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中华腔镜泌尿外科杂志(电子版) ›› 2021, Vol. 15 ›› Issue (05) : 378 -382. doi: 10.3877/cma.j.issn.1674-3253.2021.05.004

临床研究

68Ga-PSMA-11 PET/CT延迟显像探测前列腺癌根治术后盆腔复发的价值
秦露平1, 吕杰2, 李名钊3, 李建芳1, 谢良骏1, 李锦萍1, 程木华1,†()   
  1. 1. 510630　广州，中山大学附属第三医院核医学科
    2. 510120　广州医科大学附属第一医院核医学科
    3. 510630　广州，中山大学附属第三医院泌尿外科
  • 收稿日期:2021-06-15 出版日期:2021-10-01
  • 通信作者: 程木华

The value of 68Ga-PSMA-11 PET/CT delayed imaging in the detection of pelvic recurrence after radical prostatectomy

Luping Qin1, Jie Lv2, Mingzhao Li3, Jianfang Li1, Liangjun Xie1, Jinping Li1, Muhua Cheng1,†()   

  1. 1. Department of Nuclear Medicine, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
    2. Department of Nuclear Medicine, the First Affiliated Hospital of Guangzhou Medical University, 510120 Guangzhou, China
    3. Department of Urology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
  • Received:2021-06-15 Published:2021-10-01
  • Corresponding author: Muhua Cheng
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秦露平, 吕杰, 李名钊, 李建芳, 谢良骏, 李锦萍, 程木华. 68Ga-PSMA-11 PET/CT延迟显像探测前列腺癌根治术后盆腔复发的价值[J]. 中华腔镜泌尿外科杂志(电子版), 2021, 15(05): 378-382.

Luping Qin, Jie Lv, Mingzhao Li, Jianfang Li, Liangjun Xie, Jinping Li, Muhua Cheng. The value of 68Ga-PSMA-11 PET/CT delayed imaging in the detection of pelvic recurrence after radical prostatectomy[J]. Chinese Journal of Endourology(Electronic Edition), 2021, 15(05): 378-382.

目的

分析68Ga-前列腺特异性膜抗（PSMA）-11 PET/CT延迟显像探测前列腺癌根治术后盆腔复发的价值。

方法

回顾性纳入本院行前列腺癌根治术的患者24例。患者注射显像剂后60 min行68Ga-PSMA-11 PET/CT全身标准显像及180 min行局部盆腔延迟显像。比较标准显像及延迟显像探测盆腔复发病灶数目、大小、最大标准摄取值（SUVmax）及靶/本比（T/B）。

结果

24例患者中，盆腔复发患者17例。复发患者中标准显像阳性15例，延迟显像阳性17例。无复发患者7例，标准显像及延迟显像均呈阴性。标准显像探测盆腔复发灵敏度为82.24%（15/17），延迟显像灵敏度为100.0%（17/17），两者差异无统计学意义（χ2=2.125，P=0.145）。延迟显像比标准显像多探测10个盆腔阳性病灶。延迟显像额外发现的盆腔病灶直径4（3，8） mm比标准显像发现的盆腔病灶直径8（7，12） mm更小（U=94，P=0.004）。延迟显像病灶SUVmax10.08（6.58，15.50）与标准显像7.89（4.87，15.26）相当（U=1204，P=0.234），但延迟显像病灶T/B值55.90（30.45，109.27）明显高于标准显像32.89（21.67，55.07） （U=840，P=0.0005）。

结论

前列腺癌根治术后68Ga-PSMA-11 PET/CT延迟显像可以探测更多更小的盆腔复发病灶。

关键词: 前列腺肿瘤, 复发, 前列腺特异性膜抗原, 延迟显像
Objective

To analyze the value of 68Ga-Prostate-specific membrane antigen (PSMA)-11 PET/CT delayed imaging in the detection of pelvic recurrence after radical prostatectomy.

Methods

Twenty-four patients who underwent radical prostatectomy at our institution were retrospectively enrolled in the study. The patients received 68Ga-PSMA-11 PET/CT whole-body standard imaging at 60 min and pelvic delayed imaging at 180 min after intravenous injection of radiopharmaceutical. The number, size, maximum standard uptake (SUVmax) and target-to-background ratio (T/B) of pelvic recurrent lesions were compared between standard imaging and delayed imaging.

Results

Pelvic recurrence occurred in 17 of the 24 patients. Of the recurrent patients, standard imaging was positive in 15 cases and delayed imaging was positive in 17 cases. There were 7 cases without recurrence, and both standard imaging and delayed imaging were negative. There was no statistical difference (χ2=2.125, P=0.145) in the sensitivity of detecting pelvic recurrence between standard imaging (82.24%, 15/17) and delayed imaging (100.00%, 17/17). Delayed imaging detected 10 more pelvic positive lesions than standard imaging. The diameter 4(3, 8) mm of additional pelvic lesion detected by delayed imaging was smaller than that 8(7, 12) mm of pelvic lesion detected by standard imaging (U=94, P=0.004). The SUVmax 10.08(6.58, 15.50) of delayed imaging was similar to that of standard imaging 7.89(4.87, 15.26) (U=1204, P=0.234), however the T/B value of delayed imaging 55.90(30.45, 109.27) was significantly higher than that of standard imaging 32.89(21.67, 55.07) (U=840, P=0.0005).

Conclusion

68Ga-PSMA-11 PET/CT delayed imaging can detect more and smaller pelvic recurrent lesions after radical prostatectomy.

Key words: Prostatic neoplasms, Recurrence, Prostate-specific membrane antigen, Delayed imaging
图1 68Ga-PSMA-11 PET/CT延迟显像额外发现髂骨病灶 注：a为67岁，男性患者，68Ga-PSMA-11 PET/CT标准显像右侧髂骨见一高密度小结节影，边界清晰，直径为4 mm，未见放射性浓聚，本底SUVmean为0.44；b为该患者68Ga-PSMA-11 PET/CT延迟显像右侧髂骨病灶见放射性浓聚，SUVmax为2.65，本底SUVmean为0.17，T/B为15.59；c为该患者经过内分泌治疗后1年余复查68Ga-PSMA-11 PET/CT标准显像，原右侧髂骨病灶直径增大至9 mm，见放射性浓聚，SUVmax为32.47，本底SUVmean为0.40，T/B为81.18
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