Servicio de Medicina Nuclear, Complejo Hospitalario Universitario de Vigo, Vigo, Spain.
Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto Investigación Biosanitaria (IBS) Granada, Spain.
Rev Esp Med Nucl Imagen Mol (Engl Ed). 2024 Sep-Oct;43(5):500045. doi: 10.1016/j.remnie.2024.500045. Epub 2024 Jul 31.
The application of PET/CT with radiopharmaceuticals targeting PSMA is significantly transforming the diagnostic and therapeutic strategies of patients with prostate cancer. In Spain, the availability and access to positron-emitting radiopharmaceuticals targeting Prostate-Specific Membrane Antigen (PSMA) have significantly changed in recent months. These changes are affecting their use in diagnostic procedures. As a result, its use within diagnostic protocols for patients with prostate cancer is undergoing significant modifications. In this collective and cooperative document, the authors have selected the most robust evidence accumulated to date to generate a clinical guide to achieve appropriate use of this technology. A format that presents the most frequent clinical situations and the patient profiles in which PSMA PET/CT plays a significant role or will do so in the immediate future has been chosen. It should be taken into account that regulatory restrictions mediate the current indications for its use in Spain, as well as its current cost and the production capacity of radiopharmaceuticals. The guideline presents a review of the established methodology for optimized imaging with each of the radiopharmaceutical variants targeting PSMA and recommendations for structured and accurate reporting of metabolic findings in combination with CT.
正电子发射断层扫描/计算机断层扫描(PET/CT)联合放射性药物靶向前列腺特异性膜抗原(PSMA)的应用正在显著改变前列腺癌患者的诊断和治疗策略。在西班牙,近几个月来,用于诊断前列腺癌的放射性药物的供应和获取情况发生了显著变化。这些变化正在影响它们在诊断程序中的应用。因此,其在前列腺癌患者诊断方案中的应用正在发生重大改变。在这份集体合作文件中,作者选择了迄今为止积累的最有力证据,以制定临床指南,实现该技术的合理应用。选择了一种呈现最常见临床情况和 PSMA PET/CT 发挥重要作用或在不久的将来发挥作用的患者特征的格式。应该注意的是,监管限制调节了该技术在西班牙的当前适应证,以及其当前的成本和放射性药物的生产能力。该指南审查了针对 PSMA 的每种放射性药物变体进行优化成像的既定方法,并提出了代谢发现的结构化和准确报告建议,同时结合 CT 进行报告。