^(18)F-PSMA-1007 PET/CT在初诊前列腺癌中的应用价值探索:115例病例分析

Value of^(18)F-PSMA-1007 PET/CT in newly diagnosed prostate cancer:analysis of 115 cases

目的:探索^(18)F-PSMA-1007 PET/CT在初诊前列腺癌(prostate cancer,PCa)中的应用价值。方法:回顾性分析115例初诊PCa并在治疗前接受^(18)F-PSMA-1007 PET/CT检查的患者临床病理资料。分析PCa原发灶最大标准摄取值(maximum standardized uptake value,SUVmax)与患者穿刺Gleason评分、前列腺特异性抗原(prostate-specific antigen,PSA)、转移范围之间的相关性。在7例治疗后再次接受^(18)F-PSMA-1007 PET/CT检查的患者中评估其对于治疗反应的效能。结果:115例患者中位PSA值为43.9 ng/mL,原发灶SUVmax平均为(23.8±16.1)。其中49例(42.61%)患者穿刺Gleason评分为国际泌尿外科病理学会(International Society of Urological Pathology,ISUP)1~3组,66例(57.39%)患者Gleason评分为ISUP 4~5组。穿刺Gleason评分ISUP 4~5组的患者原发灶SUVmax明显高于穿刺Gleason评分ISUP 1~3组的患者[(30.2±15.7)vs(15.0±12.1),P<0.05]。PSA≥10 ng/mL的患者原发灶SUVmax显著高于PSA<10 ng/mL的患者[(25.4±16.1)vs(11.2±9.7),P<0.05]并且原发灶SUVmax值与患者PSA水平呈正相关。在7例治疗后再接受^(18)F-PSMA-1007 PET/CT检查的患者中,原发灶SUVmax变化程度与患者和PSA变化水平所表明疾病变化状态一致。结论:^(18)F-PSMA-1007 PET/CT中原发灶SUVmax值与患者穿刺Gleason评分、PSA水平密切相关并且^(18)F-PSMA-1007PET/CT检查在未接受治疗的PCa患者中表现出良好的治疗反应监测效能。

Objective To investigate the contribution and efficiency of^(18)F-PSMA-1007 PET/CT in the evaluation of newly diagnosed prostate cancer(PCa).Methods A total of 115 patients with newly diagnosed PCa who underwent^(18)F-PSMA-1007 PET/CT were retrospectively analyzed.PET/CT images were analyzed visually and semiquantitatively by measuring the SUVmax.The correlation between the Gleason score(GS),prostate-specific antigen(PSA),metastatic extent and the SUVmax of the primary tumor was analyzed.A post-treatment second^(18)F-PSMA-1007 PET/CT scan was conducted in 7 patients to monitor treatment response.Results The median PSA of 115 patients was 43.9 ng/mL,and the median SUVmax of the primary lesion was(23.8±16.1).Among them,49 patients(42.61%)were ISUP 1-3 group and 66 patients(57.39%)were ISUP 4-5 group.Significantly higher tracer uptake in primary tumors was found in the subgroup ISUP 4-5 group(30.2±15.7)compared to the subgroup ISUP 1-3 group(15.0±12.1).Patients with PSA<10 ng/mL(11.2±9.7)exhibited significantly lower tracer uptake in primary tumors than those with PSA≥10 ng/mL(25.4±16.1).In addition,the SUVmax of primary tumors was found to be positively associated with the PSA level.Compared to the patients receiving PET/CT for disease restaging,multiple^(18)F-PSMA-1007 PET/CT results in newly diagnosed PCa patients were consistent with their disease state indicated by PSA level.Conclusion Tracer uptake in the primary tumor on^(18)F-PSMA-1007 PET/CT was positively correlated with prognostic parameters,including GS and PSA.The multiple-scan application of^(18)F-PSMA-1007 PET/CT exhibited excellenttreatment response monitoring performance.