¹⁸F-Prostate-Specific Membrane Antigen PET/CT imaging for potentially resectable pancreatic cancer (PANSCAN-2): a phase I/II study.

IF 3.5 2区医学 Q2 ONCOLOGY Cancer Imaging Pub Date : 2025-01-14 DOI:10.1186/s40644-025-00822-y

Jisce R Puik, Thomas T Poels, Gerrit K J Hooijer, Matthijs C F Cysouw, Joanne Verheij, Johanna W Wilmink, Elisa Giovannetti, Geert Kazemier, Arantza Farina Sarasqueta, Daniela E Oprea-Lager, Rutger-Jan Swijnenburg

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Abstract

Background: Current diagnostic imaging modalities have limited ability to differentiate between malignant and benign pancreaticobiliary disease, and lack accuracy in detecting lymph node metastases. ¹⁸F-Prostate-Specific Membrane Antigen (PSMA) PET/CT is an imaging modality used for staging of prostate cancer, but has incidentally also identified PSMA-avid pancreatic lesions, histologically characterized as pancreatic ductal adenocarcinoma (PDAC). This phase I/II study aimed to assess the feasibility of ¹⁸F-PSMA PET/CT to detect PDAC.

Methods: Seventeen patients with clinically resectable PDAC underwent ¹⁸F-PSMA PET/CT prior to surgical resection. Images were analyzed both visually and (semi)quantitatively by deriving the maximum standardized uptake value (SUV_max) and tumor-to-background ratio (TBR). TBR was defined as the ratio between SUV_max of the primary tumor divided by SUV_max of the aortic blood pool. Finally, tracer uptake on PET was correlated to tissue expression of PSMA in surgical specimens.

Results: Out of 17 PSMA PET/CT scans, 13 scans demonstrated positive PSMA tracer uptake, with a mean SUV_max of 5.0 ± 1.3. The suspected primary tumor was detectable (TBR ≥ 2) with a mean TBR of 3.3 ± 1.3. For histologically confirmed PDAC, mean SUV_max and mean TBR were 4.9 ± 1.2 and 3.3 ± 1.5, respectively. Although eight patients had histologically confirmed regional lymph node metastases and two patients had distant metastases, none of these metastases demonstrated ¹⁸F-PSMA uptake. There was no correlation between ¹⁸F-PSMA PET/CT SUV_max and tissue expression of PSMA in surgical specimens.

Conclusions: ¹⁸F-PSMA PET/CT was able to detect several pancreaticobiliary cancers, including PDAC. However, uptake was generally low, not specific to PDAC and no tracer uptake was observed in lymph node or distant metastases. The added value of PSMA PET in this setting appears to be limited.

Trial registration: The trial is registered as PANSCAN-2 in the European Clinical Trials Database (EudraCT number: 2020-002185-14).

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18f前列腺特异性膜抗原PET/CT成像用于潜在可切除的胰腺癌（PANSCAN-2）：一项I/II期研究

背景：目前的诊断成像方式区分恶性和良性胰胆管疾病的能力有限，并且在检测淋巴结转移方面缺乏准确性。18f -前列腺特异性膜抗原（PSMA） PET/CT是一种用于前列腺癌分期的成像方式，但偶然也发现了PSMA阳性胰腺病变，组织学特征为胰腺导管腺癌（PDAC）。本I/II期研究旨在评估18F-PSMA PET/CT检测PDAC的可行性。方法：17例临床可切除的PDAC患者在手术切除前接受了18F-PSMA PET/CT检查。通过获得最大标准化摄取值（SUVmax）和肿瘤与背景比（TBR），对图像进行视觉和（半）定量分析。TBR定义为原发肿瘤SUVmax与主动脉血池SUVmax之比。最后，PET示踪剂摄取与手术标本中PSMA的组织表达相关。结果：在17次PSMA PET/CT扫描中，13次扫描显示PSMA示踪剂摄取阳性，平均SUVmax为5.0±1.3。怀疑原发肿瘤可检出（TBR≥2），平均TBR为3.3±1.3。对于组织学证实的PDAC，平均SUVmax和平均TBR分别为4.9±1.2和3.3±1.5。虽然8例患者组织学上证实有局部淋巴结转移，2例患者有远处转移，但这些转移均未表现出18F-PSMA摄取。18F-PSMA PET/CT SUVmax与手术标本中PSMA的组织表达无相关性。结论：18F-PSMA PET/CT能够检测多种胰胆管癌，包括PDAC。然而，摄取通常较低，并非PDAC特异性，在淋巴结或远处转移中未观察到示踪剂摄取。在这种情况下，PSMA PET的附加值似乎有限。试验注册：该试验在欧洲临床试验数据库中注册为PANSCAN-2 （EudraCT号：2020-002185-14）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Imaging ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

7.00

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Cancer Imaging is an open access, peer-reviewed journal publishing original articles, reviews and editorials written by expert international radiologists working in oncology. The journal encompasses CT, MR, PET, ultrasound, radionuclide and multimodal imaging in all kinds of malignant tumours, plus new developments, techniques and innovations. Topics of interest include: Breast Imaging Chest Complications of treatment Ear, Nose & Throat Gastrointestinal Hepatobiliary & Pancreatic Imaging biomarkers Interventional Lymphoma Measurement of tumour response Molecular functional imaging Musculoskeletal Neuro oncology Nuclear Medicine Paediatric.