Sara Harsini, Babak Fallahi, Najme Karamzade Ziarati, Ali Razi, Erfan Amini, Alireza Emami-Ardekani, Armaghan Fard-Esfahani, Mehdi Kardoust Parizi, Saeed Farzanehfar, Davood Beiki
{"title":"[68Ga]- psma PET/CT在新诊断中高危前列腺癌中的前瞻性研究","authors":"Sara Harsini, Babak Fallahi, Najme Karamzade Ziarati, Ali Razi, Erfan Amini, Alireza Emami-Ardekani, Armaghan Fard-Esfahani, Mehdi Kardoust Parizi, Saeed Farzanehfar, Davood Beiki","doi":"10.22038/AOJNMB.2020.52375.1358","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Prostate-specific membrane antigen (PSMA) ligand positron emission tomography/computed tomography (PET/CT) is an emerging modality to detect metastatic disease in patients with prostate cancer (PCa). This prospective study aimed to evaluate the role of [<sup>68</sup>Ga]-PSMA PET/CT in the initial workup of intermediate and high-risk PCa.</p><p><strong>Methods: </strong>Twenty-five patients with newly transrectal ultrasound biopsy-proven, untreated intermediate- and high-risk PCa (mean age, 68.5±6.2 years; range 55-83 years) were enrolled in this prospective study between September 2018 and June 2020 and underwent a [<sup>68</sup>Ga]-PSMA PET/CT examination. All images were analyzed both visually and semiquantitatively by measuring the maximum standardized uptake value (SUV<sub>max</sub>) of the primary prostatic tumor and metastatic lesions. The diagnostic sensitivity of [<sup>68</sup>Ga]-PSMA PET/CT for the diagnosis of PCa was established by histopathology as the reference standard. The associations between SUV<sub>max</sub> of the primary tumors and prostate-specific antigen (PSA) levels, Gleason scores (GSs), and metastatic extent of the disease were studied.</p><p><strong>Results: </strong>All patients had a positive [<sup>68</sup>Ga]-PSMA PET/CT exam. Seventeen patients (58%) showed [<sup>68</sup>Ga]-PSMA avidity in both prostate lobes and 8 (32%) had unilateral uptake. SUV<sub>max</sub> in the primary tumor significantly correlated with serum PSA values (r=0.57, P=0.003). PSMA PET/CT depicted regional lymph node metastases in 32% of patients, distant lymph node metastases in 20%, osseous metastases in 16% and pulmonary metastases in 8% of patients. Sixty percent of PSMA-positive bone metastases and 21.4% of intraprostatic tumoral lesions were missed on the contemporaneous bone scintigraphy and magnetic resonance imaging, respectively.</p><p><strong>Conclusion: </strong>[<sup>68</sup>Ga]-PSMA PET/CT shows promise as a valuable imaging modality with high diagnostic sensitivity in the setting of intermediate and high-risk PCa. Moreover, the SUV<sub>max</sub> of the primary tumor has a positive correlation with PSA levels at the time of the scan.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":"9 2","pages":"101-110"},"PeriodicalIF":0.0000,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8255520/pdf/AOJNMB-9-101.pdf","citationCount":"1","resultStr":"{\"title\":\"A Prospective Study on [<sup>68</sup>Ga]-PSMA PET/CT Imaging in Newly Diagnosed Intermediate- and High-Risk Prostate Cancer.\",\"authors\":\"Sara Harsini, Babak Fallahi, Najme Karamzade Ziarati, Ali Razi, Erfan Amini, Alireza Emami-Ardekani, Armaghan Fard-Esfahani, Mehdi Kardoust Parizi, Saeed Farzanehfar, Davood Beiki\",\"doi\":\"10.22038/AOJNMB.2020.52375.1358\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Prostate-specific membrane antigen (PSMA) ligand positron emission tomography/computed tomography (PET/CT) is an emerging modality to detect metastatic disease in patients with prostate cancer (PCa). This prospective study aimed to evaluate the role of [<sup>68</sup>Ga]-PSMA PET/CT in the initial workup of intermediate and high-risk PCa.</p><p><strong>Methods: </strong>Twenty-five patients with newly transrectal ultrasound biopsy-proven, untreated intermediate- and high-risk PCa (mean age, 68.5±6.2 years; range 55-83 years) were enrolled in this prospective study between September 2018 and June 2020 and underwent a [<sup>68</sup>Ga]-PSMA PET/CT examination. All images were analyzed both visually and semiquantitatively by measuring the maximum standardized uptake value (SUV<sub>max</sub>) of the primary prostatic tumor and metastatic lesions. The diagnostic sensitivity of [<sup>68</sup>Ga]-PSMA PET/CT for the diagnosis of PCa was established by histopathology as the reference standard. The associations between SUV<sub>max</sub> of the primary tumors and prostate-specific antigen (PSA) levels, Gleason scores (GSs), and metastatic extent of the disease were studied.