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哪些患有负PSMA-PET成像的患者可以安全地避免进行前列腺癌活检? 这是迈向基于PSMA的无活检策略的新一步

Yujia Li¹, Jinhui Yang¹, Ling Xiao¹

¹Department of Nuclear Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.

European journal of nuclear medicine and molecular imaging

|January 25, 2025

概括

65岁以下的男性,阴性前列腺特异性膜抗原正子发射断层扫描 (PSMA-PET) 扫描,可以安全地避免活检. 年轻的年龄改善了PSMA-PET.

科学领域:

泌尿器科泌尿器科泌尿器科泌尿器科
放射学放射学是一门学科.
在瘤学瘤学.

背景情况:

前列腺活检是诊断前列腺癌的标准.
PSMA-PET成像显示在检测前列腺癌方面具有前景.
识别那些可以安全避免活检的男性至关重要.

研究的目的:

为了确定负的PSMA-PET结果是否可以帮助选择男性进行活检,避免或延迟.
评估年龄在预测PSMA-PET阴性男性临床显著前列腺癌 (csPCa) 中的作用.

主要方法:

一项前性队列研究,涉及111名以前没有接受过治疗的男性,其PSMA-PET阴性 (PRIMARY-score 1/2).
所有参与者都接受了PSMA-PET和组织病理学检查.
使用多变量逻辑回归和ROC分析来确定非csPCa (等级组<2) 的预测因素.

主要成果:

年龄较小 (<65岁) 是缺少csPCa的独立预测因子 (P=0.006).
对于csPCa,PSMA-PET的负预测值 (NPV) 随着年龄的降低而增加,在65岁以下的男性中达到98%,在60岁以下的男性中达到100%.
将负PSMA-PET与负MRI结合起来,在男性<65.5岁时,NPV进一步提高到100%.

结论:

65岁以下的男性呈阴性PSMA-PET (PRIMARY 1/2) 可能是活检遗漏或推迟的候选人.
对年长的男性 (≥65岁) 进行活检仍然可以考虑,这些男性的PSMA-PET阴性和临床怀疑很高.
在前性,外部研究中进一步验证这一策略是有必要的.

关键词:

主要分数 - 主要分数在PSMA上,PSMA可以在PSMA上进行交易.定子发射断层扫描 (PET) 是一种定子发射断层扫描.测试的预测值测试的预测值.前列腺新生体前列腺瘤.

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