Hoffman Azik, Amiel Gilad E
Department of Urology, Rambam Health Care Center, Haifa 3109601, Israel.
Cancers (Basel). 2023 Jun 29;15(13):3402. doi: 10.3390/cancers15133402.
Prostate-specific membrane antigen (PSMA) PET use in prostate cancer treatment has recently become a routinely used imaging modality by urologists. New, established data regarding its performance in different stages of prostate cancer, as well as gaining clinical knowledge with new tracers, drives the need for urologists and other clinicians to improve the utilization of this tool. While the use of PSMA PET/CT is more common in metastatic disease, in which it outperforms classical imaging modalities and drives treatment decisions and adjustments, recently, it gained ground in localized prostate cancer as well, especially in high-risk disease. Still, PSMA PET/CT might reveal lesions within the prostate or possibly locoregional or metastatic disease, not always representing true cancer when utilized in earlier stages of the disease, potentially adding diagnostic burden and changing treatment decisions. As urological treatment options advance toward focal treatments in localized organ-confined prostate cancer, recent reports suggest the utilization of PSMA PET/CT in treatment planning and follow-up and even when choosing active surveillance. This review aims to reveal the current perspective of urologists regarding its daily use.
前列腺特异性膜抗原(PSMA)PET在前列腺癌治疗中的应用最近已成为泌尿外科医生常用的成像方式。有关其在前列腺癌不同阶段表现的新的、既定数据,以及随着新示踪剂获得的临床知识,促使泌尿外科医生和其他临床医生提高对该工具的利用。虽然PSMA PET/CT在转移性疾病中的应用更为常见,在转移性疾病中它优于传统成像方式并推动治疗决策和调整,但最近它在局限性前列腺癌中也得到了应用,尤其是在高危疾病中。然而,PSMA PET/CT可能会在前列腺内发现病变,或者可能发现局部或转移性疾病,在疾病早期使用时并不总是代表真正的癌症,这可能会增加诊断负担并改变治疗决策。随着泌尿外科治疗方案朝着局限性器官局限性前列腺癌的局部治疗发展,最近的报告表明PSMA PET/CT在治疗规划和随访中甚至在选择主动监测时都有应用。本综述旨在揭示泌尿外科医生对其日常使用的当前观点。