理解和改进18f -氟氯氯vine PET/CT报告:医生治疗前列腺癌生化复发患者的指南。

IF 2.3 Q3 ONCOLOGY Prostate Cancer Pub Date : 2020-04-26 eCollection Date: 2020-01-01 DOI:10.1155/2020/1929565
Benjamin H Lowentritt, Michael S Kipper
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引用次数: 2

摘要

正电子发射断层扫描(PET)示踪剂18f -氟氯洛夫在前列腺癌生化复发(即治疗后前列腺特异性抗原(PSA)水平升高)的男性中越来越多地用于疾病定位。18f氟氯氟PET/计算机断层扫描(CT)成像报告现在在许多医患讨论中发挥核心作用。然而,由于目前还没有标准化的分级系统或模板用于18f氟氯氟图像评估,报告在格式、全面性和术语方面各不相同,可能难以完全理解。为了更好地利用这些文献,转诊医师应了解18f氟氯叶PET/CT的六个关键特征。首先,18f -氟氯草素是一种放射性标记的合成氨基酸,靶向氨基酸转运体ASCT2和LAT1,这两种转运体在体内普遍存在,但在前列腺癌中过表达。其次,18f -氟氯烃图像解释主要是视觉/定性的:可疑病变中的放射性示踪剂摄取与骨髓或血池中的摄取进行比较。在评估病变的恶性概率时,要考虑18f -氟氯维的病变相对于典型复发部位的位置和患者其他部位的发现,在评估骨病变时,也要考虑最大强度投影图像的可见性。第三,18f -氟氯烃PET/CT检出率随PSA水平升高而升高。第四,各中心的检出率可能有所不同,这可能是由于设备和读者体验的原因。第五,由于没有诊断测试是100%准确的,扫描数据不应孤立使用。最后,18f氟化线PET/CT的发现经常导致疾病管理计划的改变。在前瞻性多中心LOCATE和FALCON研究中,扫描分别改变了59%(126/213)和64%(66/104)患者的治疗计划;78%(98/126)和65%(43/66)的变化涉及到情态转换。转诊医生和成像人员应合作改善扫描报告。转诊者应清楚地传达关键信息,包括癌前PSA水平和开放性临床问题。成像仪应该产生像咨询一样的报告,避免留下悬而未决的问题,如果需要,提供下一步诊断步骤的想法。
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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Understanding and Improving 18F-Fluciclovine PET/CT Reports: A Guide for Physicians Treating Patients with Biochemical Recurrence of Prostate Cancer.

The positron emission tomography (PET) tracer 18F-fluciclovine has seen increasing use to localize disease in men with biochemical recurrence of prostate cancer, i.e., elevated prostate-specific antigen (PSA) levels post-treatment. 18F-Fluciclovine PET/computed tomography (CT) imaging reports now play central roles in many physician-patient discussions. However, because no standardized grading system or templates yet exist for 18F-fluciclovine image assessment, reports vary in format, comprehensiveness, and terminology and may be challenging to fully understand. To better utilize these documents, referring physicians should be aware of six key features of 18F-fluciclovine PET/CT. First, 18F-fluciclovine is a radiolabeled synthetic amino acid targeting the amino acid transporters ASCT2 and LAT1, which are ubiquitous throughout the body, but overexpressed in prostate cancer. Second, 18F-fluciclovine image interpretation is predominantly visual/qualitative: radiotracer uptake in suspicious lesions is compared with uptake in bone marrow or blood pool. Location of 18F-fluciclovine-avid lesions relative to typical recurrence sites and findings elsewhere in the patient are considered when evaluating lesions' probability of malignancy, as is visibility on maximum intensity projection images when assessing bone lesions. Third, 18F-fluciclovine PET/CT detection rates increase as PSA levels rise. Fourth, detection rates may differ among centers, possibly due to equipment and reader experience. Fifth, since no diagnostic test is 100% accurate, scan data should not be used in isolation. Lastly, 18F-fluciclovine PET/CT findings frequently induce changes in disease management plans. In the prospective multicenter LOCATE and FALCON studies, scans altered management plans in 59% (126/213) and 64% (66/104) of patients, respectively; 78% (98/126) and 65% (43/66) of changes, respectively, involved modality switches. Referring physicians and imagers should collaborate to improve scan reports. Referrers should clearly convey critical information, including prescan PSA levels, and open clinical questions. Imagers should produce reports that read like consultations, avoid leaving open questions, and if needed, provide thoughts on next diagnostic steps.

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来源期刊
Prostate Cancer
Prostate Cancer ONCOLOGY-
CiteScore
2.70
自引率
0.00%
发文量
9
审稿时长
13 weeks
期刊介绍: Prostate Cancer is a peer-reviewed, Open Access journal that provides a multidisciplinary platform for scientists, surgeons, oncologists and clinicians working on prostate cancer. The journal publishes original research articles, review articles, and clinical studies related to the diagnosis, surgery, radiotherapy, drug discovery and medical management of the disease.
期刊最新文献
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