Clinical value of <sup>99m</sup>Tc-PSMA SPECT/CT in detection of prostate cancer

HU Silong; XU Xiaoping; ZHU Yao; HE Simin; SU Hengchuan; YE Dingwei; GUO Xiaomao; ZHANG Yingjian

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Clinical value of ^99mTc-PSMA SPECT/CT in detection of prostate cancer

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- Clinical value of ^99mTc-PSMA SPECT/CT in detection of prostate cancer
- Vol. 25, Issue 3, Pages: 272-278(2016)
- 作者机构：
  
  1. 复旦大学生物医学影像研究中心,上海,200032
  2. 上海分子影像探针工程技术研究中心筹,上海,200032
  3. 复旦大学上海医学院肿瘤学系,上海,200032
  4. 复旦大学附属肿瘤医院质子重离子中心,上海,201315
  5. 复旦大学附属肿瘤医院核医学科,上海,200032
  6. 复旦大学附属肿瘤医院泌尿外科,上海,200032
  7. 复旦大学附属肿瘤医院放疗科,上海,200032
- 作者简介：
- 基金信息：
- DOI：
  CLC：
- Online First：02 November 2016，
  
  Published：02 November 2016
- 稿件说明：
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胡四龙,许晓平,朱耀,等. ^99mTc-PSMA SPECT/CT探测前列腺癌病灶的临床应用价值[J]. 肿瘤影像学, 2016, 25(3): 272-278
DOI：

胡四龙,许晓平,朱耀,等. ^99mTc-PSMA SPECT/CT探测前列腺癌病灶的临床应用价值[J]. 肿瘤影像学, 2016, 25(3): 272-278 DOI：

摘要

目的：

探讨

99m

Tc标记前列腺特异性膜抗原(prostate specific membrane antigen，PSMA)小分子抑制剂(HYNIC-Glu-Urea-A，简称99mTc-PSMA) SPECT/CT显像探测前列腺癌原发灶和转移灶的临床价值。

方法：

回顾性分析69例(初诊12例、经治57例)前列腺癌患者

99m

Tc-PSMA SPECT/CT结果，评价全身平面显像结合断层显像检测前列腺癌原发和(或)转移灶的价值，分析

99m

Tc-PSMA阳性率与前列腺特异性抗原(prostate specific antigen，PSA)水平和Gleason评分的关系。

结果：

所有69例患者中，6例根治术后PSA＜0.2 ng/mL患者为治愈状态，以患者为单位，

99m

Tc-PSMA阳性率77.8% (49/63)。

99m

Tc-PSMA阳性患者PSA水平 (中位数25.52 ng/mL，范围0.85~3 239 ng/mL)明显高于

99m

Tc-PSMA阴性患者PSA水平(中位数0.35 ng/mL，范围0.003~9.28 ng/mL)(

＜0.001)；在初诊和PSA＞1.0 ng/mL的复发患者中，阳性率高达97.4% (37/38)。

99m

Tc-PSMA阳性组患者Gleason评分高于阴性组患者(

＜0.001)。

结论：

对于前列腺癌初诊患者和PSA＞1.0 ng/mL的复发患者，

99m

Tc-PSMA SPECT/CT对原发灶和复发转移灶的探测有较高应用价值，可为临床提供重要的治疗决策依据。

Abstract

Objective:

To evaluate the clinical value of technetium-

99m

labelled small molecule against prostate specific membrane antigen (PSMA) (HYNIC-Glu-Urea-A

99m

Tc-PSMA) in the detection of primary and metastatic prostate cancers.

Methods:

A total of 69 consecutive prostate cancer patients wh

o received

99m

Tc-PSMA SPECT/CT were retrospectively analyzed. The sensitivity of

99m

Tc-PSMA for the detection of the primary and metastatic lesions was evaluated. The relationships between positive

99m

Tc-PSMA and prostate specific antigen (PSA) level and Gleason score were analyzed.

Results:

Of all patients

6 cases with PSA0.2 ng/mL after radical prostatectomy remained biochemically disease-free. Based on per patient

in 77.8% (49/63) of thepatients at least one lesion indicative of prostate cancer was detected by

99m

Tc-PSMA SPECT/CT. The level of PSA in the patients with positive

99m

Tc-PSMA imaging was significantly higher than that in the patients with negative

99m

Tc-PSMA imaging (PSA median 25.52 ng/mL

range: 0.85-3 239 ng/mL)

vs.

(PSA median 0.35 ng/mL

range: 0.003-9.28 ng/mL)(

0.001). Among newly diagnosed patients and recurrent patients with PSA1.0 ng/mL

99m

Tc-PSMA imaging was able to detect lesions with improved sensitivity of 97.4% (37/38); furthermore

among recurrent patients with PSA10.0 ng/mL

the number and extent of lesions detected by

99m

Tc- PSMA SPECT/CT increased significantly. Gleason score in the patients with positive

99m

Tc-PSMA imaging was significantly higher than that in the patients with negative

99m

Tc-PSMA imaging (

0.001).

Conclusion:

Among newly diagnosed prostate cancer patients and recurrent patients with PSA1.0 ng/mL

99m

Tc-PSMA SPECT/CT can detect prostate cancer and metastases in a high number of patients and can provide important information for clinical treatment decision.

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Clinical value of 99mTc-PSMA SPECT/CT in detection of prostate cancer

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Clinical value of ^99mTc-PSMA SPECT/CT in detection of prostate cancer