</p><p><strong>Results: </strong>All patients had a positive [<sup>68</sup>Ga]-PSMA PET/CT exam. Seventeen patients (58%) showed [<sup>68</sup>Ga]-PSMA avidity in both prostate lobes and 8 (32%) had unilateral uptake. SUV<sub>max</sub> in the primary tumor significantly correlated with serum PSA values (r=0.57, P=0.003). PSMA PET/CT depicted regional lymph node metastases in 32% of patients, distant lymph node metastases in 20%, osseous metastases in 16% and pulmonary metastases in 8% of patients. Sixty percent of PSMA-positive bone metastases and 21.4% of intraprostatic tumoral lesions were missed on the contemporaneous bone scintigraphy and magnetic resonance imaging, respectively.</p><p><strong>Conclusion: </strong>[<sup>68</sup>Ga]-PSMA PET/CT shows promise as a valuable imaging modality with high diagnostic sensitivity in the setting of intermediate and high-risk PCa. Moreover, the SUV<sub>max</sub> of the primary tumor has a positive correlation with PSA levels at the time of the scan.</p>\",\"PeriodicalId\":8503,\"journal\":{\"name\":\"Asia Oceania Journal of Nuclear Medicine and Biology\",\"volume\":\"9 2\",\"pages\":\"101-110\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2021-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8255520/pdf/AOJNMB-9-101.pdf\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Asia Oceania Journal of Nuclear Medicine and Biology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.22038/AOJNMB.2020.52375.1358\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asia Oceania Journal of Nuclear Medicine and Biology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.22038/AOJNMB.2020.52375.1358","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
A Prospective Study on [68Ga]-PSMA PET/CT Imaging in Newly Diagnosed Intermediate- and High-Risk Prostate Cancer.
Objectives: Prostate-specific membrane antigen (PSMA) ligand positron emission tomography/computed tomography (PET/CT) is an emerging modality to detect metastatic disease in patients with prostate cancer (PCa). This prospective study aimed to evaluate the role of [68Ga]-PSMA PET/CT in the initial workup of intermediate and high-risk PCa.
Methods: Twenty-five patients with newly transrectal ultrasound biopsy-proven, untreated intermediate- and high-risk PCa (mean age, 68.5±6.2 years; range 55-83 years) were enrolled in this prospective study between September 2018 and June 2020 and underwent a [68Ga]-PSMA PET/CT examination. All images were analyzed both visually and semiquantitatively by measuring the maximum standardized uptake value (SUVmax) of the primary prostatic tumor and metastatic lesions. The diagnostic sensitivity of [68Ga]-PSMA PET/CT for the diagnosis of PCa was established by histopathology as the reference standard. The associations between SUVmax of the primary tumors and prostate-specific antigen (PSA) levels, Gleason scores (GSs), and metastatic extent of the disease were studied.
Results: All patients had a positive [68Ga]-PSMA PET/CT exam. Seventeen patients (58%) showed [68Ga]-PSMA avidity in both prostate lobes and 8 (32%) had unilateral uptake. SUVmax in the primary tumor significantly correlated with serum PSA values (r=0.57, P=0.003). PSMA PET/CT depicted regional lymph node metastases in 32% of patients, distant lymph node metastases in 20%, osseous metastases in 16% and pulmonary metastases in 8% of patients. Sixty percent of PSMA-positive bone metastases and 21.4% of intraprostatic tumoral lesions were missed on the contemporaneous bone scintigraphy and magnetic resonance imaging, respectively.
Conclusion: [68Ga]-PSMA PET/CT shows promise as a valuable imaging modality with high diagnostic sensitivity in the setting of intermediate and high-risk PCa. Moreover, the SUVmax of the primary tumor has a positive correlation with PSA levels at the time of the scan.
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