Background: Triple-negative breast cancer (TNBC) exhibits high aggressiveness and a notably poorer prognosis at advanced stages. Nuclear medicine offers new possibilities, not only for diagnosis but also potentially promising therapeutic strategies. This prospective study explores the potential of prostate-specific membrane antigen (PSMA) as a diagnostic and therapeutic target in TNBC. Methods: the research investigates PSMA expression in vivo among TNBC patients using [18F]PSMA-1007 PET/CT and compares it head-to-head with the standard-of-care [18F]FDG PET/CT. Results: The study involves 10 TNBC patients, revealing comparable uptake of [18F]PSMA-1007 and [18F]FDG in primary and metastatic lesions. Nodal metastases were found in eight patients, showing similar SUVmaxvalues in both modalities. Two patients had uncountable lung metastases positive in both [18F]FDG and [18F]PSMA-1007 scans. PET-positive bone metastases were identified by18F-PSMA in four patients, while elevated [18F]FDG uptake was found only in three of them. Distant metastases displayed higher SUVmaxvalues in the [18F]PSMA-1007 PET/CT, as compared to [18F]FDG. Additionally, brain metastases were exclusively detected using [18F]PSMA-1007. Conclusions: the findings provide valuable insights into the expression of PSMA in TNBC and underscore the potential clinical significance of [18F]PSMA-1007 PET/CT in enhancing both diagnostic and therapeutic approaches for this aggressive breast cancer subtype.
背景：三阴性乳腺癌（TNBC）具有高度侵袭性，晚期预后显著较差。核医学不仅为诊断提供了新的可能性，也带来了潜在的治疗策略。本研究前瞻性探讨了前列腺特异性膜抗原（PSMA）作为TNBC诊断与治疗靶点的潜力。方法：研究通过[18F]PSMA-1007 PET/CT检测TNBC患者体内PSMA表达情况，并与标准诊断方法[18F]FDG PET/CT进行头对头比较。结果：研究纳入10例TNBC患者，结果显示原发灶与转移灶对[18F]PSMA-1007和[18F]FDG的摄取程度相当。8例患者存在淋巴结转移，两种显像方式测得的SUVmax值相近。2例患者经[18F]FDG和[18F]PSMA-1007扫描均发现不可计数的肺转移灶。18F-PSMA在4例患者中检出PET阳性骨转移，而[18F]FDG仅在3例患者中发现摄取增高。与[18F]FDG相比，远处转移灶在[18F]PSMA-1007 PET/CT中显示出更高的SUVmax值。此外，脑转移灶仅通过[18F]PSMA-1007得以检出。结论：本研究为TNBC中PSMA的表达提供了重要依据，并揭示了[18F]PSMA-1007 PET/CT在提升这一侵袭性乳腺癌亚型的诊断与治疗策略方面具有潜在临床价值。
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