[Clinical Value of Dual Tracer PET Imaging With 68 Ga-PSMA and 18 F-FDG in Patients With Metastatic Prostate Cancer].
| Autor: | Dai H; （ 610041） Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu 610041, China., Huang S; （ 610041） Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu 610041, China., Tian T; （ 610041） Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu 610041, China., Hou N; （ 610041） Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu 610041, China., Zeng H; （ 610041） Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu 610041, China., Wei Q; （ 610041） Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu 610041, China., Huang R; （ 610041） Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu 610041, China. |
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| Jazyk: | čínština |
| Zdroj: | Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition [Sichuan Da Xue Xue Bao Yi Xue Ban] 2024 Sep 20; Vol. 55 (5), pp. 1063-1070. |
| DOI: | 10.12182/20240960201 |
| Abstrakt: | Objective: In this study, we retrospectively analyzed the imaging characteristics of dual-tracer 68 Ga-prostate specific membrane antigen (PSMA) and 18 F-flurodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in metastatic prostate cancer (mPCa) patients. We analyzed the uptake modes of the dual tracers, explored clinical pathological parameters affecting the 18 F-FDG uptake in the lesions, and evaluated their prognostic implications for prostate specific antigen progression-free survival (PSA-PFS). Methods: A total of 41 mPCa patients who underwent dual-tracer PET/CT ( 68 Ga-PSMA and 18 F-FDG) scans between September 2021 and January 2024 were retrospectively enrolled. One patient had negative uptake of both PSMA and FDG. According to the uptake patterns of the 2 tracers, the other patients, 40 in total, were categorized in 2 groups, including group A consisting of 33 cases who showed PSMA and FDG dual and those who showed FDG only avidity, and group B consisting of 7 cases who showed PSMA avidity only. Comparative analyses of clinical pathological characteristics between group A and group B were conducted. The relationship between various parameters and PSA-PFS was analyzed by the Kaplan-Meier method. Results: A total of 26 patients (63.4%) were diagnosed with metastatic castration-resistant prostate cancer (mCRPC), and 38 cases (92.7%) had a Gleason score of 8-9. Bone metastasis, the predominant type of distant metastasis, occurred in 36 cases (87.8%). The skeletal and distant lymph node metastases mostly showed a dual positive uptake pattern for both PSMA and FDG (85.7% [24/28] and 81.8% [9/11]). 37.5% (3/8) of the metastases to organs showed FDG only positive uptake pattern. The serum levels of prostate specific antigen (PSA) in group A were significantly higher than those in group B ( P =0.013). A total of 13 patients of special pathological classification (intraductal carcinoma and neuroendocrine differentiation) were all found to be in group A. Among the 41 cases, 16 were lost to follow-up. Of the 25 patients who completed follow-up, 9 patients, with a median PSA value of 104 ng/mL, experienced PSA progression, while the 16 other patients, with a median PSA of 0.34 ng/mL, did not incur any PSA progression. There was significant difference in the median PSA between patients showing PSA progression and those who did not show PSA progression ( P <0.001). Kaplan-Meier survival analysis revealed that the median PSA-PFS of patients of specific pathological classifications was 7 months, which was shorter than the 16 months of the patients with typical prostate cancer, with the difference between the two groups being statistically meaningful ( P =0.043). The median PSA-PFS for group A was 30 months. With more than half of the patients in the group not experiencing any PSA progression, group B did not reach the median PSA-PFS ( P =0.645). Conclusion: Dual-tracer PET/CT imaging with 68 Ga-PSMA and 18 F-FDG commonly exhibits avidity for both tracers in mPCa. Serum PSA level is a reliable biomarker for predicting FDG-positive lesions. mPCa presented with intraductal carcinoma and neuroendocrine differentiation tends to exhibit FDG avidity and is more susceptible to PSA progression. Competing Interests: 利益冲突 本文作者魏强是本刊编委会编委。该文在编辑评审过程中所有流程严格按照期刊政策进行，且未经其本人经手处理。除此之外，所有作者声明不存在利益冲突。 (© 2024《四川大学学报（医学版）》编辑部 版权所有Copyright ©2024 Editorial Office of Journal of Sichuan University (Medical Sciences).) |
| Databáze: | MEDLINE |
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