-68前列腺特异性膜抗原正子发射断层扫描/计算机断层扫描在前列腺癌试验 (PASPoRT) 的积极监测中
Joris G Heetman1, Jules Lavalaye2, Pepijn D Polm1
1Department of Urology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands.
European urology oncology
|June 9, 2023
概括
将前列腺特异性膜抗原 (PSMA) PET/CT扫描添加到标准实践中,有助于在积极监测中的患者中识别更具侵略性的前列腺癌 (PCa). 这种成像改善了风险分层和患者选择治疗的情况,可能防止诊断不足.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
背景情况:
- 目前用于选择前列腺癌 (PCa) 患者进行主动监测 (AS) 的方法是不完美的,使用临床参数和预视镜MRI.
- 前列腺特异性膜抗原 (PSMA) 定子发射断层扫描/计算机断层扫描 (PET/CT) 影像提供了改善风险分层的潜力.
研究的目的:
- 评估将PSMA PET/CT纳入PCa风险分层和AS患者选择标准实践中的有效性.
- 为了确定需要扫描 (NNS) 检测一个癌症升级患者的数量.
主要方法:
- 一项前性队列研究招募了141名PCa患者开始AS,所有人都进行了预视镜MRI和向活检.
- 患者接受了额外的[68Ga]-PSMA PET/CT,并针对之前未进行活检的PSMA急性病变 (SUVmax ≥4) 进行了针对性的活检.
- 主要结果是NNS升级;次要结果分析了通过后勤回归升级的可能性.
主要成果:
- 额外的PSMA PET/CT和向活检导致9%的患者癌症升级 (13/141).
- 检测升级的NNS为11 (95%CI 6-18). 这样可以检测到升级.
- 升级最常见的是阴性MRI (PI-RADS 1-2),PSA密度较高,并接受了额外的PSMA向活检的患者.
结论:
- 结合PSMA PET/CT和向活检,可以在AS患者的标准MRI和活检中识别出更具侵略性的PCa.
- 这种方法提高了AS的风险分层和患者选择,特别是在最初风险发现有利的患者中.
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