Biyokimyasal nüksü olan prostat kanseri hastalarının yeniden evrelemesinde gGA-68 PSMA PET/BT'nin değeri
Yükleniyor...
Dosyalar
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Günümüzde prostat kanserinde (PK) Galyum-68 prostat spesifik membran antijeni
(Ga-68 PSMA) pozitron emisyon tomografi/bilgisayarlı tomografi (PET/ BT) görüntüleme,
tüm dünyada giderek yaygınlaşmaktadır. Hastane içi sentez yapabilen jeneratör ve sentez
modülleri sayesinde prostat kanseri gör unt ̈ ulemesinde standart hale gelmek ̈ ̈uzeredir. Bu ̧
calı ̧sma ile Ga-68 PSMA PET/BT’nin biyokimyasal n ̈uksü olan prostat kanserli hastalarda
yeniden evrelemedeki ba ̧sarısının, psa kinetikleri ve histopatolojik parametrelerle
kıyaslanarak saptanması ama ̧clanmı ̧stır.
Gereç ve yöntem: Ocak 2018 ile Ekim 2020 tarihleri arasında Nükleer Tıp Bölümünde
Ga-68 PSMA PET/BT çekilen erkek hastaların kayıtları taranarak yeniden evreleme için
başvuran hastalardan biyokimyasal nüksü olan hastalar tespit edildi. Bu hastaların arşiv
kayıtları taranarak PSA kinetikleri, primer tedavi modaliteleri ve biyopsi sonuçları
kaydedildi. Hasta görüntüleri tekrar değerlendirilerek PSMA PET/BT’de lokal nüks, lenf
nodu, kemik ve diğer organ metastazları değerlendirildi.
Bulgular: Çalışmamızda, 73 kişilik biyokimyasal nüks tanılı yeniden evreleme hasta
grubunda 61 hastada rekürrens ile uyumlu artmış PSMA tutulumu izlenmiş olup, Ga-68
PSMA PET/BT, biyokimyasal rekürrens görülen prostat kanser tanılı hasta
popülasyonunda ( ortalama PSA 2,42 ng/mL, range 0,2- 24,14 ng/Ml) nüks bölgesinin
tespitinde % 83,5’lik pozitiflik oranıyla yüksek performans göstermiştir. RP grubunda %
70,5'lik bir pozitiflik oranı gözlemledik. Saptama oranı, serum PSA düzeyi arttıkça
artıyordu (PSA 2 ng/ml'nin üzerindeyken elde edilen en yüksek saptama oranı % 92 idi).
Bulgularımız RT grubunda serum PSA 2-3,3-5 ve >5,0 seviyeleri için sırasıyla % 95,2, %
90 ve % 100 Ga-68 PSMA PET/BT pozitiflik oranı saptandı.
Ga-68 PSMA PET/BT’de patolojik bulgu saptanmayan hastalar ile patolojik bulgu
iv
saptanan hastalar arasında; PSA değerleri, PSA hızları, Gleason Skoru/Grade’i ve HT alıpalmama durumları anlamlı farklılık göstermektedir (sırasıyla p:0.049, p:0,048).
Sonuç: Ga-68 PSMA PET/BT biyokimyasal nüks olan hastalarda rekürrens alanını yüksek
doğrulukta tespit edebilmektedir. Yeniden evrelemede PSMA ekspresyonunun serum PSA
seviyeleri ve Gleason skoru ile korele olduğu ve rekürrensin saptanması ile ilişkili olduğu
sonuçlarına varılmış olup, Ga-68 PSMA PET/BT incelemesinin hasta yönetimine belirgin
katkı sağlayabileceği öngörülmüştür. Ancak bulguların daha geniş serilerde prospektif
çalışmalar ile desteklenmeye ihtiyacı vardır
Background and Aim: Today, Gallium-68 prostate specific membrane antigen (Ga-68 PSMA) positron emission tomography/computed tomography (PET/CT) imaging in prostate cancer (PC) is becoming increasingly common all over the world. It is about to become a standard in prostate cancer imaging, thanks to the generator and synthesis modules capable of in-hospital synthesis. The aim of this study was to determine the success of Ga-68 PSMA PET/CT in restaging prostate cancer patients with biochemical relapse, by comparing them with psa kinetics and histopathological parameters. Materials and methods: The records of male patients who underwent Ga-68 PSMA PET/CT in the Nuclear Medicine Department between January 2018 and October 2020 were scanned, and patients with biochemical recurrence were identified among the patients who applied for restaging. Archive records of these patients were scanned and PSA kinetics, primary treatment modalities and biopsy results were recorded. Local recurrence, lymph node, bone and other organ metastases were evaluated in PSMA PET/CT by reevaluating the patient images. Results: In our study, increased PSMA uptake consistent with recurrence was observed in 61 patients in the restaging patient group with a diagnosis of biochemical recurrence of 73, and Ga-68 PSMA PET/CT was used in the patient population with a diagnosis of biochemical recurrence in prostate cancer (mean PSA 2.42 ng/mL, range 0.2- 24.14 ng/Ml) showed a high performance in the detection of the recurrence zone with a positivity rate of 83.5%. We observed a positivity rate of 70.5% in the RP group. The detection rate increased as the serum PSA level increased (the highest detection rate was 92% when PSA was above 2 ng/ml). Our findings In the RT group, 95.2%, 90% and 100% Ga-68 PSMA PET/CT positivity rates were found for serum PSA 2-3,3-5 and >5.0 levels, respectively. vi Between patients with no pathological findings in Ga-68 PSMA PET/CT and patients with pathological findings; PSA values, PSA rates, Gleason Score/Grade, and HT or not show significant differences (p:0.049, p:0.048, respectively). Conclusion: Ga-68 PSMA PET/CT can detect the area of recurrence with high accuracy in patients with biochemical recurrence. It was concluded that PSMA expression in restaging was correlated with serum PSA levels and Gleason score and was associated with the detection of recurrence, and it was predicted that Ga-68 PSMA PET/CT examination could make a significant contribution to patient management. However, the findings need to be supported by prospective studies in larger series
Background and Aim: Today, Gallium-68 prostate specific membrane antigen (Ga-68 PSMA) positron emission tomography/computed tomography (PET/CT) imaging in prostate cancer (PC) is becoming increasingly common all over the world. It is about to become a standard in prostate cancer imaging, thanks to the generator and synthesis modules capable of in-hospital synthesis. The aim of this study was to determine the success of Ga-68 PSMA PET/CT in restaging prostate cancer patients with biochemical relapse, by comparing them with psa kinetics and histopathological parameters. Materials and methods: The records of male patients who underwent Ga-68 PSMA PET/CT in the Nuclear Medicine Department between January 2018 and October 2020 were scanned, and patients with biochemical recurrence were identified among the patients who applied for restaging. Archive records of these patients were scanned and PSA kinetics, primary treatment modalities and biopsy results were recorded. Local recurrence, lymph node, bone and other organ metastases were evaluated in PSMA PET/CT by reevaluating the patient images. Results: In our study, increased PSMA uptake consistent with recurrence was observed in 61 patients in the restaging patient group with a diagnosis of biochemical recurrence of 73, and Ga-68 PSMA PET/CT was used in the patient population with a diagnosis of biochemical recurrence in prostate cancer (mean PSA 2.42 ng/mL, range 0.2- 24.14 ng/Ml) showed a high performance in the detection of the recurrence zone with a positivity rate of 83.5%. We observed a positivity rate of 70.5% in the RP group. The detection rate increased as the serum PSA level increased (the highest detection rate was 92% when PSA was above 2 ng/ml). Our findings In the RT group, 95.2%, 90% and 100% Ga-68 PSMA PET/CT positivity rates were found for serum PSA 2-3,3-5 and >5.0 levels, respectively. vi Between patients with no pathological findings in Ga-68 PSMA PET/CT and patients with pathological findings; PSA values, PSA rates, Gleason Score/Grade, and HT or not show significant differences (p:0.049, p:0.048, respectively). Conclusion: Ga-68 PSMA PET/CT can detect the area of recurrence with high accuracy in patients with biochemical recurrence. It was concluded that PSMA expression in restaging was correlated with serum PSA levels and Gleason score and was associated with the detection of recurrence, and it was predicted that Ga-68 PSMA PET/CT examination could make a significant contribution to patient management. However, the findings need to be supported by prospective studies in larger series
Açıklama
Anahtar Kelimeler
Galyum, Gallium, Pozitron emisyon tomografi, Positron-emission tomography, Prostat neoplazmları, Prostatic neoplasms
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Aydın, Z. (2021). Biyokimyasal nüksü olan prostat kanseri hastalarının yeniden evrelemesinde gGA-68 PSMA PET/BT'nin değeri. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Radyoloji Anabilim Dalı, Konya.
