在诊断前列腺癌节点转移中PSMA PET/CT准确性
Pietro Pepe1, Ludovica Pepe2, Vincenzo Fiorentino2
1Urology Unit, Cannizzaro Hospital, Catania, Italy; piepepe@hotmail.com.
In vivo (Athens, Greece)
|October 30, 2024
概括
前列腺特异性膜抗原 (PSMA) PET/CT在前列腺癌中显示出高精度的骨盆节点分期. 然而,负的PSMA PET/CT在高风险病例中可能不排除转移,因此需要进一步切解淋巴结.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 核医学就是核医学.
背景情况:
- 盆腔结节的分期对于前列腺癌 (PCa) 管理至关重要.
- 精确的分期影响治疗决策和患者的结果.
研究的目的:
- 评估前列腺特异性膜抗原 (PSMA) 定向正子发射断层扫描/计算机断层扫描 (PET/CT) 的诊断准确性,用于前列腺癌的骨盆结节分期.
- 为了比较PSMA PET/CT发现与术后遗传病理学结果.
主要方法:
- 78名具有临床意义的前列腺癌患者接受了激进前列腺切除和扩展的骨盆淋巴结解剖 (ePLND).
- 所有患者都接受了手术前的PSMA PET/CT,用于临床分期.
- 对PSMA PET/CT (SUVmax) 的焦点吸收被评估为结节转移.
主要成果:
- 在PSMA PET/CT中,在20.5%的患者中发现了结节转移,而组织学证实了23.1%.
- 对于结节转移的PSMA PET/CT的整体诊断准确率为92.3% (灵敏度为87.5%,特异性为96.8%).
- 准确度在等级组2PCa中为100%,但在等级组5PCa下降到63.6%,特别是在管道腺癌中.
结论:
- 在前列腺癌中,PSMA PET/CT是用于骨盆节点分期的高精度工具.
- 在高风险患者或带管道腺癌患者中,负的PSMA PET/CT不应排除需要进行扩展的盆腔淋巴结剖析.
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