通过[18F]F-PSMA-1007 PET/MR 综合评估对接受前列腺切除术治疗、生化复发率极低(<0.5 ng/ml)的前列腺癌患者进行局部和全身复发检出率评估。治疗意义。

J.R. Garcia, A. Compte, J. Pastor, S. Mourelo, L. Mont, P. Bassa, E. Llinares, M. Soler, E. Valls, T. Blanch, E. Riera
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Riera","doi":"10.1016/j.remnie.2024.500037","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To analyse the efficacy of integrated assessment of [<sup>18</sup>F]F-PSMA-1007 PET/MRI on the early detection of local recurrence (LR) for prostate cancer patients with PSA levels &lt;0.5<!--> <!-->ng/ml after radical prostatectomy.</p><p>To assess the location of recurrence so that therapy may be tailored to patient.</p></div><div><h3>Methods</h3><p>Prospective study including 35 patients with prostate cancer (PCa), who were referred for a [<sup>18</sup>F]F-PSMA-1007 PET/MR after prostatectomy with a very initial PSA value increase (PSA<!--> <!-->&lt;<!--> <!-->0,5<!--> <!-->ng/ml).</p><p>Simultaneous acquisition in a PET/MRI hybrid equipment (SIGNA-GE), 1<!--> <!-->h after administration of 370%<!--> <!-->±<!--> <!-->10% MBq of [<sup>18</sup>F]F-PSMA-1007:</p><p>Prostate selective imaging (20<!--> <!-->min): multiparametric PET<!--> <!-->+<!--> <!-->MRI (MRImp): DIXON, T1, T2, diffusion sequences post-gadolinium administration.</p><p>Whole body image (30<!--> <!-->min): PET<!--> <!-->+<!--> <!-->MRI: DIXON, T1, T2, diffusion, STIR sequences.</p><p>A nuclear physician and a radiologist jointly reviewed the studies:</p><p>In order to assess LR, the “Prostate Imaging for Recurrence Reporting” system was used on MRI, as well as the Likert scale on the PET prostate imaging.</p><p>The remaining lesions were classified as N1 and M1a.</p></div><div><h3>Results</h3><p>PET/MRI was positive in 25 patients (71,4%) and negative in 10 patients (28,6%).</p><p>RL was detected in 15 patients (42.9%): in 2 (5.7%) MRI was superior; in 3 (8.6%) PET was superior; integrated PET/MRI showed improved results in 5 patients (14.3%) for the detection of LR.</p><p>Location of recurrences: LR in 11 patients (44.0%); N1 in 10 (40.0%); LR<!--> <!-->+<!--> <!-->N1 (8.0%) in 2; LR<!--> <!-->+<!--> <!-->N1<!--> <!-->+<!--> <!-->M1a in 2 (8.0%).</p><p>In 20 patients (80%) the PET/MRI findings allowed radioguided radiotherapy implementation (11 on LR, and 9 on N1), whereas hormonal treatment was decided in 5 patients (20%) due to multimetastases/spread disease.</p></div><div><h3>Conclusion</h3><p>[<sup>18</sup>F]F-PSMA-1007 PET/MRI has a 71.4% recurrence detection rate after prostatectomy with PSA<!--> <!-->&lt;<!--> <!-->0.5<!--> <!-->ng/ml. 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引用次数: 0

摘要

目的分析[18F]F-PSMA-1007 PET/MRI 综合评估对 PSA 水平较高的前列腺癌患者早期发现局部复发(LR)的疗效 方法:前瞻性研究:包括35名前列腺癌(PCa)患者,这些患者在前列腺切除术后转诊接受[18F]F-PSMA-1007 PET/MR检查,且PSA值初始升高(PSA 18F]F-PSMA-1007:前列腺选择性成像(20 分钟):多参数 PET + MRI(MRImp):钆注射后的DIXON、T1、T2、弥散序列。全身成像(30 分钟):PET + MRI:DIXON、T1、T2、弥散、STIR 序列。一名核医师和一名放射医师共同审查了这些研究:为了评估 LR,核磁共振成像采用了 "前列腺成像复发报告 "系统,PET 前列腺成像采用了李克特量表。其余病变分为 N1 和 M1a:25名患者(71.4%)的 PET/MRI 呈阳性,10名患者(28.6%)呈阴性。15名患者(42.9%)检测出了LR:2名患者(5.7%)MRI结果更优;3名患者(8.6%)PET结果更优;5名患者(14.3%)PET/MRI综合结果显示LR检测结果更好。复发位置:11例患者(44.0%)为LR;10例患者(40.0%)为N1;2例患者为LR + N1 (8.0%);2例患者为LR + N1 + M1a (8.0%)。20例患者(80%)的PET/MRI检查结果允许在放射引导下实施放疗(11例在LR,9例在N1),而5例患者(20%)因多发转移/疾病扩散而决定接受激素治疗:结论:[18F]F-PSMA-1007 PET/MRI 在前列腺 PSA 切除术后的复发检测率为 71.4%。
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To evaluate the detection rate of local and whole-body recurrence by integrated [18F]F-PSMA-1007 PET/MR assessment of prostate cancer patients treated with prostatectomy with very low biochemical recurrence (<0.5 ng/ml). Therapeutic implications

Objective

To analyse the efficacy of integrated assessment of [18F]F-PSMA-1007 PET/MRI on the early detection of local recurrence (LR) for prostate cancer patients with PSA levels <0.5 ng/ml after radical prostatectomy.

To assess the location of recurrence so that therapy may be tailored to patient.

Methods

Prospective study including 35 patients with prostate cancer (PCa), who were referred for a [18F]F-PSMA-1007 PET/MR after prostatectomy with a very initial PSA value increase (PSA < 0,5 ng/ml).

Simultaneous acquisition in a PET/MRI hybrid equipment (SIGNA-GE), 1 h after administration of 370% ± 10% MBq of [18F]F-PSMA-1007:

Prostate selective imaging (20 min): multiparametric PET + MRI (MRImp): DIXON, T1, T2, diffusion sequences post-gadolinium administration.

Whole body image (30 min): PET + MRI: DIXON, T1, T2, diffusion, STIR sequences.

A nuclear physician and a radiologist jointly reviewed the studies:

In order to assess LR, the “Prostate Imaging for Recurrence Reporting” system was used on MRI, as well as the Likert scale on the PET prostate imaging.

The remaining lesions were classified as N1 and M1a.

Results

PET/MRI was positive in 25 patients (71,4%) and negative in 10 patients (28,6%).

RL was detected in 15 patients (42.9%): in 2 (5.7%) MRI was superior; in 3 (8.6%) PET was superior; integrated PET/MRI showed improved results in 5 patients (14.3%) for the detection of LR.

Location of recurrences: LR in 11 patients (44.0%); N1 in 10 (40.0%); LR + N1 (8.0%) in 2; LR + N1 + M1a in 2 (8.0%).

In 20 patients (80%) the PET/MRI findings allowed radioguided radiotherapy implementation (11 on LR, and 9 on N1), whereas hormonal treatment was decided in 5 patients (20%) due to multimetastases/spread disease.

Conclusion

[18F]F-PSMA-1007 PET/MRI has a 71.4% recurrence detection rate after prostatectomy with PSA < 0.5 ng/ml. Its combined PET and MRI study increases the detection of LR by 14.3%, with a high N1 + M1a detection rate (56%), allowing radioguided radiotherapy in 80% of patients.

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