The diagnostic value of PET/CT imaging with the 68Ga-labelled PSMA ligand HBED-CC in the diagnosis of recurrent prostate cancer
The diagnostic value of PET/CT imaging with the 68Ga-labelled PSMA ligand HBED-CC in the diagnosis of recurrent prostate cancer
复制标题
使用 68Ga 标记的 PSMA 配体 HBED-CC 进行 PET/CT 成像诊断复发性前列腺癌的价值
DOI：
10.1007/s00259-014-2949-6
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发表时间：
2015-02-01
影响因子：
9.1
通讯作者：
Haberkorn, Uwe
中科院分区：
文献类型：
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作者：
Afshar-Oromieh, Ali;Avtzi, Eleni;Haberkorn, Uwe
目的自Ga-68-PSMA-HBED-CC（-（68）GaDKFZ-PSMA-11）正电子发射断层扫描（PET）成像技术引入以来，该方法被认为是诊断复发性前列腺癌（PCa）的重要一步。然而，仅存在小患者队列的已发表数据。本次评估的目的是分析Ga-68-PSMA配体PET/CT在一个大的队列中的诊断价值和几个可能相互作用的variables.Methods的影响，我们进行了回顾性分析，在319例患者谁接受Ga-68-PSMA配体PET/CT从2011年至2014年。对前列腺特异性抗原（PSA）水平、倍增时间（DT）、Gleason评分（GSC）、雄激素剥夺治疗（ADT）、年龄和示踪剂注射量等因素的潜在影响进行了评价。在Ga-68-PSMA-配体PET/CT后对42例患者进行组织学验证。结果82.8%的患者至少检测到一个指示PCa的病灶。肿瘤检出率与PSA、ADT呈正相关。GSC和PSA-DT与肿瘤检出无关。肿瘤病灶的平均最大标准化摄取值（SUVmax）为13.3 ± 14.6（0.7-122.5）。在组织学检查的病变中，4例不同患者中有30例为假阴性，所有其他病变（n=416）均为真阳性或真阴性。基于病变的敏感性、特异性、阴性预测值（NPV）和阳性预测值（PPV）分析显示值分别为76.6%、100%、91.4%和100%。基于患者的分析显示敏感性为88.1%。在116例可随访的患者中，50例在Ga-68-PSMA-配体PET/CT.Conclusion Ga-68-PSMA-配体PET/CT后接受了局部治疗，可以检测到大量患者中的复发性PCa。此外，放射性示踪剂对PCa具有高度特异性。肿瘤检测与PSA和ADT呈正相关。Ga-68-PSMA-配体PET/CT可以帮助延迟PCa的全身治疗。
Purpose Since the introduction of positron emission tomography (PET) imaging with Ga-68-PSMA-HBED-CC (-(68)GaDKFZ-PSMA-11), this method has been regarded as a significant step forward in the diagnosis of recurrent prostate cancer (PCa). However, published data exist for small patient cohorts only. The aim of this evaluation was to analyse the diagnostic value of Ga-68-PSMA-ligand PET/CT in a large cohort and the influence of several possibly interacting variables.Methods We performed a retrospective analysis in 319 patients who underwent Ga-68-PSMA-ligand PET/CT from 2011 to 2014. Potential influences of several factors such as prostate-specific antigen (PSA) level and doubling time (DT), Gleason score (GSC), androgen deprivation therapy ADT), age and amount of injected tracer were evaluated. Histological verification was performed in 42 patients after the Ga-68-PSMA-ligand PET/CT. Tracer uptake was measured in 901 representative tumour lesions.Results In 82.8 % of the patients at least one lesion indicative of PCa was detected. Tumor-detection was positively associated with PSA level and ADT. GSC and PSA-DT were not associated with tumor-detection. The average maximum standardized uptake value (SUVmax) of tumour lesionswas 13.3 +/- 14.6 (0.7-122.5). Amongst lesions investigated by histology, 30 were false-negative in 4 different patients, and all other lesions (n=416) were true-positive or true-negative. A lesion-based analysis of sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) revealed values of 76.6 %, 100 %, 91.4 % and 100 %. A patientbased analysis revealed a sensitivity of 88.1 %. Of 116 patients available for follow-up, 50 received local therapy after Ga-68-PSMA-ligand PET/CT.Conclusion Ga-68-PSMA-ligand PET/CT can detect recurrent PCa in a high number of patients. In addition, the radiotracer is highly specific for PCa. Tumour detection is positively associated with PSA and ADT. Ga-68-PSMA-ligand PET/CT can help delay systemic therapy of PCa.