ПЭТ/КТ с 18F-фторхолином в режиме двухэтапного сканирования при биохимических рецидивах рака предстательной железы

Позитронная эмиссионная томографии/компьютерная томография (ПЭТ/КТ) с 18F-фторхолином, основанная на оценке биораспределения фосфатидилхолина, является эффективным методом диагностики при биохимических рецидивах рака предстательной железы (РПЖ). По результатам нашего исследования, основанном на анализе 71 наблюдения пациентов с биохимическим рецидивом РПЖ (уровень простатспецифического антигена в сыворотке крови 1,775 (0,0245; 56,0975) нг/мл, чувствительность двухэтапной ПЭТ/КТ с 18F-фторхолином составила 66,7 %, доверительный интервал (ДИ) 55,3–78,0, при специфичности 80 % (ДИ 44,9–100,0), общая точность метода колебалась от 56,7 до 78,5 %. Полученные результаты свидетельствуют о целесообразности применения ПЭТ/КТ с 18F-фторхолином в режиме двухэтапного сканирования при биохимических рецидивах РПЖ.

1. Статистика злокачественных новообразований в России и странах СНГ в 2008 г. Под ред. М. И. Давыдова, Е. М. Аксель. Вестник РОНЦ им. Н. Н. Блохина РАМН, 2010. Т. 21.

2. Злокачественные новообразования в России в 2012 году (заболеваемость и смертность). Под ред. А. Д. Каприна, В. В. Старинского, Г. В. Петровой. М.: ФГБУ «МНИОИ им. П. А. Герцена» Минздрава России, 2014.

3. Ferlay J., Soerjomataram I., Dikshit R. et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015;136: E359–86.

4. Budiharto T., Joniau S., Lerut E. et al. Prospective evaluation of 11C-choline positron emission tomography/computed tomography and diffusion weighted magnetic resonance imaging for the nodal staging of prostate cancer with a high risk of lymph node metastases. Eur Urol 2011;60:125–30.

5. Etzioni R., Cha R., Feuer E. J., Davidov O. Asymptomatic incidence and duration of prostate cancer. Am J Epidemiol 1998;148(8):775–85.

6. Cimitan M., Bortolus R., Morassut S. et al. [18F] fluorocholine PET/CT imaging for the detection of recurrent prostate cancer at PSA relapse: experience in 100 consecutive patients. Eur J Nucl Med 2006;33(12):1387–98.

7. Hara T., Kosaka N., Kishi H. PET imaging of prostate cancer using carbon-11-choline. J Nucl Med1998;39(6):990–5.

8. Mottet N., Bastian P. J., Bellmunt J. et al. EAU guidelines on prostate cancer. Update April 2014. European Association of Urology. http://www.uroweb.org/guidelines/onlineguidelines/.

9. Arlen P. M., Bianco F., Dahut W. L. et al. Prostate Specific Antigen Working Group. Prostate Specific Antigen Working Group guidelines on prostate specific antigen doubling time. J Urol 2008;179(6):2181–5.

10. