Clinical Utility of (18)F-PSMA-1007 Positron Emission Tomography/Magnetic Resonance Imaging in Prostate Cancer: A Single-Center Experience.
Clinical Utility of (18)F-PSMA-1007 Positron Emission Tomography/Magnetic Resonance Imaging in Prostate Cancer: A Single-Center Experience.
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DOI：
10.3389/fonc.2020.612701
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发表时间：
2020
影响因子：
4.7
通讯作者：
Xu D
中科院分区：
文献类型：
--
作者：
Liu A;Zhang M;Huang H;Zhang C;Ruan X;Lin W;Li B;Chen L;Xu D
本研究旨在评价18F-PSMA-1007正电子发射断层扫描（PSMA PET）/磁共振成像（MRI）成像在疑似或确诊前列腺癌患者中的临床效用。在初步研究中，我们回顾性研究了2019年6月至2020年6月期间因疑似或确定的PCa接受PSMA-PET/MRI的62例患者。将患者分为三个亚组：（1）无组织学证据的疑似PCa，（2）原发性PCa，（3）生化复发性前列腺癌（BRPCa）。两名核科医生独立解释PSMA-PET/MRI的结果。回顾性报告了PSMA-PET/MRI之前的管理策略，并根据PSMA-PET/MRI结果对每例患者的管理策略进行了重新评价。记录策略的变化。此外，前列腺特异性抗原（PSA）水平与管理变化的相关性也通过Fisher精确检验进行评估，双侧p < 0.05假设为统计学意义。疑似PCa组（第1组）有28例患者，原发性PCa组（第2组）有12例患者，BRPCa组（第3组）有22例患者。总体而言，62例患者中有26例（41.9%）在PSMA-PET/MRI后改变了预期决定，其中疑似PCa组11/28例（39.3%），原发性PCa组1/12例（8.4%），BCR组14/24例（63.6%）。在第1组中，对后续管理的主要影响包括减少主动监测（从20到9）和增加前列腺活检（从8到19）。PSA水平与疑似PCa患者的管理变化无显著相关性（p = 0.865）。在第2组中，对后续管理的主要影响包括根治性手术减少（从8例减少到7例）和多模式治疗出现（n = 1）。仅在PSA水平≥20 ng/ml的类别中，改变了原发性PCa的管理。在第3组中，对后续治疗的主要影响包括挽救性放疗减少（从5到2），全身治疗增加（从6到7），多模式治疗增加（从11到13）。0.5≤PSA<1 ng/ml的BCR患者发生管理变更的比例最高。根据我们的初步经验，PSMA-PET/MRI可能是确定PCa病变和改变管理的有价值的工具。管理意图的影响最大的是BRPCa患者，尤其是0.5≤PSA<1 ng/ml的患者。然而，还需要进一步的研究来证实我们的初步发现。
This study aimed to evaluate the clinical utility of 18F-PSMA-1007 positron emission tomography (PSMA PET)/magnetic resonance imaging (MRI) imaging in patients with suspected or defined prostate cancer. In the pilot study, we retrospectively investigated 62 patients who underwent PSMA-PET/MRI for suspected or defined PCa between June 2019 and June 2020. Patients were grouped into three subgroups: (1) suspected PCa without histological evidence, (2) primary PCa, (3) biochemical recurrent prostate cancer (BRPCa). Two nuclear physicians independently interpreted the results of PSMA-PET/MRI. Management strategies before PSMA-PET/MRI were retrospectively reported, and the management strategy was re-evaluated for each patient considering the PSMA-PET/MRI result. The changes in strategies were recorded. Besides, the correlation between prostate specific antigen (PSA) level and management changes was also accessed by Fisher exact test, and two-side p < 0.05 was assumed as statistical significance. There were 28 patients in the suspected PCa group (group 1), 12 in the primary PCa group (group 2), and 22 in the BRPCa group (group 3). Overall, the intended decisions were changed in 26 (41.9%) of 62 patients after PSMA-PET/MRI, including 11/28 (39.3%) in suspected PCa group, 1/12 (8.4%) in primary PCa group, and 14/24 (63.6%) in BCR group. In group 1, the main impact on subsequent management included decreased active surveillance (from 20 to 9) and increased prostate biopsy (from 8 to 19). PSA levels were not significantly associated with management changes in suspected PCa patients (p = 0.865). In group 2, the main impact on subsequent management included decreased radical surgery (from 8 to 7), and multimodal therapy appearance (n = 1). Only in the category of PSA levels of ≥20 ng/ml, the management of primary PCa was changed. In group 3, the main impact on subsequent management included decreased salvage radiotherapy (from 5 to 2), increased systemic therapy (from 6 to 7), and increased multimodal therapy (from 11 to 13). The highest proportion of management changes occurred in BCR patients with 0.5≤PSA<1 ng/ml. From our preliminary experience, PSMA-PET/MRI may be a valued tool for defining PCa lesions and changing management. The biggest impact of management intent was in patients with BRPCa, especially in patients with 0.5≤PSA<1 ng/ml. However, further studies are needed to confirm our pilot findings.
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DOI：
10.1007/s00259-019-04643-7
发表时间：
2019-12-23
影响因子：
9.1
作者：
Kulkarni, Meghana;Hughes, Simon;Cook, Gary J. R.
通讯作者：
Cook, Gary J. R.
影响因子：
9.3
作者：
Hope, Thomas A.;Aggarwal, Rahul;Carroll, Peter R.
通讯作者：
Carroll, Peter R.
影响因子：
2.6
作者：
Bianchi, Lorenzo;Schiavina, Riccardo;Brunocilla, Eugenio
通讯作者：
Brunocilla, Eugenio
根治性前列腺切除术后通过 68Ga-PSMA 配体 PET/CT 确定的复发模式 对定制和个性化治疗的重要性
影响因子：
3.1
作者：
Henkenberens, Christoph;Derlin, Thorsten;von Klot, Christoph A.
通讯作者：
von Klot, Christoph A.
影响因子：
3.3
作者：
Perner, Sven;Hofer, Matthias D.;Rubin, Mark A.
通讯作者：
Rubin, Mark A.