11C-acetate PET in the early evaluation of prostate cancer recurrence
11C-acetate PET in the early evaluation of prostate cancer recurrence
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DOI：
10.1007/s00259-006-0163-x
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发表时间：
2007-02-01
影响因子：
9.1
通讯作者：
Miralbell, Raymond
中科院分区：
文献类型：
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作者：
Albrecht, Susanne;Buchegger, Franz;Miralbell, Raymond
目的：本研究的首要目的是探讨 C-11-醋酸 PET 在前列腺癌复发早期检测中的诊断潜力。第二个目标是在这种情况下评估早期和晚期 PET。方法：研究人群包括 32 名前列腺癌患者，这些患者在初次放疗（A 组）或根治性手术（B 组）后有早期复发证据。 A组（n=17）患者的中位PSA为6ng/ml（范围2.6-30.2），而B组（n=15）患者的中位PSA为0.4ng/ml（范围0.08-4.8）。注射C-11-乙酸盐后2分钟开始盆腔-腹腔-胸部PET，并与CT融合后进行评估。结果：A组：以SUVmax≥2为截止点，PET显示14/17名患者出现局部复发，并且有两个结果模棱两可。在六名患者中观察到远处疾病，在一名患者中获得了模棱两可的结果。 12/12 例患者的直肠内 MRI 呈阳性。活检证实六名患者中有六名（100%）局部复发。活检证实复发的 6 名患者中有 5 名 PET 呈阳性，而其余患者的结果则模棱两可。 B 组：在 15 名患者中，视觉判读对 5 名患者的局部复发呈阳性，4 名患者的局部复发结果模棱两可。 1 个闭孔淋巴结呈阳性。 11/15 名患者的直肠内 MRI 呈阳性，2 名患者的结果模棱两可。在 9 名患者中的 7 名中观察到 PET 和直肠内 MRI 的阳性/可疑结果的位置相关性。 8/14 例患者在挽救性放疗后 PSA 显着下降，为局部复发提供了有力的证据。 8 名对放疗有反应的患者中，3 名患者的 PET 呈阳性，2 名患者的 PET 呈阳性。结论：C-11 醋酸盐 PET 在前列腺癌复发的早期评估中具有重要价值。优化扫描时间和使用现代 PET-CT 设备可能会带来进一步的改进。
Purpose: The first aim of the study was to investigate the diagnostic potential of C-11-acetate PET in the early detection of prostate cancer recurrence. A second aim was the evaluation of early and late PET in this context.Methods: The study population comprised 32 prostate cancer patients with early evidence of relapse after initial radiotherapy ( group A) or radical surgery ( group B). The median PSA of group A ( n=17) patients was 6 ng/ml ( range 2.6 - 30.2) while that of group B ( n= 15) was 0.4 ng/ ml ( range 0.08 - 4.8). Pelvic-abdominal-thoracic PET was started 2 min after injection of C-11-acetate and evaluated after fusion with CT.Results: Group A: Taking a SUVmax >= 2 as the cut-off, PET showed local recurrences in 14/17 patients and two equivocal results. Distant disease was observed in six patients and an equivocal result was obtained in one. Endorectal MRI was positive in 12/12 patients. Biopsy confirmed local recurrence in six of six (100%) patients. PET was positive in five of the six patients with biopsy-proven recurrences, the result in the remaining patient being equivocal. Group B: Among the 15 patients, visual interpretation was positive for local recurrences in five patients and equivocal in four. One obturator lymph node was positive. Endorectal MRI was positive in 11/15 patients and equivocal in two. Positional correlation of positive/equivocal results on PET and endorectal MRI was observed in seven of nine patients. PSA decreased significantly after salvage radiotherapy in 8/14 patients, providing strong evidence for local recurrence. PET of the eight patients responding to RT was positive in three and equivocal in two.Conclusion: C-11-acetate PET was found to be valuable in the early evaluation of prostate cancer relapse. Optimising scanning time and use of modern PET-CT equipment might allow further improvement.