Department of Radiology and Nuclear Medicine, Erasmus MC, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands.
Department of Medical Oncology, Erasmus MC, Rotterdam, the Netherlands.
Ann Nucl Med. 2024 Nov;38(11):913-918. doi: 10.1007/s12149-024-01965-x. Epub 2024 Jul 26.
In 2021, the tubarial salivary glands (TSGs) were newly identified on prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) as macroscopic glands in the nasopharyngeal wall. However, the relative contribution of the TSGs to the total salivary gland function, and consequently on the development of xerostomia after external beam radiotherapy (EBRT) or PSMA-targeted radionuclide therapy (RNT) is not known. Therefore, we aimed to determine the presence of the TSGs and to quantify uptake in the TSGs on PSMA PET.
Qualitative and quantitative analyses were performed on Ga-PSMA-11 PET/CT scans of 100 patients with prostate cancer. The mean and maximum standardized uptake value (SUVmean and SUVmax) in the TSGs were measured and compared to the parotid, submandibular and sublingual salivary glands (PSGs, SMSGs and SLSGs, respectively). Furthermore, proportional function of the TSGs was compared to the PSGs, SMSGs and SLSGs based on the total organ PSMA (TO-PSMA).
The TSGs were visible on 95% of the Ga-PSMA-11 PET/CT scans. The normalized median SUVmean and SUVmax was significantly higher for the PSGs (p < 0.001) and SMSGs (p < 0.001) compared to the TSGs, but not for the SLSGs (p = 0.242 and p = 0.300, respectively). The normalized median TO-PSMA was significantly higher for the PSGs (p < 0.001) and SMSGs (p < 0.001), and significant lower for the SLSGs (p < 0.001) compared the TSGs.
The SUVmean, SUVmax and TO-PSMA of the TSGs were most comparable to the SLSGs. However, the measured PSMA uptake may be disproportional towards the saliva production. Therefore, future studies should focus on the relation between PSMA uptake and salivary function before and after PSMA therapy.
2021 年，在前列腺特异性膜抗原（PSMA）正电子发射断层扫描/计算机断层扫描（PET/CT）上，新发现了管周唾液腺（TSG）作为鼻咽壁上的宏观腺体。然而，TSG 对总唾液腺功能的相对贡献，以及随后在外照射放疗（EBRT）或 PSMA 靶向放射性核素治疗（RNT）后发生口干的程度尚不清楚。因此，我们旨在确定 TSG 的存在，并对 PSMA PET 上 TSG 的摄取进行定量分析。
对 100 例前列腺癌患者的 Ga-PSMA-11 PET/CT 扫描进行定性和定量分析。测量 TSG 中的平均和最大标准化摄取值（SUVmean 和 SUVmax），并与腮腺、颌下腺和舌下腺（PSG、SMSG 和 SLSG）进行比较。此外，基于总器官 PSMA（TO-PSMA），比较 TSG 与 PSG、SMSG 和 SLSG 的相对功能。
95%的 Ga-PSMA-11 PET/CT 扫描可见 TSG。PSG（p<0.001）和 SMSG（p<0.001）的标准化 SUVmean 和 SUVmax 中位数明显高于 TSG，但 SLSG 无统计学差异（p=0.242 和 p=0.300）。PSG（p<0.001）和 SMSG（p<0.001）的标准化 TO-PSMA 中位数明显高于 TSG，而 SLSG 明显低于 TSG（p<0.001）。
TSG 的 SUVmean、SUVmax 和 TO-PSMA 与 SLSG 最相似。然而，测量的 PSMA 摄取可能与唾液产生不成比例。因此，未来的研究应集中在 PSMA 治疗前后 PSMA 摄取与唾液功能之间的关系上。
