Preliminary clinical study of<sup>99m</sup>Tc-labelled small molecules against PSMA for prostate cancer imaging

胡四龙; 许晓平; 朱　耀

doi:10.19401/j.cnki.1007-3639.2016.07.008

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Preliminary clinical study of^99mTc-labelled small molecules against PSMA for prostate cancer imaging

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- Preliminary clinical study of^99mTc-labelled small molecules against PSMA for prostate cancer imaging
- China Oncology Vol. 26, Issue 7, Pages: 608-615(2016)
- 作者机构：
  
  1. 复旦大学附属肿瘤医院核医学科，复旦大学上海医学院肿瘤学系,上海,200032
  2. 复旦大学生物医学影像研究中心,上海,200032
  3. 上海分子影像探针工程技术研究中心( 筹),上海,200032
  4. 复旦大学附属肿瘤医院质子重离子中心,上海,201315
  5. 复旦大学附属肿瘤医院泌尿外科，复旦大学上海医学院肿瘤学系,上海,200032
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2016.07.008
  CLC：
- Published Online：22 August 2016，
  
  Published：22 August 2016
- 稿件说明：
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胡四龙,许晓平,朱　耀,等.

胡四龙, 许晓平, 朱　耀. Preliminary clinical study of^99mTc-labelled small molecules against PSMA for prostate cancer imaging[J]. China Oncology, 2016, 26(7): 608-615.
胡四龙,许晓平,朱　耀,等. DOI： 10.19401/j.cnki.1007-3639.2016.07.008.

胡四龙, 许晓平, 朱　耀. Preliminary clinical study of^99mTc-labelled small molecules against PSMA for prostate cancer imaging[J]. China Oncology, 2016, 26(7): 608-615. DOI： 10.19401/j.cnki.1007-3639.2016.07.008.

摘要

背景与目的：前列腺特异性膜抗原(prostate-specific membrane antigen，PSMA)在前列腺癌细胞表面特异性高表达，是前列腺癌诊断和治疗的极具有吸引力的靶点。放射性核素标记的PSMA小分子抑制剂能够高效、特异性探测前列腺癌病灶并进行分期。本研究初步探讨

99m

Tc标记PSMA小分子抑制剂(HYNIC-Glu-Urea-A，简称

99m

Tc-PSMA)SPECT/CT显像诊断前列腺原发灶和转移灶的价值。方法：24例前列腺癌和1例前列腺增生患者静脉注射99mTc-PSMA 2 h后行全身平面扫描和腹盆部SPECT/CT断层显像，采用感兴趣区技术计算肿瘤和肌肉摄取

99m

Tc-PSMA比值(T/N)进行半定量分析，评价全身平面显像结合断层显像检测前列腺癌原发灶和(或)转移灶的灵敏度和特异度，分析

99m

Tc-PSMA阳性率与前列腺癌特异性抗原(prostate-specific antigen，PSA)水平和Gleason评分的关系。结果：以患者为单位，

99m

Tc-PSMA SPECT/CT对前列腺癌原发灶或转移灶检测的灵敏度为72.7%(16/22)、特异度为100%(3/3)。

99m

Tc-PSMA阳性患者，(中位数17.31 ng/mL，范围2.26~3 239.00 ng/mL)水平明显高于

99m

Tc-PSMA阴性患者PSA(中位数0.49 ng/mL，范围0.07~9.28 ng/mL)(Z=-3.51，P0.001)；在初诊和PSA大于2 ng/mL的复发患者中，

99m

Tc-PSMA阳性率明显提高，灵敏度达94.1%(16/17)；

99m

Tc-PSMA的阳性率与Gleason评分高低无关(Z=-0.69，P=0.52)。结论：

99m

Tc-PSMA全身平面显像结合局部SPECT/CT断层显像对前列腺癌原发灶和转移灶的探测有较高应用价值，灵敏度及特异度均较高。

Abstract

Background and purpose: Prostate-specific membrane antigen (PSMA)

a cell surface protein with high expression in prostate carcinoma (PC) cells

is an attractive target for PC imaging and therapy. Small-molecule radiopharmaceuticals targeting PSMA can detect the loc

ation and extent of disease with high sensitivity and specificity. The aim of this study was to evaluate the value of technetium-99m-labelled small molecule against PSMA (HYNICGlu- Urea-A

99m

Tc-PSMA) for the detection of primary and metastatic prostate cancers. Methods: Twenty-four prostate cancer patients and 1 patient with benign prostate hyperplasia received whole-body scan followed by abdominopelvic SPECT/CT 2 h after intravenous injection of

99m

Tc-PSMA. Tumor to muscle uptake ratio of

99m

Tc-PSMA was calculated using region of interest (ROI) technology. The sensitivity and specificity of

99m

Tc-PSMA were evaluated. The relationships between positive

99m

Tc-PSMA and prostate specific antigen (PSA) level and Gleason Score were analyzed. Results: Based on per patient

the sensitivity and specificity of

99m

Tc-PSMA were 72.7% (16/22) and 100% (3/3)

respectively. The level of PSA in patients with positive

99m

Tc-PSMA imaging was significantly higher than that in patients with negative

99m

Tc-PSMA imaging [(PSA median 17.31 ng/mL

range: 2.26-3 239.0 ng/mL) vs (PSA median 0.49 ng/ mL

range: 0.07-9.28 ng/mL)

]

(Z=-3.51

P0.001). Among newly diagnosed patients and recurrent patients with PSA more than 2.0 nm/mL

it was apparent that

99m

Tc-PSMA imaging was able to detect lesions with improved sensitivity of 94.1% (16/17). Gleason Scores between positive

99m

Tc-PSMA patients and negative

99m

Tc-PSMA patients were not significantly different (Z=-0.69

P=0.52). Conclusion: With the combination of whole-body scan and tomography

99m

Tc-PSMA SPECT/CT can be an excellent and specific molecular imaging strategy to detect prostate cancer and its metastases.

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Preliminary clinical study of99mTc-labelled small molecules against PSMA for prostate cancer imaging

DOI：10.19401/j.cnki.1007-3639.2016.07.008

摘要

Abstract

关键词

Keywords

references

Preliminary clinical study of^99mTc-labelled small molecules against PSMA for prostate cancer imaging