake value maximum (SUVmax) of 8.2 (3.1-45.3) in early phase versus 12.2 (3.1-73.4) in late phase and a median standard uptake value mean (SUVmean) of 4.2 (1.6-24.1) in early phase versus 5.8 (1.6-39.9) in late phase, significantly increasing over time (p = < 0.001). Higher SUVmax and SUVmean were associated with higher Gleason grade group (p = 0.004 and p = 0.003, respectively) and higher PSA levels (p = < 0.001). In 13/100 patients the semi-quantitative parameters including SUVmax were declining in the late phase compared to early phase. Two-phase [Ga]Ga-PSMA-11 PET/CT demonstrates a high detection rate for primary tumor of untreated PCa of 94% and improves diagnostic accuracy. Higher PSA levels and Gleason grade group are associated with higher semi-quantitative parameters in the primary tumor. Early imaging provides additional information in a small sub-group with declining semi-quantitative parameters in the late phase.
新型正电子发射断层扫描（PET）示踪剂 [Ga]Ga-PSMA-11 已被确立用于前列腺癌（PCa）分期。本研究旨在确定两期 PET/CT 中早期静态成像的价值。2017 年 1 月至 2019 年 10 月，对 100 例经组织病理学证实未经治疗的 PCa 患者进行了 [Ga]Ga-PSMA-11 PET/CT 检查，这些患者被纳入研究。两期成像方案包括骨盆早期静态扫描（注射后 6 分钟）和晚期全身扫描（注射后 60 分钟）。研究人员通过感兴趣区（VOI）来评估半定量参数与 Gleason 分级组和 PSA 的相关性。在 94/100 例（94%）患者中，在两期扫描中均检测到原发肿瘤。在 29/100 例（29%）患者中，在中位 PSA 水平为 32.2ng/ml（0.41-503ng/ml）时检测到转移。在 71/100 例（71%）无转移的患者中，中位 PSA 水平为 10.1ng/ml（0.57-103ng/ml）（p<0.001）。早期肿瘤的最大标准摄取值（SUVmax）中位数为 8.2（3.1-45.3），晚期为 12.2（3.1-73.4），早期肿瘤的平均标准摄取值（SUVmean）中位数为 4.2（1.6-24.1），晚期为 5.8（1.6-39.9），随时间推移呈显著增加（p<0.001）。较高的 SUVmax 和 SUVmean 与较高的 Gleason 分级组（p=0.004 和 p=0.003）和较高的 PSA 水平相关（p<0.001）。在 13/100 例患者中，与早期相比，晚期的半定量参数（包括 SUVmax）下降。两期 [Ga]Ga-PSMA-11 PET/CT 对未经治疗的 PCa 原发肿瘤的检测率高达 94%，提高了诊断准确性。较高的 PSA 水平和 Gleason 分级组与原发肿瘤中较高的半定量参数相关。早期成像在一小部分半定量参数在晚期下降的患者中提供了额外的信息。
