在前列腺癌的诊断中使用PSMA PET/CT:为什么以及何时?
Pietro Pepe1, Ludovica Pepe2, Daniele Cignoli3
1Urology Unit, Cannizzaro Hospital, Catania. piepepe@hotmail.com.
概括
前列腺特异性膜抗原 (PSMA) PET/CT对检测前列腺癌 (PCa) 有希望,与瘤的攻击性相关. 虽然有效,但它的使用仍然是实验性的,具有成本和可用性等局限性.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 核医学是一种核医学.
背景情况:
- 前列腺特异性膜抗原 (PSMA) 在前列腺癌 (PCa) 中高度表达,包括转移性疾病.
- PSMA的表达与原发性瘤的攻击性相关.
- 标有68 (68Ga) 和18 (18F) 的PSMA抑制剂用于PCa检测.
研究的目的:
- 评估PSMA正子发射断层扫描/计算机断层扫描 (PET/CT) 在检测PCa.的作用.
- 评估PSMA PET/CT在各种临床场景中的性能,包括高风险PCa和主动监测.
- 为了比较PSMA PET/CT与多参数MRI (mpMRI) 向活检用于PCa检测.
主要方法:
- 在接受前列腺活检或监测的男性中评估了PSMA PET/CT成像.
- 对PSMA PET/CT的检测率与mpMRI向活检进行了比较.
- 考虑了PSMA PET/CT的局限性和潜在益处.
主要成果:
- 在生物化学复发中,PSMA PET/CT对检测初级病变,淋巴腺病变和转移敏感.
- 在PSMA PET/CT上瘤吸收与PCa的攻击性相关.
- 在实验研究中,PSMA PET/CT的检测率与mpMRI向活检相当.
结论:
- PSMA PET/CT是PCa检测的敏感工具,特别是在生化复发和高风险病例中.
- 尽管检测率与mpMRI相比较,但PSMA PET/CT的使用是有局限性的实验性.
- 对于患有MRI禁忌的患者来说,PSMA PET/CT可能是一个有价值的替代方案,例如闭塞恐惧症或心脏起器.
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