Li Xiao, Yu Mingming, Yang Jian, Li Danni, Li Rou, Mao Juanli, Zuo Changjing, Liang Zeying, Li Qiang, Cheng Chao
Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, 204333, China.
Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai, 201800, China.
EJNMMI Rep. 2024 Sep 9;8(1):28. doi: 10.1186/s41824-024-00217-5.
To evaluate the physiological distribution and tumour detection ability of [F]AlF-PSMA-11 positron emission tomography (PET) dual-phase scans in patients with prostate cancer (PCa).
As a retrospective study, clinical and PET data of PCa patients who underwent dual-phase [F]AlF-PSMA-11 PET of routine scan (45-50 min) and delayed scan (120 min) from November 2020 to June 2021 were collected, and physiological and pathological regions of interest were quantified to determine the time-dependent maximum standardized uptake value (SUV) of [F]AlF-PSMA-11. Part of the above subjects who underwent [Ga]Ga-PSMA-11 PET in the following 6 months were included in a head-to-head comparison. The difference with a p-value < 0.05 was defined as statistical significance. Diagnosis accuracy of primary and metastatic lesions was measured referring to the surgical findings, pathology, and follow-up imaging.
[Ga]Ga-PSMA-11 and [F]AlF-PSMA-11 were of the comparable uptake in glands in head, but the latter was of a significant lower distribution in liver and spleen. For the 25 patients initially diagnosed with prostate cancer and 3 patients with biochemical recurrence after radical surgery, the SUV of the primary lesions, lacrimal glands, parotid glands and submandibular glands was higher at 120 min compared to that at 45-50 min, but not a significant difference. SUV of the liver, spleen and bladder decreased significantly at 120 min, but the bladder SUV remained higher than that of primary lesions. SUV of the kidneys and centrum was the same in dual-phase scans. For the 31 primary lesions detected in [F]AlF-PSMA-11 PET, both the SUV of the two phases kept the positive correlation with PSA, Gleason score and initial risk stratification. For the 39 distant metastatic lesions, 94.87% accuracy of routine scan and 100% accuracy of delayed scan were acquired, and 7.14% patients (2/28) benefited from the dual-phase [F]AlF-PSMA-11 scans that revealed novel information on metastatic lesions compared to the routine scan.
[F]AlF-PSMA-11 PET expanded the time window and further decreased metabolic background of [Ga]Ga-PSMA-11 PET. The dual-phase scan of [F]AlF-PSMA-11 PET can benefit prostate cancer diagnosis via providing more PSMA-specific information.
评估[F]AlF-PSMA-11正电子发射断层扫描（PET）双期扫描在前列腺癌（PCa）患者中的生理分布及肿瘤检测能力。
作为一项回顾性研究，收集了2020年11月至2021年6月期间接受常规扫描（45 - 50分钟）和延迟扫描（120分钟）的[F]AlF-PSMA-11 PET双期扫描的PCa患者的临床及PET数据，对生理和病理感兴趣区域进行量化，以确定[F]AlF-PSMA-11的时间依赖性最大标准化摄取值（SUV）。将上述部分在接下来6个月内接受[Ga]Ga-PSMA-11 PET检查的受试者纳入头对头比较。p值<0.05的差异定义为具有统计学意义。参照手术结果、病理及随访影像测量原发灶和转移灶的诊断准确性。
[Ga]Ga-PSMA-11和[F]AlF-PSMA-11在头部腺体中的摄取相当，但后者在肝脏和脾脏中的分布显著更低。对于25例初诊前列腺癌患者及3例根治术后生化复发患者，原发灶、泪腺、腮腺及颌下腺在120分钟时的SUV高于45 - 50分钟时，但差异无统计学意义。肝脏、脾脏及膀胱的SUV在120分钟时显著下降，但膀胱SUV仍高于原发灶。双期扫描中肾脏和椎体的SUV相同。对于[F]AlF-PSMA-11 PET检测到的31个原发灶，两期的SUV均与前列腺特异抗原（PSA）、 Gleason评分及初始风险分层呈正相关。对于39个远处转移灶，常规扫描的准确率为94.87%，延迟扫描的准确率为100%，7.14%的患者（2/28）从[F]AlF-PSMA-11 PET双期扫描中获益，与常规扫描相比，该扫描揭示了转移灶的新信息。
[F]AlF-PSMA-11 PET扩展了时间窗并进一步降低了[Ga]Ga-PSMA-11 PET的代谢背景。[F]AlF-PSMA-11 PET双期扫描可通过提供更多PSMA特异性信息有助于前列腺癌的诊断。
