Localized prostate cancer (PCa) can be treated with radical prostatectomy (RP). Up to 30% of patients undergoing this procedure experience biochemical recurrence (BCR), namely the rise in serum prostate-specific antigen (PSA) levels during the post-surgical follow-up, requiring further treatments and with the risk of severe disease progression. Currently, the most accurate imaging technique to confirm, detect, and locate disease relapses in BCR patients is prostate-specific membrane antigen (PSMA)-targeted PET, as recommended by international clinical guidelines. The aim of the study was to investigate potential clinical and pathological predictors of PSMA PET positivity, validated by clinical and instrumental follow-up or histopathological data. In this study, a selected cohort of BCR patients after RP and no other PCa-related therapy who underwent either PSMA PET/CT or PSMA PET/MRI has been analysed. Among the considered predictors, both pathological staging after RP equal or higher than pT3a and higher PSA levels at the time of the scan were significantly correlated with PSMA PET positivity on multivariate logistic regression analysis. As expected, PSMA PET confirmed its role as an accurate imaging technique in the setting of BCR in PCa. These findings may inform appropriate and tailored patient selection and scan timing to optimize and fully exploit this powerful diagnostic tool.
局限性前列腺癌可通过根治性前列腺切除术进行治疗。接受该手术的患者中高达30%会出现生化复发，即在术后随访期间血清前列腺特异性抗原水平升高，需要进一步治疗且存在疾病严重进展风险。根据国际临床指南建议，目前确认、检测和定位生化复发患者疾病复发最准确的影像学技术是前列腺特异性膜抗原靶向PET成像。本研究旨在探讨PSMA PET阳性结果的潜在临床与病理预测因素，并通过临床与仪器随访或组织病理学数据进行验证。本研究分析了一组经筛选的根治性前列腺切除术后生化复发患者，这些患者未接受其他前列腺癌相关治疗，并接受了PSMA PET/CT或PSMA PET/MRI检查。在多变量逻辑回归分析中，根治性前列腺切除术后病理分期≥pT3a以及扫描时较高的PSA水平均与PSMA PET阳性结果显著相关。正如预期，PSMA PET在前列腺癌生化复发场景中再次证实其作为精准影像学技术的重要价值。这些发现可为优化这一强大诊断工具的应用提供依据，指导临床制定个体化的患者筛选方案和扫描时机选择策略。
肿瘤(癌症)患者之家