早期生物化学复发的前列腺癌中，肿瘤对背景比率随时间显著增加，利用[89Zr]Zr-PSMA-617 PET/CT实现肿瘤定位

Outstanding increase in tumor-to-background ratio over time allows tumor localization by [89Zr]Zr-PSMA-617 PET/CT in early biochemical recurrence of prostate cancer

CANCER IMAGING

影响因子:3.5

分区:医学2区 / 肿瘤学2区核医学2区

发表日期:2024 Oct 07

作者: Caroline Burgard, Florian Rosar, Elena Larsen, Fadi Khreish, Johannes Linxweiler, Robert J Marlowe, Andrea Schaefer-Schuler, Stephan Maus, Sven Petto, Mark Bartholomä, Samer Ezziddin

DOI: 10.1186/s40644-024-00778-5

摘要

采用锆-89（89Zr；半衰期约78.41小时）标记的前列腺特异性膜抗原（PSMA）靶向放射性示踪剂的正电子发射断层扫描/计算机断层扫描（PET/CT）在局部化前列腺癌生化复发（BCR）方面显示出良好前景。在一项回顾性分析中，包括38名连续发生BCR的男性（中位数[最小-最大]前列腺特异性抗原0.52[0.12-2.50] ng/mL），他们在前一次阴性[68Ga]Ga-PSMA-11 PET/CT后接受了[89Zr]Zr-PSMA-617 PET/CT检测。PET/CT在注射后1小时、24小时和48小时进行扫描，中位（最小-最大）[89Zr]Zr-PSMA-617示踪剂活性为123（84-166）MBq。检测到总共57个病灶，包括18个局部复发、33个淋巴结转移和6个骨转移，涉及30/38名BCR患者（78%），且先前阴性常规PSMA PET/CT。病灶的摄取显著从1小时到24小时增加，在多数情况下，从24小时到48小时也有增加。肿瘤对背景的比率随时间显著上升，绝对值增加达100或以上。未观察到副作用。经过[89Zr]Zr-PSMA-617 PET/CT指导的治疗后，所有患者的前列腺特异性抗原水平下降，其中三分之一的患者检测不到。该系列研究提供了进一步证据支持[89Zr]Zr-PSMA-617 PET/CT作为定位早期BCR的有效影像学手段。显著的肿瘤对背景比率随时间的增加，有助于定位传统PSMA PET/CT未能发现的肿瘤。

Abstract

Positron emission tomography/computed tomography (PET/CT) using prostate-specific membrane antigen (PSMA)-targeted radiotracers labeled with zirconium-89 (89Zr; half-life ~ 78.41 h) showed promise in localizing biochemical recurrence of prostate cancer (BCR) in pilot studies.Retrospective analysis of 38 consecutive men with BCR (median [minimum-maximum] prostate-specific antigen 0.52 (0.12-2.50 ng/mL) undergoing [89Zr]Zr-PSMA-617 PET/CT post-negative [68Ga]Ga-PSMA-11 PET/CT. PET/CT acquisition 1-h, 24-h, and 48-h post-injection of a median (minimum-maximum) [89Zr]Zr-PSMA-617 tracer activity of 123 (84-166) MBq.[89Zr]Zr-PSMA-617 PET/CT detected altogether 57 lesions: 18 local recurrences, 33 lymph node metastases, 6 bone metastases in 30/38 men with BCR (78%) and prior negative conventional PSMA PET/CT. Lesion uptake significantly increased from 1-h to 24-h and, in a majority of cases, from 24-h to 48-h. Tumor-to-background ratios significantly increased over time, with absolute increases of 100 or more. No side effects were noted. After [89Zr]Zr-PSMA-617 PET/CT-based treatment, prostate-specific antigen concentration decreased in all patients, becoming undetectable in a third of patients.retrospective, single center design; infrequent histopathological and imaging verification.This large series provides further evidence that [89Zr]Zr-PSMA-617 PET/CT is a beneficial imaging modality to localize early BCR. A remarkable increase in tumor-to-background ratio over time allows localization of tumor unidentified on conventional PSMA PET/CT.