目的:分析[18F]DCFPyL与[18F]F-胆碱在前列腺癌(PCa)生化复发(BCR)头对头比较中获得的分子影像学TNM(miTNM)分期的诊断和治疗效果。
方法:将先前[18F]F-胆碱-PET/CT(阴性或寡转移疾病)根治性治疗后的PCaBCR患者招募至[18F]DCFPyL-PET/CT。患者按等级分组,欧洲泌尿外科分类协会,PSA,PSA倍增时间(PSAdt)和PSA速度(PSAvel)。根据PROMISE标准,评估了放射性示踪剂和相关(Kappa)的总体检出率(DR)和miTNM阶段。确定了PSA和动力学对PET/CT(DR和miTNM)的影响以及不良动力学对miTNM的预测价值。切断PSA,确定能够预测PET/CT结果的PSAdt和PSAvel值。还评估了与[18F]F-胆碱相比的源自[18F]DCFPyL信息的miTNM和治疗的变化。
结果:我们研究了138例患者。[18F]DCFPyL表现出比[18F]F-胆碱更高的DR(64.5%对33.3%),具有相当的一致性。[18F]DCFPyL和[18F]F-胆碱检测到T分别为33.3%和19.6%,N为27.5%对13.8%,和M分别为30.4%和8.7%。两种示踪剂都显示出与PSA和PSAvel的显着关联。仅在[18F]F-胆碱-PET/CT上发现miTNM和PSA之间存在显着相关性(p=0.033)。对于[18F]F-胆碱和[18F]DCFPyL-PET/CT,PSAdt截止时间为4.09和5.59个月,分别,能够预测M期。[18F]DCFPyL改变了40/138例患者的治疗管理。
结论:[18F]DCFPyL比[18F]F-胆碱提供更高的DR和更高的miTNM分期,尤其是高PSA和不利的PSA动力学,与[18F]F-胆碱有相当的一致性。
To analyse diagnostic and therapeutic impact of molecular imaging TNM (
miTNM) stage obtained with [18F]DCFPyL versus [18F]F-choline in head-to-head comparison in biochemical recurrence (BCR) of prostate cancer (PCa).
Patients with BCR of PCa after radical treatment with previous [18F]F-choline-PET/CT (negative or oligometastatic disease) were recruited to [18F]DCFPyL-PET/CT. Patients were classified according to: grade group, European Association of Urology classification, PSA, PSA doubling time (PSAdt) and PSA velocity (PSAvel). The overall detection rate (DR) and
miTNM stage according to PROMISE criteria were assessed for both radiotracers and also correlated (Kappa). The influence of PSA and kinetics on both PET/CT (DR and
miTNM) and predictive value of unfavourable kinetics on
miTNM were determined. Cut-off PSA, PSAdt and PSAvel values able to predict PET/CT results were determined. Change in miTNM and treatment derived from [18F]DCFPyL information compared with [18F]F-choline were also evaluated.
We studied 138 patients. [18F]DCFPyL showed a higher DR than [18F]F-choline (64.5% versus 33.3%) with a fair agreement. [18F]DCFPyL and [18F]F-choline detected T in 33.3% versus 19.6%, N in 27.5% versus 13.8%, and M in 30.4% versus 8.7%. Both tracers\' DR showed significant associations with PSA and PSAvel. Significant association was only found between
miTNM and PSA on [18F]F-choline-PET/CT (p = 0.033). For [18F]F-choline and [18F]DCFPyL-PET/CT, a PSAdt cut-off of 4.09 and 5.59 months, respectively, were able to predict M stage. [18F]DCFPyL changed therapeutic management in 40/138 patients.
[18F]DCFPyL provides a higher DR and superior miTNM staging than [18F]F-choline in restaging BCR, especially with high PSA and unfavourable PSA kinetics, showing a fair agreement to [18F]F-choline.