锝标记的iPSMA SPECT/CT在低中危、高危和极高危前列腺癌患者初始分期中的诊断性能：与氟标记的PSMA-1007 PET/CT的对比分析

Diagnostic Performance of Tc-iPSMA SPECT/CT in the Initial Staging of Patients with Unfavorable Intermediate-, High-, and Very High-Risk Prostate Cancer: A Comparative Analysis with F-PSMA-1007 PET/CT.

作者信息

Vargas-Ahumada Joel E, González-Rueda Sofía Denisse, Sinisterra-Solís Fabio Andrés, Casanova-Triviño Pamela, Pitalúa-Cortés Quetzali, Soldevilla-Gallardo Irma, Scavuzzo Anna, Jimenez-Ríos Miguel Angel, García-Pérez Francisco Osvaldo

机构信息

Nuclear Medicine Department, Instituto Nacional de Cancerología, Tlalpan, Mexico City 14080, Mexico.

Urologic Sugery Department, Instituto Nacional de Cancerología, Tlalpan, Mexico City 14080, Mexico.

出版信息

Cancers (Basel). 2023 Dec 13;15(24):5824. doi: 10.3390/cancers15245824.

DOI:10.3390/cancers15245824

PMID:38136369

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10742124/

Abstract

UNLABELLED

Prostate cancer is a leading cause of cancer death in men worldwide. Imaging plays a key role in disease detection and initial staging. Emerging data has shown the superiority of PSMA imaging with PET/CT over conventional imaging for primary diagnoses. Single photon emission computed tomography is more available worldwide, and the imaging agent is low in cost. The aim of this study is to compare the diagnostic accuracy of Tc-EDDA/HYNIC-iPSMA SPECT/CT to F-PSMA-1007 PET/CT in the primary diagnosis of prostate cancer and the impact on clinical staging.

METHODS

In this prospective controlled study, 18 patients with histologically confirmed prostate cancer with unfavorable intermediate-, high-, and very high-risk characteristics were recruited to undergo F-PSMA-PET/CT and Tc-iPSMA SPECT/CT. The median age of the patients was 71 years old, and the median PSA level was 23.3 ng/mL. Lesions were divided into the prostate, seminal vesicles, lymph nodes, bone, and visceral metastases. Volumetric analysis was also performed between the two imaging modalities and correlated with PSA levels.

RESULTS

A total of 257 lesions were detected on F-PSMA-PET/CT: prostate (n = 18), seminal vesicles (n = 12), locoregional lymph nodes (n = 62), non-locoregional (n = 67), bone (n = 90), and visceral (n = 8). Of these, Tc-iPSMA-SPECT/CT detected 229 lesions, while both reviewers detected 100% of the lesions in the prostate (18/18), seminal vesicles (12/12), and visceral (8/8); LN LR (56/62; 90%), NLR (57/67; 85%), and bone (78/90; 86%). There were no statistically significant differences between volumetric parameters ( = -0.02122; = 0.491596).

CONCLUSIONS

Tc-iPSMA SPECT/CT is useful in the primary diagnosis of prostate cancer. Despite it showing a slightly lower lesion detection rate compared to F-PSMA PET/CT, it exhibited no impact on clinical staging and, consequently, the initial treatment intention.

摘要

未标注

前列腺癌是全球男性癌症死亡的主要原因。影像学在疾病检测和初始分期中起着关键作用。新出现的数据表明，PSMA成像结合PET/CT在原发性诊断方面优于传统成像。单光子发射计算机断层扫描在全球范围内更易获得，且成像剂成本较低。本研究的目的是比较Tc-EDDA/HYNIC-iPSMA SPECT/CT与F-PSMA-1007 PET/CT在前列腺癌原发性诊断中的诊断准确性以及对临床分期的影响。

方法

在这项前瞻性对照研究中，招募了18例经组织学确诊的具有不良中危、高危和极高危特征的前列腺癌患者，接受F-PSMA-PET/CT和Tc-iPSMA SPECT/CT检查。患者的中位年龄为71岁，中位PSA水平为23.3 ng/mL。病变分为前列腺、精囊、淋巴结、骨和内脏转移。还对两种成像方式进行了体积分析，并与PSA水平相关联。

结果

F-PSMA-PET/CT共检测到257个病变：前列腺（n = 18）、精囊（n = 12）、局部区域淋巴结（n = 62）、非局部区域（n = 67）、骨（n = 90）和内脏（n = 8）。其中，Tc-iPSMA-SPECT/CT检测到229个病变，而两位阅片者均检测到前列腺（18/18）、精囊（12/12）和内脏（8/8）中的所有病变；局部区域淋巴结（56/62；90%）、非局部区域淋巴结（57/67；85%）和骨（78/90；86%）。体积参数之间无统计学显著差异（ = -0.02122； = 0.491596）。