疑似攝護腺癌患者注射 18F-PSMA-1007進行PET/CT 造影後之最佳造影時間 - 病例報告

童敏哲¹、曾能泉²、許兆畬¹、翁瑋駿¹、黃立華¹、林益聖¹、黃雅庭³、歐宴泉^1,4

童綜合醫療社團法人童綜合醫院 泌尿外科¹; 童綜合醫療社團法人童綜合醫院 核子醫學科²; 普瑞默生物科技股份有限公司³; 童綜合醫療社團法人童綜合醫院 研發創新中心⁴

What PET/CT acquired interval after 18F-PSMA-1007 injection among patients with suspected prostate cancer is better- a report of case series?

Min-Che Tung¹, Neng-Chuan Tseng², Chao-Yu Hsu¹, Wei-Chun Weng¹, Henry Li-Hua Huang¹, Yi-Sheng Lin¹, Ya Ting Huang³, Yen-chuan Ou^1,4

¹Division of Urology, Department of Surgery, Tungs’ Taichung Metro Harbor Hospital, Taichung, Taiwan;

²Division of Nuclear Medicine, Tungs’ Taichung Metro Harbor Hospital, Taichung, Taiwan;

³Primo Biotechnology Co., Ltd , Taipei, Taiwan

⁴Department of Research, Tungs’ Taichung Metro Harbor Hospital, Taichung, Taiwan

Purpose

Prostate-specific membrane antigen (PSMA)-positron emission tomography (PET) is widely used for the staging and detection of recurrent prostate cancer. Additionally, it was also a companion diagnostic imaging tool for PSMA radioligand therapy such as Pluvicto® for treating metastatic Castration-Resistant Prostate Cancer. Although PSMA-PET has been used in recent years to detect suspicious or early-stage prostate cancers, 18F-PSMA-1007 PET is rare, unlike Ga68-PSMA-11. The current study aimed to assess the normal organ biodistribution and imaging visibility of suspected lesions at different times (60, 90, and 180 min postinjection).

Materials and Methods

In the current series, we included six patients with suspected prostate cancer who had serum prostate-specific antigen (PSA) levels of 4–20 ng/mL or below 4 ng/mL with abnormal digital rectal examination. When the participants were included in this study, they underwent multiparametric MRI (mpMRI) and 18F-PSMA-1007 PET/computed tomography (CT). Finally, suspected lesions were validated using mpMRI or PET imaging via biopsy or surgical pathological analyses.

Results

The average age of these six participants was 66.83 ± 7.41 years and serum PSA was 8.15 ± 4.34 ng/mL. The maximum standardized uptake value (SUVmax) of the normal organs such as the spleen, kidney, salivary glands, bone marrow, and the blood pool increased with time. The SUVmax of prostate malignant lesions was higher than that of benign lesions (9.12 ± 0.92 vs. 5.25 ± 1.98). None of the participants experienced any drug-related adverse events during the examination. One of the six patients was diagnosed with prostate cancer by biopsy, and a robot-assisted laparoscopic prostatectomy was performed. The location of the suspected lesion on mpMRI was highly correlated with the positive PSMA staining location in the whole-mount tissue.

Conclusions

The 60-min acquisition time of 18F-PSMA-1007 was sufficient to detect intra-prostatic lesions. Additionally, PSMA-PET imaging can be used as an imaging tool for detecting intra-prostatic lesions, and the uptake of malignant prostate lesions is higher than that of benign lesions.