诊断学理论与实践

诊断学理论与实践 ›› 2023, Vol. 22 ›› Issue (06): 567-572.doi: 10.16150/j.1671-2870.2023.06.009

• 论著 • 上一篇    下一篇

18F-PSMA PET/MRI在早期诊断前列腺癌根治术后复发、转移中的价值

周熠磊, 张淼, 郭睿, 周金鑫, 李彪, 李翔()   

  1. 上海交通大学医学院附属瑞金医院核医学科，上海 200025
  • 收稿日期:2023-05-23 出版日期:2023-12-25 发布日期:2024-03-18
  • 通讯作者: 李翔 E-mail：lx40768@rjh.com.cn
  • 基金资助:
    上海市卫生健康委员会面上项目(202240031)

Value of 18F-PSMA PET/MRI for early diagnosis of recurrence and metastasis in prostate cancer patients after radical prostatectomy

ZHOU Yilei, ZHANG Miao, GUO Rui, ZHOU Jinxin, LI Biao, LI Xiang()   

  1. Department of Nuclear Medicine，Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2023-05-23 Published:2023-12-25 Online:2024-03-18

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摘要：

目的： 探讨18氟-前列腺特异性膜抗原（18F-prostate-specific membrane antigen, 18F-PSMA）-1007正电子发射计算机断层显像/磁共振成像系统(positron emission tomography/magnetic resonance imaging, PET/MRI)（以下简称PET/MRI）检查在早期诊断前列腺癌根治术后患者复发、转移中的价值。方法： 连续纳入2019年6月至2022年1月上海交通大学医学院附属瑞金医院收治的前列腺癌根治术后患者143例，均于术后12~60个月内完成PET/MRI检查。统计PET/MRI检查对患者术后肿瘤复发或转移灶的检出率，根据患者的血清前列腺特异性抗原(prostate-specific antigen, PSA)水平分为PSA≤0.2 ng/mL、0.2 ng/mL<PSA≤0.5 ng/mL、0.5 ng/mL<PSA≤4.0 ng/mL、4.0 ng/mL<PSA<10.0 ng/mL和PSA≥10.0 ng/mL 5组，比较不同组中复发或转移灶的检出率。结果： 25%PSA≤0.2 ng/mL、0.2 ng/mL<PSA≤0.5 ng/mL、0.5 ng/mL<PSA≤4.0 ng/mL、4.0 ng/mL<PSA<10.0 ng/mL和PSA≥10.0 ng/mL组中PET/MRI对复发或转移灶的检出率分别为25.00%（6/24）、70.00%（7/10）、66.67%（16/24）、74.07%（20/27）和94.83%（55/58），各组间两两比较检出率差异有统计学意义（P<0.01或P<0.05）。34例（27.64%）患者根据PET/MRI检查结果改变了治疗方案。结论： PET/MRI在PSA未升高的前列腺癌患者中检出了约1/4存在肿瘤复发或转移的患者，且随着血清PSA水平升高，检出率随之升高，提示PET/MRI可早期检出前列腺癌复发、转移灶，有效指导治疗方案的制定。

关键词: 正电子发射断层显像计算机体层摄影术, 磁共振成像, 前列腺癌

Abstract:

Objective: To investigate the value and significance of 18F-prostate-specific membrane antigen (18F-PSMA)-1007 PET/MR for early diagnosis of recurrence and metastasis in prostate cancer patients after radical prostatectomy (RP). Methods: A total of 143 patients with prostate cancer after radical prostatectomy were enrolled during June 2019 to January 2022 in Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. All the patients underwent 18F-PSMA-1007 PET/MR imaging within 12 to 60 months after surgery. According to the serum prostate-specific antigen (PSA) levels, patients were divided into 5 groups（PSA≤0.2 ng/mL, 0.2 ng/mL<PSA≤0.5 ng/mL, 0.5 ng/mL<PSA≤4.0 ng/mL, 4.0 ng/mL<PSA<10.0 ng/mL and PSA≥10.0 ng/mL). The detection rates of recurrence or metastasis were compared between different groups. Results: The detection rates of 18F-PSMA-1007 PET/MR for recurrence or metastasis in PSA≤0.2 ng/mL, 0.2 ng/mL<PSA≤0.5 ng/mL, 0.5 ng/mL< PSA ≤ 4.0 ng/mL, 4.0 ng/mL<PSA<10.0 ng/mL and PSA ≥ 10.0 ng/mL groups were 25.00% (6/24)，70.00% (7/10)，66.67% (16/24)，74.07% (20/27) and 94.83% (55/58) respectively, and bilateral comparison between groups revealed that difference in detection rate was statistically significant (P<0.01 or P<0.05). In terms of treatment，34 patients (27.64%) changed their pre-examination treatment regimen based on the results of 18F-PSMA-1007 PET/MR imaging. Conclusions: It reveals that prostate patients with detected recurrence or metastasis account for 25% of those with normal PSA level.The detection rate increases with the increase of PSA levels. It suggests that 18F-PSMA PET/MR can detect recurrence and metastasis in the early stage, which can effectively guide the formulation of treatment plans.

Key words: Positron emission tomography computed tomography, Magnetic resonance imaging, Prostate cancer

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