Valor clínico de un PET/TC con [18F]F-PSMA negativo en pacientes diagnosticados de cáncer de próstata tratados con prostatectomía con elevación del PSA, inferior a 1 ng/ml, en los resultados de la radioterapia de rescate

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.2024.500071

M. Cózar Santiago , J. García Garzón , A. Esteban Hurtado , J. Pastor Peiro , J. Ferrer Rebolleda

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引用次数: 0

Abstract

Objective

To assess the clinical value of [¹⁸F]F-PSMA negative PET/CT, in patients diagnosed with prostate cancer treated with prostatectomy with elevated PSA less than 1 ng/mL, on the outcome of salvage radiotherapy.

Method

We prospectively included 98 patients diagnosed with prostate cancer treated with prostatectomy with biochemical recurrence [mean PSA 0.51 ng/mL (range 0.17-1,0 ng/mL)] who were referred for an [¹⁸F]F-PSMA-PET/CT study.

The [¹⁸F]F-PSMA-PET/CT scan was negative in 53/98 patients (54.09%). Differences were analysed between those patients who were or were not candidates for pelvic salvage radiotherapy (PSRT) decided upon multidisciplinary committee and patient consent, with a minimum follow-up time for 1 year. Response to treatment was defined as a 50% reduction in PSA levels. Recurrence was ascertained upon clinical, analytical and imaging follow-up outcomes.

Results

54.7% (29/53) of the patients with a negative [¹⁸F]F-PSMA-PET/CT underwent PSRT. Of these, 93.1% (27/29) patients demonstrated response to treatment (PSMA false negatives). The remaining two patients showed fluctuating PSA levels without detecting disease on the [¹⁸F]F-PSMA-PET/CT follow-up study.

45.3% (24/53) of patients with negative [¹⁸F]F-PSMA-PET/CT did not undergo PSRT. Of these, progressive PSA elevation was observed in 62.5% (15/24) (PSMA false negatives), localising recurrence on the [¹⁸F]F-PSMA-PET/CT follow-up study in 4 patients. The remaining 9 patients (37.5%) showed fluctuating PSA levels without detecting disease on the [¹⁸F]F-PSMA-PET/CT follow-up study.

Our series confirmed 42 (42.85%) [¹⁸F]F-PSMA-PET/CT false negatives cases.

Conclusion

Patients diagnosed with prostate cancer with post-prostatectomy biochemical recurrence and a negative [¹⁸F]F-PSMA-PET/CT study are likely to benefit from pelvic salvage radiotherapy, with response seen in 93.1% of our cases.

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在接受前列腺切除术治疗、PSA升高小于1纳克/毫升的前列腺癌患者中，具有[18F]F-PSMA阴性的PET/ CT临床值

目的探讨[18F]F-PSMA阴性PET/CT对前列腺癌行前列腺切除术且PSA升高小于1 ng/mL患者补救性放疗预后的临床价值。方法前瞻性纳入98例经前列腺切除术诊断为前列腺癌并生化复发的患者[平均PSA 0.51 ng/mL（范围0.17-1,0 ng/mL）]，转介进行[18F]F-PSMA-PET/CT研究。[18F]F-PSMA-PET/CT扫描阴性53/98例（54.09%）。经多学科委员会和患者同意决定是否接受盆腔保留放疗（PSRT）的患者之间进行差异分析，随访时间至少为1年。对治疗的反应被定义为PSA水平降低50%。结果54.7%（29/53）的F-PSMA-PET/CT阴性患者接受了PSRT治疗。其中，93.1%（27/29）患者表现出对治疗的反应（PSMA假阴性）。其余2例患者在[18F]F-PSMA-PET/CT随访研究中显示PSA水平波动，但未发现疾病，45.3%（24/53）的[18F]F-PSMA-PET/CT阴性患者未进行PSRT。其中，62.5%（15/24）的患者出现进行性PSA升高（PSMA假阴性），在[18F]F-PSMA-PET/CT随访研究中，4例患者出现局部复发。其余9例（37.5%）患者在[18F]F-PSMA-PET/CT随访研究中显示PSA水平波动，但未发现疾病。本组共确诊42例（42.85%）[18F]F-PSMA-PET/CT假阴性。结论诊断为前列腺癌的前列腺切除术后生化复发且F-PSMA-PET/CT阴性的患者可能受益于盆腔补救性放疗，93.1%的病例有反应。

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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.