Pisotskyi Oleksii, Petrasz Piotr, Zorga Piotr, Gałęski Marcin, Szponar Paweł, Koper Krzysztof, Brzeźniakiewicz-Janus Katarzyna, Drewa Tomasz, Kaczmarek Krzysztof, Cezary Czarnogórski Michał, Adamowicz Jan
Urology and Urological Oncology Department, Multidisciplinary Regional Hospital, Gorzow Wielkopolski, Poland.
Department and Chair of Urology and Andrology, University Hospital No. 1 in Bydgoszcz, Ludwik Rydygier's Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.
Cent European J Urol. 2025;78(1):52-60. doi: 10.5173/ceju.2025.0014. Epub 2025 Mar 14.
Prostate cancer (PC) remains a significant global health burden, necessitating accurate staging for optimal treatment planning. Conventional imaging methods, including multiparametric magnetic resonance imaging (mpMRI), computed tomography (CT), and bone scintigraphy (BS), exhibit limitations in sensitivity and specificity. Gallium-68 prostate-specific membrane antigen positron emission tomography/computed tomography (Ga PSMA-PET/CT) has emerged as a promising alternative, with potential advantages in staging accuracy.
A comprehensive review of current literature was conducted to assess the role of Ga PSMA-PET/CT in primary PC staging. The diagnostic performance of PSMA-PET/CT was compared with conventional imaging techniques in detecting locoregional and distant metastases. Studies evaluating sensitivity, specificity, and clinical utility in treatment decision-making were analyzed.
Ga PSMA-PET/CT demonstrated superior sensitivity and specificity in detecting lymph node and distant metastases compared to conventional imaging. It enables earlier and more precise disease staging, potentially reducing the need for multiple imaging modalities. Emerging evidence suggests its role in guiding therapeutic strategies, particularly in high-risk and recurrent PC cases. Despite its advantages, limitations such as accessibility, cost, and occasional false-negative findings must be considered.
Ga PSMA-PET/CT represents a transformative diagnostic tool for PC staging, offering enhanced accuracy compared to traditional imaging. Its integration into clinical practice could streamline diagnostic pathways, improve treatment selection, and potentially optimize patient outcomes. Further research and cost-effectiveness analyses are needed to establish its widespread implementation.
前列腺癌(PC)仍然是一项重大的全球健康负担,因此需要进行准确分期以制定最佳治疗方案。包括多参数磁共振成像(mpMRI)、计算机断层扫描(CT)和骨闪烁显像(BS)在内的传统成像方法在敏感性和特异性方面存在局限性。镓-68前列腺特异性膜抗原正电子发射断层扫描/计算机断层扫描(Ga PSMA-PET/CT)已成为一种有前景的替代方法,在分期准确性方面具有潜在优势。
对当前文献进行全面综述,以评估Ga PSMA-PET/CT在原发性PC分期中的作用。将PSMA-PET/CT的诊断性能与传统成像技术在检测局部和远处转移方面进行比较。分析评估其在治疗决策中的敏感性、特异性和临床实用性的研究。
与传统成像相比,Ga PSMA-PET/CT在检测淋巴结和远处转移方面显示出更高的敏感性和特异性。它能够实现更早、更精确的疾病分期,可能减少对多种成像方式的需求。新出现的证据表明其在指导治疗策略方面的作用,特别是在高危和复发性PC病例中。尽管具有优势,但必须考虑其可及性、成本和偶尔出现的假阴性结果等局限性。
Ga PSMA-PET/CT是一种用于PC分期的变革性诊断工具,与传统成像相比具有更高的准确性。将其纳入临床实践可以简化诊断流程,改善治疗选择,并可能优化患者预后。需要进一步的研究和成本效益分析来确定其广泛应用。