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术前[镓]镓-PSMA-11 PET/CT对疑似胶质源性脑肿瘤患者的诊断及早期预后的意义。

Imply on diagnosis and early prognosis of preoperative [Ga]Ga-PSMA-11 PET/CT in patients with suspected brain tumours of glial origin.

作者信息

Pełka K, Koczyk K, Koperski L, Dziedzic T, Nowak A, Królicki L, Kunert P, Kunikowska J

机构信息

Nuclear Medicine Department, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland.

Laboratory of Centre for Preclinical Research, Department of Research Methodology, Medical University of Warsaw, Warsaw, Poland.

出版信息

Sci Rep. 2025 Jan 2;15(1):214. doi: 10.1038/s41598-024-84036-5.

Abstract

PET/CT targeting prostate-specific membrane antigen (PSMA) is commonly used in patients with prostate cancer. PSMA has been found in other solid tumours, including primary brain tumours. The aim of this study was to evaluate the usefulness of [Ga]Ga-PSMA-11 PET/CT for preoperative diagnosis and 2-year prognosis. We prospectively screened patients with suspected glioma tumour. The PET/CT qualitative and quantitative results were compared to the histopathological examination. We compared glioblastoma (GBM) diagnostic data or between high-grade (HGG) and low-grade (LGG) gliomas. Overall (OS) and progression free survival (PFS) were analysed. Forty-four patients met the inclusion criteria. Twenty of them had positive and twenty-four negative scans. The sensitivity, specificity, positive predictive value, and negative predictive value for HGG diagnosis were 71.4 (95% confidence interval - 51.3-86.8), 100.0 (79.4-100.0), 100.0 (83.1-100.0), and 66.7 (44.7-84.4), respectively. For differentiation between GBM vs non-GBM tumours, the best parameter was the tumour-to-background ratio, with the area under the receiver operating characteristic curve 0.81 (0.66-0.96; 42.2) (95% CI; cut-off). Patients with positive PET/CT scans had similar PFS and OS to patients with HGG. PSMA accumulation negatively affected the PFS and OS of patients with diagnosed GBM. [Ga]Ga-PSMA-11 PET/CT showed optimistic diagnostic results and may be prognostic a factor.Registration at www.clinicaltrials.gov 09/06/2023 with number NCT05896449.

摘要

正电子发射断层扫描/计算机断层扫描(PET/CT)靶向前列腺特异性膜抗原(PSMA)常用于前列腺癌患者。PSMA也存在于其他实体瘤中,包括原发性脑肿瘤。本研究的目的是评估[镓]Ga-PSMA-11 PET/CT在术前诊断和2年预后评估中的作用。我们前瞻性地筛选了疑似胶质瘤患者。将PET/CT的定性和定量结果与组织病理学检查结果进行比较。我们比较了胶质母细胞瘤(GBM)的诊断数据,以及高级别(HGG)和低级别(LGG)胶质瘤之间的数据。分析了总生存期(OS)和无进展生存期(PFS)。44名患者符合纳入标准。其中20人扫描结果为阳性,24人扫描结果为阴性。HGG诊断的敏感性、特异性、阳性预测值和阴性预测值分别为71.4(95%置信区间-51.3-86.8)、100.0(79.4-100.0)、100.0(83.1-100.0)和66.7(44.7-84.4)。对于GBM与非GBM肿瘤的鉴别,最佳参数是肿瘤与本底比值,受试者操作特征曲线下面积为0.81(0.66-0.96;42.2)(95%CI;临界值)。PET/CT扫描阳性的患者与HGG患者的PFS和OS相似。PSMA聚集对诊断为GBM的患者的PFS和OS有负面影响。[镓]Ga-PSMA-11 PET/CT显示出乐观的诊断结果,可能是一个预后因素。于2023年06月09日在www.clinicaltrials.gov注册,编号为NCT05896449。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/077c/11697079/93f685aa64b0/41598_2024_84036_Fig1_HTML.jpg

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