常规的前列腺特异性膜抗原正子发射断层扫描/计算机断层扫描如何改变目前的前列腺癌管理? 一个多学科的观点
Daniela E Oprea-Lager1,2, Tessa van Elst3,4, Shafak Aluwini5
1Department of Radiology & Nuclear Medicine, Amsterdam University Medical Center, VU University, Amsterdam, The Netherlands.
European urology open science
|April 21, 2025
概括
前列腺特异性膜抗原正子发射断层扫描/计算机断层扫描 (PSMA-PET/CT) 首选用于转移性前列腺癌的分期. 专家们同意它用于治疗规划,但解释疾病程度的标准需要改进.
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:
- 前列腺特异性膜抗原正子发射断层扫描/计算机断层扫描 (PSMA-PET/CT) 和新的治疗方法正在改变转移性前列腺癌 (PCa) 管理.
- 这些进展在临床实践中的实施需要就定义和成像策略达成共识.
研究的目的:
- 在先进成像时代,在荷兰专家之间就定义,阶段化成像的首选和转移性PCa的治疗选择达成共识.
- 制定将PSMA-PET/CT整合到常规PCa护理中的指导方针.
主要方法:
- 采用了经过修改的Delphi方法,包括两轮投票和与40名荷兰PCa专家的面对面会议.
- 共识被定义为≥75%的小组成员之间的共识;适当性使用RAND/UCLA方法进行评估.
主要成果:
- 在使用PSMA-PET/CT用于不良中期或高风险PCa的转移性查方面达成共识.
- 对于同步转移性激素敏感PCa患者的治疗决策,PSMA-PET/CT发现被认为是可行的,大多数人赞成基于阶段变化的治疗加剧或减强.
- 在解释PSMA-PET/CT转移性疾病体积的CHAARTED标准上没有达成一致,这凸显了具体标准应用的不确定性.
结论:
- 在荷兰,PSMA-PET/CT是首选用于PCa初始分期的方法,并且越来越多地纳入治疗计划.
- 虽然PSMA-PET/CT指导治疗强化和减强,但解释转移性疾病体积的明确标准仍然不确定,需要进一步研究.
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