在PSMA成像技术下重新定义寡转移前列腺癌:对诊断和治疗策略的影响

Redefining Oligometastatic Prostate Cancer Based on PSMA Imaging:Impacts on Diagnostic and Treatment Strategies

随着前列腺特异性膜抗原(prostate specific membrane antigen,PSMA)PET/CT成像技术的应用,前列腺癌(prostate cancer,PCa)的诊断方式逐渐由解剖成像向功能成像改进,PCa的分期和治疗策略也因此发生改变。研究表明PSMA PET/CT能发现更多微小转移灶,一些既往被认定为局限性的PCa,经PSMA成像证实存在远处淋巴结或骨骼微转移,这使得我们需要重新思考和定义寡转移PCa。目前对寡转移的定义仍基于传统影像学手段(MRI/CT、骨扫描),相比PSMA,这些定义显然过于宽泛。综上,本文对PSMA成像技术在诊断和治疗寡转移性PCa中的作用进行了综述,特别强调了该技术如何改变临床实践并为未来的治疗策略提供指导。

With the development of prostate-specific membrane antigen(PSMA)PET/CT imaging,the diagnostic approach for prostate cancer(PCa)has gradually shifted from anatomical to functional imaging,leading to the changes in the staging and treatment strategies of PCa.Studies have demonstrated that PSMA PET/CT can detect more micrometastases,and some cases previously considered localized PCa have been confirmed to have distant lymph nodes or bone micrometastases through PSMA imaging.This necessitates a reevaluation and redefinition of oligometastatic PCa.The current definition of oligometastasis is still based on traditional imaging methods(MRI/CT,bone scans),which is evidently too broad compared to PSMA.In conclusion,this article reviews the role of PSMA imaging in the diagnosis and treatment of oligometastatic PCa,emphasizing how this technology transforms clinical practice and guides future treatment strategies.