How does 68Ga-prostate-specific membrane antigen positron emission tomography/computed tomography impact the management of patients with prostate cancer recurrence after surgery?
How does 68Ga-prostate-specific membrane antigen positron emission tomography/computed tomography impact the management of patients with prostate cancer recurrence after surgery?
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DOI：
10.1111/iju.14012
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发表时间：
2019-08-01
影响因子：
2.6
通讯作者：
Brunocilla, Eugenio
中科院分区：
文献类型：
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作者：
Bianchi, Lorenzo;Schiavina, Riccardo;Brunocilla, Eugenio
目的评价Ga-68-前列腺特异性膜抗原正电子发射断层扫描/计算机断层扫描对前列腺癌术后生化复发患者计划性治疗的临床意义。方法我们纳入了276例前列腺癌患者，由于手术后生化复发（连续两次前列腺特异性抗原检测>= 0.2 ng/mL）而接受Ga-68-前列腺特异性膜抗原正电子发射断层扫描/计算机断层扫描。首先，根据不同的前列腺特异性抗原水平评估Ga-68-前列腺特异性膜抗原正电子发射断层扫描/计算机断层扫描的检出率。其次，评估Ga-68-前列腺特异性膜抗原正电子发射断层扫描/计算机断层扫描阳性结果的独立预测因素。最后，由一个多学科团队根据欧洲泌尿外科协会指南、患者临床状况和临床参数评估了Ga-68-前列腺特异性膜抗原正电子发射断层扫描/计算机断层扫描翻修前的预期治疗。然后，在Ga-68-前列腺特异性膜抗原正电子发射断层扫描/计算机断层扫描修订后，由同一委员会前瞻性记录治疗计划的重新评估。Ga-68-前列腺特异性膜抗原正电子发射断层扫描/计算机断层扫描的有效临床影响被评定为重大（治疗方法的改变）、轻微（相同治疗，但修改了治疗策略）或无。结果Ga-68-前列腺特异性膜抗原正电子发射断层扫描/计算机断层扫描的总检出率为47.5%。Ga-68处的前列腺特异性抗原-前列腺特异性膜抗原正电子发射断层扫描/计算机断层扫描（比值比3.52）和前列腺特异性抗原倍增时间
Objective To evaluate the clinical impact of Ga-68-prostate-specific membrane antigen positron emission tomography/computed tomography on the planned management of prostate cancer patients with biochemical recurrence after surgery. Methods We enrolled 276 prostate cancer patients referred to Ga-68-prostate-specific membrane antigen positron emission tomography/computed tomography due to biochemical recurrence after surgery (two consecutive prostate-specific antigen assays >= 0.2 ng/mL). First, the detection rate of Ga-68-prostate-specific membrane antigen positron emission tomography/computed tomography was assessed according to different prostate-specific antigen levels. Second, the independent predictors of Ga-68-prostate-specific membrane antigen positron emission tomography/computed tomography positive results were assessed. Finally, the intended treatment before revision of Ga-68-prostate-specific membrane antigen positron emission tomography/computed tomography was assessed by a multidisciplinary team based on the European Association of Urology guidelines, patient clinical condition and clinical parameters. Then, re-assessment of the treatment plan was prospectively recorded by the same board after revision of Ga-68-prostate-specific membrane antigen positron emission tomography/computed tomography. The effective clinical impact of Ga-68-prostate-specific membrane antigen positron emission tomography/computed tomography was rated as major (change in therapeutic approach), minor (same treatment, but modified therapeutic strategy) or none. Results The overall detection rate of Ga-68-prostate-specific membrane antigen positron emission tomography/computed tomography was 47.5%. Prostate-specific antigen at Ga-68-prostate-specific membrane antigen positron emission tomography/computed tomography (odds ratio 3.52) and prostate-specific antigen doubling time