PSMA PET/CT 在腺样囊性癌评估中的适用性

IF 1.8 Q3 HEMATOLOGY

Hematology, Transfusion and Cell Therapy Pub Date : 2025-04-15 DOI:10.1016/j.htct.2025.103809

Lucas Pinho, Ellen Lima, Natália Tobar, Simone Kuba, Hádila Sousa, Lígia Macedo, Allan Santos, Carmen Lima, Elba Etchebehere

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引用次数: 0

摘要

腺样囊性癌（adenoid Cystic Carcinoma， ACC）是一种罕见的侵袭性肿瘤，其特点是生长缓慢、缓慢、高复发、高转移率，难以早期发现，18F-FDG PET/CT成像对其诊断、分期和监测至关重要。在过去的十年中，18F-PSMA PET/CT治疗前列腺癌的前景很好，因此在ACC中使用18-Fluor（诊断）和177-Lutetium（治疗）来评估PSMA靶标，ACC细胞过度表达这种表面抗原。由于这是一项新发现，需要进一步的研究来评估18F-PSMA PET/CT在ACC病例中预测预后和评估治疗反应的应用。与18F-FDG PET/CT相比，18F-PSMA PET/CT是否可以用作ACC的诊断技术，因此，标记PSMA是否可能成为这种癌症的治疗资源？目的评价18F-PSMA PET/CT与18F-FDG PET/CT在ACC治疗中的适用性。材料与方法5例确诊为ACC的患者（A、B、C、D、E）分别接受18F-FDG PET/CT和18F-PSMA PET/CT检查（除2例外，间隔24小时），并使用两种示踪剂评估病变的摄取情况。初步结果患者A仅在颈部淋巴结18F-FDG PET/CT表现为高代谢；B在原发病变部位、颈部淋巴结和肺部的18F-FDG PET/CT上表现出明显较高的摄取（检查和阿霉素治疗后46天）；C和D对两种示踪剂的摄取相似：C在L5椎体和肺，D在肺；E表现出两种示踪剂的摄取，在有18F-FDG的颈部淋巴结，提示炎症，在有18F-PSMA的肺部。初步数据表明，ACC中两种示踪剂的摄取模式相似，但存在差异，需要进一步研究。结论本研究强调了18F-PSMA PET/CT在ACC诊断管理中的潜在应用，扩大了其可能的治疗应用。

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APPLICABILITY OF PSMA PET/CT IN THE EVALUATION OF ADENOID CYSTIC CARCINOMA

Introduction/Justification: Introduction

Adenoid Cystic Carcinoma (ACC) is a rare and aggressive tumor characterized by slow and indolent growth, high recurrence, high metastasis rates, and challenging early detection, and 18F-FDG PET/CT imaging has become essential for diagnosis, staging, and monitoring of it. In the last decade, the promising theranostic approach of 18F-PSMA PET/CT for prostate carcinoma has led to the evaluation of PSMA target with 18-Fluor (diagnostic) and 177-Lutetium (therapeutic) in ACC, whose cells overexpress this surface antigen.

Justification

As it is a recent discovery, further studies are needed to evaluate the use of 18F-PSMA PET/CT to predict the prognosis and assess therapy response in ACC cases.

Research Question

Could 18F-PSMA PET/CT, compared to 18F-FDG PET/CT, be used as a diagnostic technique for ACC and, as a consequence, labeled PSMA be potentially a therapeutic resource for this cancer?

Objective

Evaluate the applicability of 18F-PSMA PET/CT compared to 18F-FDG PET/CT in the management of ACC.

Materials and Methods

Five patients (A, B, C, D, and E) diagnosed with ACC underwent 18F-FDG PET/CT and 18F-PSMA PET/CT (24-hour intervals, except by two cases), and the lesions uptakes were evaluated with both radiotracers.

Preliminary Results

Patient A showed hypermetabolism only for 18F-FDG PET/CT at cervical lymph nodes; B exhibited an uptake substantially higher on 18F-FDG PET/CT at the primary lesion site, cervical lymph nodes, and lung (46 days between the exams and after treatment with doxorubicin); C and D showed similar uptake on both tracers: C at L5 vertebra and lung, and D at lung; E exhibited uptake of both tracers, in cervical lymph nodes with 18F-FDG, suggesting inflammation, and in the lung with 18F-PSMA.