Abstract：
OBJECTIVE: The study aims to determine the physiological and pathophysiological distribution of the radiopharmaceutical (Ga68-PSMA-617) and investigate whether there are differences in distribution according to the laboratory, histopathological and clinical findings that can affect image evaluation. Also, we aimed to determine cut-off values to distinguish physiological and pathological uptake in prostate, bone, and lymph nodes.
METHODS: 229 prostate cancer patients who underwent Ga68-PSMA PET/CT at our department were retrospectively analyzed. The patients were grouped according to PET/CT results, Gleason scores, PSA values, received treatments, metastatic status and other laboratory values. The SUV values of the organs, tissues, and pathological lesions of the patients in these subgroups were compared among themselves.
RESULTS: No significant difference was detected in the physiological uptake of lymph nodes and bone between the groups. In the group with patients that received androgen deprivation therapy (ADT), the bone metastasis SUV values were found to be higher and the SUV values of the submandibular gland and renal cortex were found to be lower (Mann-Whitney U, p = 0.043; 0.004; 0.01, respectively). In the group with patients who received radiotherapy, the normal prostate tissue SUV values were determined to be higher (Mann-Whitney U, p = 0.009). The SUV values of the submandibular gland, muscle, liver, and blood pool were found to be lower in the group of patients with high serum LDH values. The cut-off SUVmax value was determined to be 6.945 (sensitivity 89.6%, specificity 98.1%) for primary prostate lesion; 4.72 for lymph node metastasis; 4.25 for bone metastasis. The serum PSA cut-off value to distinguish the negative/positive groups was found to be 1,505 (sensitivity 79.7%, specificity 77.3%).
CONCLUSIONS: In conclusion, PSMA-617 demonstrates a similar biodistribution with other PSMA ligands. The physiological uptake of lymph nodes and bone which are mostly metastasized in prostate cancer, are not affected by the factors we examined. It should be kept in mind that the normal prostate tissue uptake may increase in patients receiving radiotherapy, and the physiological/pathological uptake of the organs may differ due to the changes in PSMA expression in patients receiving ADT, tumor burden, and kidney function may affect the biodistribution.
METHODS: 229 prostate cancer patients who underwent Ga68-PSMA PET/CT at our department were retrospectively analyzed. The patients were grouped according to PET/CT results, Gleason scores, PSA values, received treatments, metastatic status and other laboratory values. The SUV values of the organs, tissues, and pathological lesions of the patients in these subgroups were compared among themselves.
RESULTS: No significant difference was detected in the physiological uptake of lymph nodes and bone between the groups. In the group with patients that received androgen deprivation therapy (ADT), the bone metastasis SUV values were found to be higher and the SUV values of the submandibular gland and renal cortex were found to be lower (Mann-Whitney U, p = 0.043; 0.004; 0.01, respectively). In the group with patients who received radiotherapy, the normal prostate tissue SUV values were determined to be higher (Mann-Whitney U, p = 0.009). The SUV values of the submandibular gland, muscle, liver, and blood pool were found to be lower in the group of patients with high serum LDH values. The cut-off SUVmax value was determined to be 6.945 (sensitivity 89.6%, specificity 98.1%) for primary prostate lesion; 4.72 for lymph node metastasis; 4.25 for bone metastasis. The serum PSA cut-off value to distinguish the negative/positive groups was found to be 1,505 (sensitivity 79.7%, specificity 77.3%).
CONCLUSIONS: In conclusion, PSMA-617 demonstrates a similar biodistribution with other PSMA ligands. The physiological uptake of lymph nodes and bone which are mostly metastasized in prostate cancer, are not affected by the factors we examined. It should be kept in mind that the normal prostate tissue uptake may increase in patients receiving radiotherapy, and the physiological/pathological uptake of the organs may differ due to the changes in PSMA expression in patients receiving ADT, tumor burden, and kidney function may affect the biodistribution.
摘要：
目的：该研究旨在确定放射性药物（Ga68-PSMA-617）的生理和病理生理分布，并根据实验室调查分布是否存在差异，可能影响图像评估的组织病理学和临床表现。此外，我们的目的是确定截断值，以区分前列腺的生理和病理摄取，骨头,和淋巴结。
方法：对在我科接受Ga68-PSMAPET/CT检查的229例前列腺癌患者进行回顾性分析。根据PET/CT结果对患者进行分组,格里森分数，PSA值,接受治疗,转移状态和其他实验室值。器官的SUV价值，组织，并对这些亚组患者的病理病变进行了比较。
结果：两组之间的淋巴结和骨骼的生理摄取没有显着差异。在接受雄激素剥夺治疗（ADT）的患者组中，发现骨转移SUV值较高，而下颌下腺和肾皮质的SUV值较低（Mann-WhitneyU，p=0.043;0.004;0.01)。在接受放疗的患者组中，正常前列腺组织SUV值被确定为更高(Mann-WhitneyU，p=0.009)。下颌下腺的SUV值，肌肉，肝脏,在血清LDH值高的患者组中发现血池较低。截止SUVmax值确定为6.945（灵敏度89.6%，原发性前列腺病变的特异性为98.1％）；淋巴结转移为4.72；骨转移为4.25。区分阴性/阳性组的血清PSA临界值为1,505（灵敏度为79.7％，特异性77.3%)。
结论：结论：PSMA-617与其他PSMA配体表现出类似的生物分布。在前列腺癌中主要转移的淋巴结和骨骼的生理摄取，不受我们检查的因素影响。应该记住，接受放射治疗的患者的正常前列腺组织摄取可能会增加，由于接受ADT的患者PSMA表达的变化，器官的生理/病理摄取可能有所不同，肿瘤负荷，肾功能可能影响生物分布。
方法：对在我科接受Ga68-PSMAPET/CT检查的229例前列腺癌患者进行回顾性分析。根据PET/CT结果对患者进行分组,格里森分数，PSA值,接受治疗,转移状态和其他实验室值。器官的SUV价值，组织，并对这些亚组患者的病理病变进行了比较。
结果：两组之间的淋巴结和骨骼的生理摄取没有显着差异。在接受雄激素剥夺治疗（ADT）的患者组中，发现骨转移SUV值较高，而下颌下腺和肾皮质的SUV值较低（Mann-WhitneyU，p=0.043;0.004;0.01)。在接受放疗的患者组中，正常前列腺组织SUV值被确定为更高(Mann-WhitneyU，p=0.009)。下颌下腺的SUV值，肌肉，肝脏,在血清LDH值高的患者组中发现血池较低。截止SUVmax值确定为6.945（灵敏度89.6%，原发性前列腺病变的特异性为98.1％）；淋巴结转移为4.72；骨转移为4.25。区分阴性/阳性组的血清PSA临界值为1,505（灵敏度为79.7％，特异性77.3%)。
结论：结论：PSMA-617与其他PSMA配体表现出类似的生物分布。在前列腺癌中主要转移的淋巴结和骨骼的生理摄取，不受我们检查的因素影响。应该记住，接受放射治疗的患者的正常前列腺组织摄取可能会增加，由于接受ADT的患者PSMA表达的变化，器官的生理/病理摄取可能有所不同，肿瘤负荷，肾功能可能影响生物分布。
