Department of Nuclear Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
Eur J Nucl Med Mol Imaging. 2023 Nov;50(13):4096-4106. doi: 10.1007/s00259-023-06355-5. Epub 2023 Aug 14.
The purpose of this study was to assess whether total-body [ Ga]Ga-PSMA-11 PET/CT could improve the detection rate compared with conventional [ Ga]Ga-PSMA-11 PET/CT in patients with biochemical recurrent prostate cancer.
Two hundred biochemical recurrent prostate cancer patients with similar clinicopathological characteristics were included, of whom 100 patients underwent early total-body [ Ga]Ga-PSMA-11 PET/CT and diuretic-delayed total-body [ Ga]Ga-PSMA-11 PET/CT, and the other 100 patients received early conventional [ Ga]Ga-PSMA-11 PET/CT and diuretic-delayed conventional [ Ga]Ga-PSMA-11 PET/CT. The detection rates of total-body [ Ga]Ga-PSMA-11 PET/CT and conventional [ Ga]Ga-PSMA-11 PET/CT were compared using a chi-square test and stratified analysis. The image quality of total-body [ Ga]Ga-PSMA PET/CT and conventional [ Ga]Ga-PSMA-11 PET/CT was compared based on subjective scoring and objective parameters. Subjective scoring was conducted from background noise and lesion prominence using a 5-point scale. Objective parameters were evaluated by SUVmax, SUVmean, the standard deviation (SD) of SUV, and the signal-to-noise ratio (SNR) of liver and gluteus maximus. The SUVmax of the recurrent lesions was also measured.
The liver SD of the total-body [ Ga]Ga-PSMA-11 PET/CT was significantly lower than that of conventional [ Ga]Ga-PSMA-11 PET/CT, the SNR was significantly higher than that of conventional [ Ga]Ga-PSMA-11 PET/CT, and the subjective evaluation was significantly better than that of conventional [ Ga]Ga-PSMA-11 PET/CT. The detection rate of total-body [ Ga]Ga-PSMA PET/CT for biochemical recurrence of prostate cancer was significantly higher than that of conventional [ Ga]Ga-PSMA-11 PET/CT (91.0% vs. 74.0%, P = 0.003). Total-body [ Ga]Ga-PSMA-11 PET/CT had better detection efficiency for patients with a Gleason score ≤ 8 or PSA ≤ 2 ng/ml. The advantages of diuretic-delayed total-body [ Ga]Ga-PSMA-11 PET/CT were more obvious.
Total-body [ Ga]Ga-PSMA-11 PET/CT could significantly improve the detection rate compared with conventional [ Ga]Ga-PSMA-11 PET/CT in patients with biochemical recurrent prostate cancer.
本研究旨在评估全身[68Ga]Ga-PSMA-11 PET/CT 是否比传统的[68Ga]Ga-PSMA-11 PET/CT 更能提高生化复发前列腺癌患者的检测率。
本研究纳入了 200 例具有相似临床病理特征的生化复发前列腺癌患者，其中 100 例患者接受了早期全身[68Ga]Ga-PSMA-11 PET/CT 和利尿剂延迟全身[68Ga]Ga-PSMA-11 PET/CT 检查，另外 100 例患者接受了早期传统[68Ga]Ga-PSMA-11 PET/CT 和利尿剂延迟传统[68Ga]Ga-PSMA-11 PET/CT 检查。使用卡方检验和分层分析比较全身[68Ga]Ga-PSMA-11 PET/CT 和传统[68Ga]Ga-PSMA-11 PET/CT 的检测率。基于主观评分和客观参数比较全身[68Ga]Ga-PSMA PET/CT 和传统[68Ga]Ga-PSMA-11 PET/CT 的图像质量。主观评分采用 5 分制评估背景噪声和病变突出程度。客观参数通过 SUVmax、SUVmean、SUV 标准差（SD）和肝脏及臀肌的信噪比（SNR）进行评估。还测量了复发病灶的 SUVmax。
全身[68Ga]Ga-PSMA-11 PET/CT 的肝脏 SD 明显低于传统[68Ga]Ga-PSMA-11 PET/CT，SNR 明显高于传统[68Ga]Ga-PSMA-11 PET/CT，主观评价明显优于传统[68Ga]Ga-PSMA-11 PET/CT。全身[68Ga]Ga-PSMA PET/CT 对前列腺癌生化复发的检测率明显高于传统[68Ga]Ga-PSMA-11 PET/CT（91.0% vs. 74.0%，P=0.003）。全身[68Ga]Ga-PSMA-11 PET/CT 对 Gleason 评分≤8 或 PSA≤2ng/ml 的患者具有更好的检测效率。利尿剂延迟全身[68Ga]Ga-PSMA-11 PET/CT 的优势更加明显。
全身[68Ga]Ga-PSMA-11 PET/CT 可显著提高生化复发前列腺癌患者的检测率，优于传统[68Ga]Ga-PSMA-11 PET/CT。
