Abstract：
This case series evaluated the feasibility of prostate-specific membrane antigen (PSMA)-radioguided surgery (RGS) with 99mTc-MIP-1404 in recurrent prostate cancer. Methods: Nine patients with PSMA-positive lesions on PET/CT received 99mTc-MIP-1404 (median, 747 MBq; interquartile range [IQR], 710-764 MBq) 17.2 h (IQR, 16.9-17.5 h) before SPECT/CT and 22.3 h (IQR, 20.8-24.0 h) before RGS. Results: Seventeen PSMA-positive lesions were detected on PET/CT (median short-axis diameter, 4 mm; IQR, 3-6 mm; median SUVmax, 8.9; IQR, 5.2-12.6). Nine of 17 (52.9%) were visible on SPECT/CT (median SUVmax, 13.8; IQR, 8.0-17.9). Except for 2 foci, all PET/CT-positive findings demonstrated intraoperative count rates above the background level (median count, 31; IQR, 17-89) and were lymph node metastases. Moreover, PSMA-RGS identified 2 additional metastases compared with PET/CT. Prostate-specific antigen values decreased after RGS in 6 of 9 patients (67%). Conclusion: PSMA-RGS with 99mTc-MIP-1404 identified lymph node metastases in all patients, including 2 additional lesions compared with PET/CT.
摘要：
该病例系列评估了前列腺特异性膜抗原（PSMA）放射性手术（RGS）与99mTc-MIP-1404在复发性前列腺癌中的可行性。方法：9例PET/CT上PSMA阳性病变患者接受99mTc-MIP-1404（中位数，747MBq；四分位数范围[IQR]，710-764MBq)17.2小时(IQR，SPECT/CT前16.9-17.5小时)和22.3小时(IQR，20.8-24.0小时）在RGS之前。结果:PET/CT共检出17个PSMA阳性病灶(中短轴径,4mm;IQR,3-6mm;中值SUVmax,8.9；IQR，5.2-12.6)。在SPECT/CT上可见17例中的9例（52.9％）（中位SUVmax，13.8；IQR，8.0-17.9）。除了2个病灶,所有PET/CT阳性结果均显示术中计数率高于背景水平（中位数计数，31；IQR，17-89）和淋巴结转移。此外，与PET/CT相比，PSMA-RGS识别出2个额外的转移。9例患者中有6例（67％）在RGS后前列腺特异性抗原值降低。结论：PSMA-RGS与99mTc-MIP-1404在所有患者中都能识别淋巴结转移，与PET/CT相比，包括2个额外的病变。
