Is 18F-PSMA PET/CT a reliable imaging modality to evaluate the status of recurrent/residual brain tumors in post-treatment patients?

IF 3.1 2区医学 Q2 CLINICAL NEUROLOGY

Journal of Neuro-Oncology Pub Date : 2025-11-01 Epub Date: 2025-07-31 DOI:10.1007/s11060-025-05167-x

Tarun Kumar Jain, Mansha Vohra, Bhawani Shanker Sharma, Anushree Loyal, Priya Sharma, Patel Meet, Shikha Dhal, Vineet Mishra, Jitendra Singh Verma, Surabhi Tyagi, Hemant Malhotra

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引用次数: 0

Abstract

Background: Brain tumors are the most challenging malignancies. The existing investigational and treatment modalities have a few drawbacks with high rate of recurrence / residual tumoral tissue. Positron Emitting Tomography combined with computed tomography (PET-CT) is a widely used imaging modality for oncology and non-oncological purposes with fluorine-18-floruodeoxyglucose (18 F-FDG) being the most familiar radiotracer. Physiological uptake of FDG in brain parenchyma makes it a challenging task to currently delineate the residual/ recurrent brain tumors which brings us to investigate new radiotracers.

Objective: The purpose of present study is to identify the role of 18 fluoride labelled Prostate Specific Membrane Antigen (PSMA) in residual recurrent brain malignancies and compared the PSMA PET-CT scan with standard conventional imaging in same purpose.

Methods: This was a prospective study and patients were enrolled after underwent treatment (surgery and /or concurrent chemoradiotherapy). In order to detection of the residual recurrent disease, 18 F PSMA PET-CT as well as conventional imaging modalities were performed. We calculated the diagnostic performance of the PSMA PET-CT and also compared with standard conventional imaging modalities.

Results: Thirty-one patients were included in the study. Out of 31 patients, 23 (~ 74.2%) patients were positive on PSMA PET-CT scan and 18 (~ 58.06%) were on conventional imaging (CI) for residual recurrent mitotic disease. The calculated sensitivity, specificity, PPV, NPV and diagnostic yields for PSMA PET-CT and CI were 96%, 88%, 96%, 88% and 93.5% and 83%, 50%, 83%, 50% and 74.2% respectively. In our study, among 31 patients, 22 patients underwent MRI imaging in form of convention imaging and calculated sensitivity, specificity, PPV, NPV and diagnostic yields for MRI was 81%, 42.85%, 76.5%, 50% and 77.3% respectively. Among these 22 patients, MRI with PSMA PET-CT scan was discordant in 7 patients (27.3%).

Conclusion: 18 F-PSMA PET-CT imaging has higher diagnostic yield then existing conventional diagnostic modalities with capability to rule out extracranial lesions and inherent-potential of being utilised as theragnostic moiety.

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18F-PSMA PET/CT是评估治疗后患者复发/残留脑肿瘤状态的可靠成像方式吗？

背景：脑肿瘤是最具挑战性的恶性肿瘤。现有的研究和治疗方式有一些缺点，复发率高/残留肿瘤组织。正电子发射断层扫描结合计算机断层扫描（PET-CT）是一种广泛用于肿瘤和非肿瘤目的的成像方式，氟-18-氟脱氧葡萄糖（18 F-FDG）是最熟悉的放射性示踪剂。脑实质中FDG的生理摄取使得目前描述残留/复发脑肿瘤成为一项具有挑战性的任务，这促使我们研究新的放射性示踪剂。目的：探讨18氟化物标记前列腺特异性膜抗原（PSMA）在脑恶性肿瘤残留复发中的作用，并将PSMA PET-CT扫描与标准常规影像学检查进行比较。方法：这是一项前瞻性研究，患者在接受治疗（手术和/或同步放化疗）后入组。为了检测残留的复发性疾病，我们进行了18 F PSMA PET-CT和常规影像学检查。我们计算了PSMA PET-CT的诊断性能，并与标准的常规成像方式进行了比较。结果：31例患者纳入研究。31例患者中，23例（~ 74.2%）PSMA PET-CT扫描阳性，18例（~ 58.06%）常规影像学检查残余复发有丝分裂性疾病。PSMA PET-CT和CI的计算灵敏度、特异性、PPV、NPV和诊断率分别为96%、88%、96%、88%和93.5%，83%、50%、83%、50%和74.2%。在我们的研究中，31例患者中有22例采用常规成像方式进行MRI成像，计算出MRI的敏感性、特异性、PPV、NPV和诊断率分别为81%、42.85%、76.5%、50%和77.3%。22例患者中，MRI与PSMA PET-CT扫描不一致者7例（27.3%）。结论：18 F-PSMA PET-CT成像具有比现有常规诊断方式更高的诊断率，能够排除颅外病变，具有作为诊断部分的内在潜力。

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

Journal of Neuro-Oncology 医学-临床神经学

CiteScore

6.60

自引率

7.70%

发文量

277

审稿时长

3.3 months

期刊介绍： The Journal of Neuro-Oncology is a multi-disciplinary journal encompassing basic, applied, and clinical investigations in all research areas as they relate to cancer and the central nervous system. It provides a single forum for communication among neurologists, neurosurgeons, radiotherapists, medical oncologists, neuropathologists, neurodiagnosticians, and laboratory-based oncologists conducting relevant research. The Journal of Neuro-Oncology does not seek to isolate the field, but rather to focus the efforts of many disciplines in one publication through a format which pulls together these diverse interests. More than any other field of oncology, cancer of the central nervous system requires multi-disciplinary approaches. To alleviate having to scan dozens of journals of cell biology, pathology, laboratory and clinical endeavours, JNO is a periodical in which current, high-quality, relevant research in all aspects of neuro-oncology may be found.