Background and purpose

[⁶⁸Ga]Ga-PSMA PET imaging has been extensively utilized for the detection of biochemical recurrence (BCR) in prostate cancer. However, the detection rate declines to merely 10–40% when PSA levels are < 0.2 ng/mL employing short axial field-of-view (SAFOV) PET. Prior studies exhibited superior detection rates with total-body [⁶⁸Ga]Ga-PSMA-11 PET compared to SAFOV [⁶⁸Ga]Ga-PSMA-11 PET in BCR patients with PSA > 0.2 ng/mL. Nevertheless, the diagnostic utility of total-body [⁶⁸Ga]Ga-PSMA-11 PET for BCR patients when PSA is < 0.2 ng/mL remains unclear. This study aimed to assess whether total-body [⁶⁸Ga]Ga-PSMA-11 PET/CT could improve the detection rate compared to SAFOV [⁶⁸Ga]Ga-PSMA-11 PET/CT in BCR patients with PSA < 0.2 ng/mL.

Methods

Eighty BCR patients with PSA < 0.2 ng/mL underwent total-body [⁶⁸Ga]Ga-PSMA-11 PET/CT. These patients were matched by baseline qualities to another 80 patients who received SAFOV [⁶⁸Ga]Ga-PSMA-11 PET/CT. The detection rates of total-body [⁶⁸Ga]Ga-PSMA-11 PET/CT and SAFOV [⁶⁸Ga]Ga-PSMA-11 PET/CT were compared utilizing a chi-square test and stratified analysis. Image quality of total-body [⁶⁸Ga]Ga-PSMA PET/CT and SAFOV [⁶⁸Ga]Ga-PSMA-11 PET/CT was assessed based on subjective scoring and objective parameters. The objective parameters measured were SUVmax, SUVmean, standard deviation (SD) of SUV, and signal-to-noise ratio (SNR) of liver and gluteus maximus.

Results

The image quality of total-body [⁶⁸Ga]Ga-PSMA PET/CT was superior to that of SAFOV [⁶⁸Ga]Ga-PSMA-11 PET/CT in both early and delayed scans. The detection rate of total-body [⁶⁸Ga]Ga-PSMA PET/CT for BCR patients with PSA < 0.2 ng/mL was significantly higher than that of SAFOV [⁶⁸Ga]Ga-PSMA-11 PET/CT (73.75% vs. 43.75%, P < 0.001). Total-body [⁶⁸Ga]Ga-PSMA PET/CT resulted in noteworthy modifications to the treatment regimen when contrasted with SAFOV [⁶⁸Ga]Ga-PSMA-11 PET/CT.

Conclusions

In BCR patients with PSA < 0.2 ng/mL, total-body [⁶⁸Ga]Ga-PSMA-11 PET/CT not only demonstrated a significantly higher detection rate compared to SAFOV [⁶⁸Ga]Ga-PSMA-11 PET/CT but also led to significant alterations in treatment regimens.

中文翻译：

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对于 PSA < 0.2 ng 的早期复发性前列腺癌患者，全身 [68Ga]Ga-PSMA-11 PET/CT 的检出率优于短轴视场 [68Ga]Ga-PSMA-11 PET/CT /mL 根治性前列腺切除术后

背景和目的

[ ⁶⁸ Ga]Ga-PSMA PET 成像已广泛用于检测前列腺癌的生化复发（BCR）。然而，当使用短轴向视场 (SAFOV) PET 时 PSA 水平 < 0.2 ng/mL 时，检出率仅下降至 10-40%。先前的研究表明，在 PSA > 0.2 ng/mL 的 BCR 患者中，全身 [ ⁶⁸ Ga]Ga-PSMA-11 PET 的检出率优于 SAFOV [ ⁶⁸ Ga]Ga-PSMA-11 PET 。然而，当 PSA < 0.2 ng/mL 时，全身 [ ⁶⁸ Ga]Ga-PSMA-11 PET 对 BCR 患者的诊断效用仍不清楚。本研究旨在评估PSA < 0.2 ng/的 BCR 患者中，与SAFOV [ ⁶⁸ Ga]Ga-PSMA-11 PET/CT 相比，全身 [ 68 Ga]Ga-PSMA-11 PET/CT 是否^可以提高检出率毫升。

方法

80 名 PSA < 0.2 ng/mL 的 BCR 患者接受了全身 [ ⁶⁸ Ga]Ga-PSMA-11 PET/CT。这些患者的基线质量与另外 80 名接受 SAFOV [ ⁶⁸ Ga]Ga-PSMA-11 PET/CT 的患者相匹配。采用卡方检验和分层分析比较全身[ ⁶⁸ Ga]Ga-PSMA-11 PET/CT 和 SAFOV [ ⁶⁸ Ga]Ga-PSMA-11 PET/CT 的检出率。根据主观评分和客观参数评估全身[ ⁶⁸ Ga]Ga-PSMA PET/CT 和SAFOV [ ⁶⁸ Ga]Ga-PSMA-11 PET/CT 的图像质量。测量的客观参数为SUVmax、SUVmean、SUV的标准差(SD)以及肝脏和臀大肌的信噪比(SNR)。

结果

在早期和延迟扫描中，全身[ ⁶⁸ Ga]Ga-PSMA PET/CT 的图像质量优于SAFOV [ ⁶⁸ Ga]Ga-PSMA-11 PET/CT。全身[ ⁶⁸ Ga]Ga-PSMA PET/CT对PSA < 0.2 ng/mL的BCR患者的检出率显着高于SAFOV[ ⁶⁸ Ga]Ga-PSMA-11 PET/CT（73.75% vs 43.75%，P  <0.001）。与SAFOV [ ⁶⁸ Ga]Ga-PSMA-11 PET/CT相比，全身[ ^{68 Ga]Ga-PSMA PET/CT 对治疗方案产生了值得注意的修改。}

结论

在 PSA < 0.2 ng/mL 的 BCR 患者中，全身 [ ⁶⁸ Ga]Ga-PSMA-11 PET/CT 不仅表现出比 SAFOV [ ⁶⁸ Ga]Ga-PSMA-11 PET/CT 显着更高的检出率，而且也导致了治疗方案的重大改变。