非前列腺癌症相关病理学的2-脱氧-2-[18F]氟-D-葡萄糖正电子发射断层扫描/计算机断层扫描偶然发现前列腺摄入过多导致前列腺癌症的风险:一项单中心回顾性研究

IF 2.4 3区 医学 Q2 UROLOGY & NEPHROLOGY
Anthony Franklin , Troy Gianduzzo , Boon Kua , David Wong , Louise McEwan , James Walters , Rachel Esler , Matthew J. Roberts , Geoff Coughlin , John W. Yaxley
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引用次数: 0

摘要

目的回顾澳大利亚昆士兰州布里斯班卫斯理医院泌尿科因非前列腺癌相关病理而偶然报告前列腺内摄取2-脱氧-2-[18F]氟-d-葡萄糖正电子发射断层扫描/计算机断层扫描(18F-FDG PET/CT)增加的男性罹患前列腺癌(PCa)的风险。方法对2014年8月至2019年8月期间因非正常前列腺相关疾病到一家医院接受18F-FDG PET/CT检查的连续男性患者进行了回顾性分析。根据前列腺特异性抗原(PSA)、PSA速度、活检组织病理学、三特斯拉(3 T)多参数磁共振成像(mpMRI)前列腺成像报告和数据系统评分结果,或镓-68-前列腺特异性膜抗原(68Ga-PSMA)PET/CT结果,男性被分为良性、不确定或恶性。85%的男性(231/273)接受了进一步检查,包括 PSA 测试(227/231,98.3%)、3 T mpMRI(68/231,29.4%)、68Ga-PSMA PET/CT(33/231,14.3%)和前列腺活检(57/231,24.7%)。130/231(56.3%)例结果为良性,31/231(13.4%)例为不确定,70/231(30.3%)例为恶性。51/57(89.5%)名男性进行了活检,其中26/27(96.3%)名男性的前列腺成像报告和数据系统(Prostate Imaging Reporting and Data System)mpMRI评分为4-5分,6名男性的68Ga-PSMA PET/CT评分为阳性。活检时最常见的格里森评分大于或等于 4+5(14/51,27.5%)。在 26/33 例(78.8%)中,68Ga-PSMA PET/CT 与 18F-FDG 检查结果一致。所有13名18F-FDG、3 T mpMRI和68Ga-PSMA PET/CT结果一致的男性在活检时均发现了PCa。本研究中,在 18F-FDG PET/CT 意外发现前列腺内病变后,231 例病例中有 70 例(30.3%;占整个队列的 0.8%)的结果与 PCa 一致,最常见的是 Gleason 评分大于或等于 4+5 的疾病。除非因合并其他疾病而导致预期寿命有限,否则应根据 PCa 检测原则对偶然发现 18F-FDG 前列腺内摄取的男性进行进一步检查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The risk of prostate cancer on incidental finding of an avid prostate uptake on 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography/computed tomography for non-prostate cancer-related pathology: A single centre retrospective study

Objective

To review the risk of prostate cancer (PCa) in men with incidentally reported increased intraprostatic uptake at 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) ordered at Department of Urology, The Wesley Hospital, Brisbane, QLD, Australia for non-PCa related pathology.

Methods

Retrospective analysis of consecutive men between August 2014 and August 2019 presenting to a single institution for 18F-FDG PET/CT for non-prostate related conditions was conducted. Men were classified as benign, indeterminate, or malignant depending of the results of prostate-specific antigen (PSA), PSA velocity, biopsy histopathology, and three-Tesla (3 T) multiparametric MRI (mpMRI) Prostate Imaging Reporting and Data System score, or gallium-68-prostate-specific membrane antigen (68Ga-PSMA) PET/CT results.

Results

Three percent (273/9122) of men demonstrated 18F-FDG avidity within the prostate. Eighty-five percent (231/273) were further investigated, including with PSA tests (227/231, 98.3%), 3 T mpMRI (68/231, 29.4%), 68Ga-PSMA PET/CT (33/231, 14.3%), and prostate biopsy (57/231, 24.7%). Results were considered benign in 130/231 (56.3%), indeterminate in 31/231 (13.4%), and malignant in 70/231 (30.3%). PCa was identified in 51/57 (89.5%) of the men who proceeded to biopsy, including 26/27 (96.3%) men with Prostate Imaging Reporting and Data System scores 4–5 mpMRI and six men with a positive 68Ga-PSMA PET/CT. The most common Gleason score on biopsy was greater than or equal to 4+5 (14/51, 27.5%). 68Ga-PSMA PET/CT was concordant with the 18F-FDG findings in 26/33 (78.8%). All 13 men with a positive concordant 18F-FDG, 3 T mpMRI, and 68Ga-PSMA PET/CT had PCa on biopsy. There was no statistically significant difference in the 18F-FDG maximum standardized uptake value between the benign or malignant groups (5.7 vs. 6.1; p=0.580).

Conclusion

In this study, after an incidental finding of an avid intraprostatic lesion on 18F-FDG PET/CT, 70 of the 231 cases (30.3%; 0.8% of the entire cohort) had results consistent with PCa, most commonly as Gleason score greater than or equal to 4+5 disease. Unless there is limited life expectancy due to competing medical co-morbidity, men with an incidental finding of intraprostatic uptake on 18F-FDG should be further investigated using principles of PCa detection.

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来源期刊
Asian Journal of Urology
Asian Journal of Urology UROLOGY & NEPHROLOGY-
CiteScore
4.00
自引率
3.80%
发文量
100
审稿时长
4 weeks
期刊介绍: Asian Journal of Urology (AJUR), launched in October 2014, is an international peer-reviewed Open Access journal jointly founded by Shanghai Association for Science and Technology (SAST) and Second Military Medical University (SMMU). AJUR aims to build a communication platform for international researchers to effectively share scholarly achievements. It focuses on all specialties of urology both scientifically and clinically, with article types widely covering editorials, opinions, perspectives, reviews and mini-reviews, original articles, cases reports, rapid communications, and letters, etc. Fields of particular interest to the journal including, but not limited to: • Surgical oncology • Endourology • Calculi • Female urology • Erectile dysfunction • Infertility • Pediatric urology • Renal transplantation • Reconstructive surgery • Radiology • Pathology • Neurourology.
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