Aims & Objectives: Aim of the study was to evaluate inter-observer variability in interpretation of Gallium-68 labeled Prostate Specific Membrane Antigen sub-type 11 (68Ga-PSMA-11) Positron Emission Tomography-Com...Aims & Objectives: Aim of the study was to evaluate inter-observer variability in interpretation of Gallium-68 labeled Prostate Specific Membrane Antigen sub-type 11 (68Ga-PSMA-11) Positron Emission Tomography-Computed Tomography PET_CT scan according to Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE) criteria. Method and Materials: Forty-four consecutive patients of prostate cancer were prospectively studied between the duration of January 2021 to June 2021 at Institute of Nuclear Medicine and Oncology (INMOL), Lahore. All PET-CT scans were assessed by a researcher and 3 nuclear physicians and divided into two groups, interpreted in two phases. In the first phase, each group independently evaluated the scans while in the second phase, a consensus meeting was held and all the cases with discordance were discussed. Cohen’s Kappa test was used to measure interobserver variability with the cut-off of K’s alpha Results: The study showed 41 out of 44 scans with positive PSMA findings while 03 scans were negative for any PSMA avid disease. In the first phase of image analysis, the level of agreement was slight in T stage (Kappa = 0.068, p = 0.65), moderate in the miN stage (Kappa = 0.46, p = 0.02) and substantial in miM stage (Kappa = 0.77, p ≤ 0.001) was seen. For PSMA score, overall agreement was substantial agreement (Kappa = 0.64, p Conclusion: Remarkable inter-observer agreement was seen in PROMISE criteria.展开更多
Objective: Prostate cancers(PCa) in Asian individuals are molecularly distinct from those found in their Caucasian counterparts.There is no risk stratification tool for Asian men with rapid biochemical recurrence(BCR)...Objective: Prostate cancers(PCa) in Asian individuals are molecularly distinct from those found in their Caucasian counterparts.There is no risk stratification tool for Asian men with rapid biochemical recurrence(BCR) following radical prostatectomy(Rad P). This study aims to assess the detection rate of ^(68)Ga-prostate-specific membrane antigen-positron emission tomography/computed tomography(PSMA-PET/CT) for diagnosis of clinical recurrence and as a treatment decision making tool in Asian patients with BCR post-Rad P.Methods: ^(68)Ga PSMA-PET and CT body with/without bone scan [conventional workup(CWU)] were performed in 55 Asian patients with BCR within 36 months post-Rad P. Two blinded reviewers assessed the images. Detection rates of ^(68)Ga PSMAPET/CT were evaluated, and impact on management was reviewed by comparison with CWU.Results: Median time to BCR post-Rad P was 8.1 months. Detection rate for ^(68)Ga PSMA-PET/CT was 80%(44/55). A positive scan was significantly associated with increasing prostate-specific antigen(PSA) level [odds ratio(OR) = 1.13(95% CI 1.05–1.30), P =0.017], but not with higher Gleason grade or shorter PSA doubling time. Compared to CWU, ^(68)Ga PSMA-PET/CT detected an additional 106 lesions in 33/44 patients with a positive scan, resulting in a change in management in 25/44(56.8%) patients: 10 to hormonal therapy(HT) and whole pelvis radiotherapy(RT) in addition to bed RT, and 15 to palliative HT alone.Conclusions: In the present report, we demonstrated the diagnostic and treatment decision utility of ^(68)Ga PSMA-PET/CT in Asian men with rapid BCR. Detection of small volume nodal and systemic recurrences at low PSA levels(< 1.0 ng/mL) highlights the role of the tool in assigning patients to treatment intensification with HT-RT or palliative HT in polymetastatic disease.展开更多
目的:前列腺特异性膜抗原(prostate specific membrane antigen,PSMA)可作为前列腺癌诊断的重要靶点。该研究成功制备了1种新型68Ga标记PSMA小分子抑制剂PSMA11,并根据《中华人民共和国药典》标准进行质量控制,同时探讨该分子影像探针...目的:前列腺特异性膜抗原(prostate specific membrane antigen,PSMA)可作为前列腺癌诊断的重要靶点。该研究成功制备了1种新型68Ga标记PSMA小分子抑制剂PSMA11,并根据《中华人民共和国药典》标准进行质量控制,同时探讨该分子影像探针在前列腺癌动物模型中的靶向显像效果。方法:利用68Ge/68Ga发生器淋洗产生68Ga液,标记PSMA11制备正电子分子探针68Ga-PSMA11;建立符合药典标准的质量标准草案,对药品进行质量控制;利用小动物PET/CT,在人前列腺癌细胞LNCaP的SCID小鼠移植瘤模型上研究68Ga-PSMA11在注射后体内动态分布情况。结果:成功制备获得68GaPSMA11,质量控制符合规定,放射化学纯度大于99%,其在体内除肾脏及膀胱放射性生理性高分布外,在肿瘤部位有较明显特异性浓聚,其余器官组织放射性分布均处于较低水平。结论:68Ga-PSMA11标记方法简便,在体内肿瘤中特异性摄取程度高,是一个理想的正电子型PSMA特异性分子探针。展开更多
