Precise low dose brachytheray of prostate cancer uder PSMA-receptor molecular visualization

Abstract

The method of choice in the treatment of localized prostate cancer (prostate cancer) without signs of germination of the gland capsule and in the absence of signs of metastases (stage cT1-T3aN0M0) is brachytherapy with implantation of seeds with 125I. Structural imaging methods (ultrasound, CT, MRI) do not have high specificity in the differential diagnosis of prostate cancer. Hybrid technologies of radiation imaging (SPECT/CT, PET/CT, PET/MRI) combine the advantages of high sensitivity of cross-sectional structural imaging methods (CT, MRI) and high specificity of molecular imaging methods (SPECT, PET) with tumorotropic radiopharmaceuticals. In this original clinical study, based on 7 patients with localized prostate cancer (Gleason 6-7), it was shown that the precision of low-dose brachytherapy with 125I micro sources of localized prostate carcinomas, as well as their targeted biopsy, can be increased when using hybrid methods of PSMA-receptor molecular imaging (SPECT) for navigation/CT, PET/CT). The SPECT/CT method is more accessible than PET/CT, and in the presence of cold kits (HYNIC-PSMA), it allows you to perform research in any radioisotope diagnostics laboratory with the appropriate equipment. The innovative technology of PSMA-precision biopsy of brachytherapy under the control of hybrid molecular imaging can be used in primary and recurrent cases of localized prostate cancer, increases the accuracy and reduces the traumatic nature of procedures, increases the medical and economic efficiency of low-dose brachytherapy with 125I seeds. Further research is needed to improve the technology and evaluate long-term treatment outcomes in a large group of patients.