Guglielmo Priscilla, Buffi Nicolò, Porreca Angelo, Setti Lucia, Aricò Demetrio, Muraglia Lorenzo, Evangelista Laura
Nuclear Medicine Unit, Humanitas Gavazzeni, Bergamo, Italy.
Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Ann Nucl Med. 2025 Mar;39(3):247-254. doi: 10.1007/s12149-025-02015-w. Epub 2025 Jan 15.
The purpose of this systematic review was to evaluate the role of PSMA PET/CT in intermediate-risk prostate cancer (PCa) patients, to determine whether it could help improve treatment strategy and prognostic stratification. A systematic literature search up to May 2024 was conducted in the PubMed, Embase and Scopus databases. Articles with mixed risk patient populations, review articles, editorials, letters, comments, or case reports were excluded. The quality of the papers was assessed by using the CASP criteria. The literature search returned 1111 studies; however, 1105 articles were excluded, and therefore 6 full-text papers were retrieved for the final analysis. Three out of six papers focused on the utility of SUVmax in identifying high ISUP grade in patients with intermediate-risk PCa. The latest three papers discussed the controversial role of PSMA PET/CT in predicting the lymph node involvement, mainly in the case of favorable subset. PSMA PET has completely changed the management of patients with PCa; indeed its role is still undefined in patients with intermediate-risk disease. Future perspective is to investigate larger cohorts of intermediate-risk PCa patients, to fully recognize the added value offered by PSMA PET in this category of subjects.
本系统评价的目的是评估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）在中危前列腺癌（PCa）患者中的作用，以确定其是否有助于改善治疗策略和预后分层。截至2024年5月，我们在PubMed、Embase和Scopus数据库中进行了系统的文献检索。排除了研究对象为混合风险患者群体的文章、综述文章、社论、信件、评论或病例报告。采用CASP标准评估论文质量。文献检索共返回1111项研究；然而，排除了1105篇文章，因此最终分析仅检索到6篇全文论文。6篇论文中有3篇聚焦于SUVmax在识别中危PCa患者高国际泌尿病理学会（ISUP）分级方面的效用。最近的3篇论文讨论了PSMA PET/CT在预测淋巴结受累方面存在争议的作用，主要是在有利亚组的情况下。PSMA PET已经彻底改变了PCa患者的管理方式；事实上，其在中危疾病患者中的作用仍不明确。未来的研究方向是调查更大规模的中危PCa患者队列，以充分认识PSMA PET在此类患者中提供的附加价值。
