Mohseninia Nasibeh, Zamani-Siahkali Nazanin, Harsini Sara, Divband Ghasemali, Pirich Christian, Beheshti Mohsen
Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, Salzburg, Austria.
Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital, Paracelsus Medical University, Salzburg, Austria; Department of Nuclear Medicine, Research center for Nuclear Medicine and Molecular Imaging, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Semin Nucl Med. 2024 Jan;54(1):97-118. doi: 10.1053/j.semnuclmed.2023.07.004. Epub 2023 Aug 17.
Prostate cancer is the second most common cause of malignancy among men, with bone metastasis being a significant source of morbidity and mortality in advanced cases. Detecting and treating bone metastasis at an early stage is crucial to improve the quality of life and survival of prostate cancer patients. This objective strongly relies on imaging studies. While CT and MRI have their specific utilities, they also possess certain drawbacks. Bone scintigraphy, although cost-effective and widely available, presents high false-positive rates. The emergence of PET/CT and PET/MRI, with their ability to overcome the limitations of standard imaging methods, offers promising alternatives for the detection of bone metastasis. Various radiotracers targeting cell division activity or cancer-specific membrane proteins, as well as bone seeking agents, have been developed and tested. The use of positron-emitting isotopes such as fluorine-18 and gallium-68 for labeling allows for a reduced radiation dose and unaffected biological properties. Furthermore, the integration of artificial intelligence (AI) and radiomics techniques in medical imaging has shown significant advancements in reducing interobserver variability, improving accuracy, and saving time. This article provides an overview of the advantages and limitations of bone scan using SPECT and SPECT/CT and PET imaging methods with different radiopharmaceuticals and highlights recent developments in hybrid scanners, AI, and radiomics for the identification of prostate cancer bone metastasis using molecular imaging.
前列腺癌是男性中第二常见的恶性肿瘤病因，在晚期病例中，骨转移是发病和死亡的重要原因。早期检测和治疗骨转移对于提高前列腺癌患者的生活质量和生存率至关重要。这一目标很大程度上依赖于影像学检查。虽然CT和MRI有其特定的用途，但也存在某些缺点。骨闪烁显像虽然具有成本效益且应用广泛，但假阳性率较高。PET/CT和PET/MRI的出现，因其能够克服标准成像方法的局限性，为骨转移的检测提供了有前景的替代方案。已经研发并测试了多种针对细胞分裂活性或癌症特异性膜蛋白的放射性示踪剂以及亲骨剂。使用正电子发射同位素如氟-18和镓-68进行标记可降低辐射剂量且不影响生物学特性。此外，人工智能（AI）和放射组学技术在医学成像中的整合在减少观察者间差异、提高准确性和节省时间方面已显示出显著进展。本文概述了使用SPECT、SPECT/CT以及采用不同放射性药物的PET成像方法进行骨扫描的优缺点，并重点介绍了在使用分子成像识别前列腺癌骨转移方面，混合扫描仪、AI和放射组学的最新进展。