颈动脉体瘤(carotid body tumor,CBT)是一种化学感受器肿瘤,大部分位于劲总动脉分叉处,对体内二氧化碳、酸碱度及温度等刺激起神经反射作用。CBT多为良性肿瘤,恶性者占6%~10%[1]。超声、CT、MRI及DSA等影像学检查技术常用于诊断颈动脉...颈动脉体瘤(carotid body tumor,CBT)是一种化学感受器肿瘤,大部分位于劲总动脉分叉处,对体内二氧化碳、酸碱度及温度等刺激起神经反射作用。CBT多为良性肿瘤,恶性者占6%~10%[1]。超声、CT、MRI及DSA等影像学检查技术常用于诊断颈动脉体瘤。近年来,PET/CT显像诊断多灶性颈动脉体瘤上的优势越来越吸引着临床大夫的眼球。现报道一例右侧颈动脉体瘤18F-FDG PET/CT显像结果及复习相关文献来探讨分子影像学技术在颈动脉体瘤中的应用。展开更多
文摘Aims & Objectives: Aim of the study was to evaluate inter-observer variability in interpretation of Gallium-68 labeled Prostate Specific Membrane Antigen sub-type 11 (68Ga-PSMA-11) Positron Emission Tomography-Computed Tomography PET_CT scan according to Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE) criteria. Method and Materials: Forty-four consecutive patients of prostate cancer were prospectively studied between the duration of January 2021 to June 2021 at Institute of Nuclear Medicine and Oncology (INMOL), Lahore. All PET-CT scans were assessed by a researcher and 3 nuclear physicians and divided into two groups, interpreted in two phases. In the first phase, each group independently evaluated the scans while in the second phase, a consensus meeting was held and all the cases with discordance were discussed. Cohen’s Kappa test was used to measure interobserver variability with the cut-off of K’s alpha Results: The study showed 41 out of 44 scans with positive PSMA findings while 03 scans were negative for any PSMA avid disease. In the first phase of image analysis, the level of agreement was slight in T stage (Kappa = 0.068, p = 0.65), moderate in the miN stage (Kappa = 0.46, p = 0.02) and substantial in miM stage (Kappa = 0.77, p ≤ 0.001) was seen. For PSMA score, overall agreement was substantial agreement (Kappa = 0.64, p Conclusion: Remarkable inter-observer agreement was seen in PROMISE criteria.
基金supported in part by Varian, Paolo Alto, CA through a structured research agreementsupported by the National Medical Research Council Singapore Clinician-Scientist Award (Grant No. NMRC/CSA/0027/ 2018)the Duke-NUS Oncology Academic Program Proton Research Program
文摘Objective: Prostate cancers(PCa) in Asian individuals are molecularly distinct from those found in their Caucasian counterparts.There is no risk stratification tool for Asian men with rapid biochemical recurrence(BCR) following radical prostatectomy(Rad P). This study aims to assess the detection rate of ^(68)Ga-prostate-specific membrane antigen-positron emission tomography/computed tomography(PSMA-PET/CT) for diagnosis of clinical recurrence and as a treatment decision making tool in Asian patients with BCR post-Rad P.Methods: ^(68)Ga PSMA-PET and CT body with/without bone scan [conventional workup(CWU)] were performed in 55 Asian patients with BCR within 36 months post-Rad P. Two blinded reviewers assessed the images. Detection rates of ^(68)Ga PSMAPET/CT were evaluated, and impact on management was reviewed by comparison with CWU.Results: Median time to BCR post-Rad P was 8.1 months. Detection rate for ^(68)Ga PSMA-PET/CT was 80%(44/55). A positive scan was significantly associated with increasing prostate-specific antigen(PSA) level [odds ratio(OR) = 1.13(95% CI 1.05–1.30), P =0.017], but not with higher Gleason grade or shorter PSA doubling time. Compared to CWU, ^(68)Ga PSMA-PET/CT detected an additional 106 lesions in 33/44 patients with a positive scan, resulting in a change in management in 25/44(56.8%) patients: 10 to hormonal therapy(HT) and whole pelvis radiotherapy(RT) in addition to bed RT, and 15 to palliative HT alone.Conclusions: In the present report, we demonstrated the diagnostic and treatment decision utility of ^(68)Ga PSMA-PET/CT in Asian men with rapid BCR. Detection of small volume nodal and systemic recurrences at low PSA levels(< 1.0 ng/mL) highlights the role of the tool in assigning patients to treatment intensification with HT-RT or palliative HT in polymetastatic disease.
文摘目的:前列腺特异性膜抗原(prostate specific membrane antigen,PSMA)可作为前列腺癌诊断的重要靶点。该研究成功制备了1种新型68Ga标记PSMA小分子抑制剂PSMA11,并根据《中华人民共和国药典》标准进行质量控制,同时探讨该分子影像探针在前列腺癌动物模型中的靶向显像效果。方法:利用68Ge/68Ga发生器淋洗产生68Ga液,标记PSMA11制备正电子分子探针68Ga-PSMA11;建立符合药典标准的质量标准草案,对药品进行质量控制;利用小动物PET/CT,在人前列腺癌细胞LNCaP的SCID小鼠移植瘤模型上研究68Ga-PSMA11在注射后体内动态分布情况。结果:成功制备获得68GaPSMA11,质量控制符合规定,放射化学纯度大于99%,其在体内除肾脏及膀胱放射性生理性高分布外,在肿瘤部位有较明显特异性浓聚,其余器官组织放射性分布均处于较低水平。结论:68Ga-PSMA11标记方法简便,在体内肿瘤中特异性摄取程度高,是一个理想的正电子型PSMA特异性分子探针。
文摘颈动脉体瘤(carotid body tumor,CBT)是一种化学感受器肿瘤,大部分位于劲总动脉分叉处,对体内二氧化碳、酸碱度及温度等刺激起神经反射作用。CBT多为良性肿瘤,恶性者占6%~10%[1]。超声、CT、MRI及DSA等影像学检查技术常用于诊断颈动脉体瘤。近年来,PET/CT显像诊断多灶性颈动脉体瘤上的优势越来越吸引着临床大夫的眼球。现报道一例右侧颈动脉体瘤18F-FDG PET/CT显像结果及复习相关文献来探讨分子影像学技术在颈动脉体瘤中的应用。
