Comparación de la estadificación mediante [68Ga]Ga-PSMA-11 PET/TC y los resultados anatomopatológicos en pacientes con cáncer de próstata de riesgo intermedio y alto tratados con prostatectomía radical y linfadenectomía pélvica

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

Revista Espanola De Medicina Nuclear E Imagen Molecular Pub Date : 2025-03-01 DOI:10.1016/j.remn.2024.500076

J.J. Rosales , V. Betech Antar , F. Mínguez , F. Pareja , F. Guillén , E. Prieto , G. Quincoces , F. Díez Caballero , B. Miñana , J.L. Pérez-Gracia , M. Rodríguez-Fraile

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引用次数: 0

Abstract

Objective

To evaluate the diagnostic accuracy of [⁶⁸Ga]Ga-PSMA-11 PET/CT (PET-PSMA) in local and loco-regional nodal staging compared with histopathological results in intermediate- and high-risk prostate cancer patients treated with radical prostatectomy (RP) and pelvic lymph node dissection (PLND).

Materials y methods

A total of 122 intermediate- and high-risk prostate cancer (PCa) patients staged with PET-PSMA and treated with RP (36/122) and RP plus PLND (86/122) from December 2018 to December 2023 were included. Visual and semiquantitative analysis findings using the SUVmax of the molecular imaging were correlated with histopathological results.

Results

The primary tumor was visible by PET-PSMA in 96.7% of the patients. A positive correlation was found between PSA levels and SUVmax (Spearman's r: 0.303, p< 0.001). PET-PSMA detected nodal involvement in 25/89 patients (28.08%). The sensitivity, specificity, and diagnostic accuracy of PET-PSMA for detecting nodal involvement were 75%, 82.2%, and 80.9%, respectively. Patients with PSA levels >20 ng/ml, Gleason score ≥7b, ISUP grade >2, and extracapsular extension showed significantly higher SUVmax values. No differences were observed in SUVmax between risk groups or in other histopathological variables.

Conclusions

PET-PSMA is an effective tool for the initial staging of intermediate- and high-risk PCa. SUVmax values were significantly higher in patients with unfavorable clinical features.

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采用[68Ga]Ga-PSMA-11 PET/TC测定与根治性前列腺切除术和盆腔淋巴结切除术治疗的中、高风险前列腺癌患者的解剖病理学结果的比较

目的评价[68Ga]Ga-PSMA-11 PET/CT （PET- psma）对中高危前列腺癌根治性前列腺切除术（RP）联合盆腔淋巴结清扫术（PLND）局部及局部区域淋巴结分期的诊断准确性，并与病理结果进行比较。方法2018年12月至2023年12月共纳入122例PET-PSMA分期并接受RP（36/122）和RP + PLND（86/122）治疗的中高危前列腺癌（PCa）患者。使用分子成像的SUVmax进行视觉和半定量分析的结果与组织病理学结果相关。结果96.7%的患者PET-PSMA显示原发肿瘤。PSA水平与SUVmax呈正相关(Spearman’s r: 0.303, p<；0.001)。89例患者中有25例（28.08%）PET-PSMA检测到淋巴结受累。PET-PSMA检测淋巴结受累的敏感性、特异性和诊断准确性分别为75%、82.2%和80.9%。PSA水平为20 ng/ml、Gleason评分≥7b、ISUP分级为2级、囊外延伸的患者SUVmax值明显升高。危险组间SUVmax或其他组织病理学变量均无差异。结论pet - psma是中高危前列腺癌早期分期的有效工具。具有不良临床特征的患者的SUVmax值明显更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.