Evaluación de la tasa de detección de la recidiva local y de cuerpo completo mediante la valoración integrada de la PET/RM con [18F]F-PSMA-1007 de pacientes con cáncer de próstata tratados con prostatectomía con recidiva bioquímica muy baja (< 0,5 ng/ml). Implicaciones terapéuticas

IF 1.6 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Revista Espanola De Medicina Nuclear E Imagen Molecular Pub Date : 2024-09-01 DOI:10.1016/j.remn.2024.500037

J.R. Garcia, A. Compte, J. Pastor, S. Mourelo, L. Mont, P. Bassa, E. Llinares, M. Soler, E. Valls, T. Blanch, E. Riera

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引用次数: 0

Abstract

Objective

To analyse the efficacy of integrated assessment of [¹⁸F]F-PSMA-1007 PET/MRI on the early detection of local recurrence (LR) for prostate cancer patients with PSA levels < 0.5 ng/ml after radical prostatectomy.

To assess the location of recurrence so that therapy may be tailored to patient.

Methods

Prospective study including 35 patients with prostate cancer (PCa), who were referred for a [¹⁸F]F-PSMA-1007 PET/MR after prostatectomy with a very initial PSA value increase (PSA < 0,5 ng/ml).

Simultaneous acquisition in a PET/MRI hybrid equipment (SIGNA-GE), 1 hour after administration of 370 ± 10% MBq of [¹⁸F]F-PSMA-1007:

Prostate selective imaging (20 min): Multiparametric PET+MRI (MRImp): DIXON,T1,T2,diffusion sequences post-Gadolinium administration.

Whole body image (30 min): PET+MRI: DIXON,T1,T2,diffusion,STIR sequences.

A Nuclear Physician and a Radiologist jointly reviewed the studies:

In order to assess LR, the ‘Prostate Imaging for Recurrence Reporting’ system was used on MRI, as well as the Likert scale on the PET prostate imaging.

The remaining lesions were classified as N1 and M1a.

Results

PET/MRI was positive in 25 patients (71.4%) and negative in 10 patients (28.6%).

RL was detected in 15 patients (42.9%): in 2 (5.7%) MRI was superior; in 3 (8.6%) PET was superior; integrated PET/MRI showed improved results in 5 patients (14.3%) for the detection of LR.

Location of recurrences: LR in 11 patients (44.0%); N1 in 10 (40.0%); LR+N1(8.0%) in 2; LR+N1+M1a in 2 (8.0%).

In 20 patients (80%) the PET/MRI findings allowed radioguided radiotherapy implementation (11 on LR, and 9 on N1), whereas hormonal treatment was decided in 5 patients (20%) due to multimetastases/spread disease.

Conclusion

[¹⁸F]F-PSMA-1007 PET/MRI has a 71.4% recurrence detection rate after prostatectomy with PSA < 0.5 ng/ml. Its combined PET and MRI study increases the detection of LR by 14.3%, with a high N1+M1a detection rate (56%), allowing radioguided radiotherapy in 80% of patients.

查看原文本刊更多论文

用[18F]F-PSMA-1007对接受前列腺切除术且生化复发率极低（< 0.5 ng/ml）的前列腺癌患者进行 PET/MR 综合评估，评估局部和全身复发检测率。治疗意义

目的分析综合评估[18F]F-PSMA-1007 PET/MRI对早期发现前列腺癌患者局部复发（LR）的疗效。方法前瞻性研究包括 35 名前列腺癌（PCa）患者，这些患者在前列腺切除术后接受了[18F]F-PSMA-1007 PET/MR检查，但PSA值在术后初期出现上升（PSA大于等于0.5 ng/ml）：多参数 PET+MRI (MRImp)：服用钆后的 DIXON、T1、T2、弥散序列：全身图像（30 分钟）：PET+MRI：一名核医师和一名放射医师共同审查了这些研究：为了评估 LR，在 MRI 上使用了 "前列腺成像复发报告 "系统，在 PET 前列腺成像上使用了 Likert 量表。结果 25 例患者（71.4%）PET/MRI 为阳性，10 例患者（28.6%）为阴性。15 例患者（42.9%）检测到 LR：2 例患者（5.7%）MRI 更优；3 例患者（8.6%）PET 更优；5 例患者（14.3%）PET/MRI 综合检测 LR 的结果更好：20例患者（80%）的PET/MRI结果允许在放射引导下实施放疗（11例在LR，9例在N1），而5例患者（20%）因多发转移/疾病扩散而决定接受激素治疗。结论 PSA 为 0.5 ng/ml 的前列腺切除术后，[18F]F-PSMA-1007 PET/MRI 的复发检出率为 71.4%。其 PET 和 MRI 联合研究可将 LR 的检出率提高 14.3%，N1+M1a 检出率高（56%），80% 的患者可在放射引导下接受放疗。

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来源期刊

Revista Espanola De Medicina Nuclear E Imagen Molecular RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

1.10

自引率

16.70%

发文量

审稿时长

24 days

期刊介绍： The Revista Española de Medicina Nuclear e Imagen Molecular (Spanish Journal of Nuclear Medicine and Molecular Imaging), was founded in 1982, and is the official journal of the Spanish Society of Nuclear Medicine and Molecular Imaging, which has more than 700 members. The Journal, which publishes 6 regular issues per year, has the promotion of research and continuing education in all fields of Nuclear Medicine as its main aim. For this, its principal sections are Originals, Clinical Notes, Images of Interest, and Special Collaboration articles.