Positron tomographic assessment of androgen receptors in prostatic carcinoma
Positron tomographic assessment of androgen receptors in prostatic carcinoma
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DOI：
10.1007/s00259-005-1764-5
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发表时间：
2005-03-01
影响因子：
9.1
通讯作者：
Welch, MJ
中科院分区：
文献类型：
--
作者：
Dehdashti, F;Picus, J;Welch, MJ
目的：本研究的目的是评估通过正电子发射断层扫描（PET）使用16β[F-18]氟-5α-二氢睾酮（FDHT）进行雄激素受体（AR）成像的可行性，并评估前列腺癌患者中FDHT与AR的结合选择性。方法：对 20 名患有晚期前列腺癌的男性（年龄范围 56-87 岁）进行了研究。除一名外，所有患者均患有经活检和/或放射学研究证实的转移性疾病。一名放射学检查结果表明单个肝转移的患者在 FDHT-PET 后获得的活检中发现有局灶性脂肪浸润，因此被排除在进一步的数据分析之外。通过测定标准化摄取值（SUV）和肿瘤与肌肉比率（T/M）来半定量评估FDHT摄取。此外，为了评估 FDHT 的 AR 结合选择性，在给予 AR 拮抗剂（氟他胺）后对具有一个或多个 FDHT 积累异常增加病灶的患者进行了研究。结果：常规影像学显示 2 名晚期前列腺癌患者有无数病灶，其余 17 名晚期前列腺癌患者有 43 个病灶。 19 名患者中有 12 名 FDHT-PET 呈阳性（敏感性为 63%），其中包括两名有无数病灶的患者。 FDHT-PET 在其余 10 名患者中检测到 28 个已知病变中的 24 个（86%）。此外，FDHT-PET 在这 10 名患者中的 5 名中检测到 17 个未怀疑的病变。所有 12 名 FDHT-PET 阳性患者在接受氟他胺 1 天（250 mg，t.i.d.）后均接受了重复 PET 研究。在所有这些患者中，氟他胺治疗后肿瘤 FDHT 摄取均有所减少；平均值（+/- 标准差）SUV 和 T/M 分别从 7.0 +/- 4.7 和 6.9 +/- 3.9 分别降至 3.0 +/- 1.5 和 3.0 +/- 1.6 (p=0.002)。 FDHT-PET 阳性患者的平均 PSA 显着高于 FDHT-PET 阴性患者 (p=0.006)。结论：我们的结果证明了使用 FDHT 对前列腺癌进行 PET 成像的可行性，并表明肿瘤对 FDHT 的摄取是一个受体介导的过程。阳性 PET 研究与较高的 PSA 水平相关，因此可能与较大的肿瘤负荷相关。
Purpose: The purpose of this study was to evaluate the feasibility of androgen receptor (AR) imaging with 16 beta[F-18]fluoro-5 alpha-dihydrotestosterone (FDHT) by positron emission tomography (PET) and to assess the binding selectivity of FDHT to AR in patients with prostate cancer. Methods: Twenty men (age range 56-87 years) with advanced prostate cancer were studied. All except one had metastatic disease confirmed by biopsy and/or radiological studies. One patient who had radiological findings suggesting a single hepatic metastasis was found to have focal fatty infiltration on biopsy obtained after FDHT-PET and was excluded from further data analysis. FDHT uptake was assessed semiquantitatively by determination of the standardized uptake value (SUV) and tumor-to-muscle ratio (T/M). Additionally, to assess the AR binding selectivity of FDHT, patients with one or more foci of abnormally increased FDHT accumulation were studied after administration of an AR antagonist (flutamide). Results: Conventional imaging demonstrated innumerable lesions in two patients and 43 lesions in the remaining 17 patients with advanced prostate cancer. FDHT-PET was positive in 12 of 19 patients (sensitivity of 63%), including the two patients with innumerable lesions. FDHT-PET detected 24 of 28 known lesions (86%) in the remaining ten patients. In addition, FDHT-PET detected 17 unsuspected lesions in five of these ten patients. All 12 patients with positive FDHT-PET underwent a repeat PET study after receiving flutamide for 1 day (250 mg t.i.d.). In all of these patients, there was a decrease in tumor FDHT uptake after flutamide; the mean (+/- standard deviation) SUV and T/M decreased from 7.0 +/- 4.7 and 6.9 +/- 3.9, respectively, to 3.0 +/- 1.5 and 3.0 +/- 1.6, respectively (p=0.002). The mean PSA in patients with positive FDHT-PET was significantly higher than that in patients with negative FDHT-PET (p=0.006). Conclusion: Our results document the feasibility of PET imaging of prostate cancer with FDHT and suggest that tumor uptake of FDHT is a receptor-mediated process. Positive PET studies were associated with higher PSA levels and thus, presumably, with greater tumor burden.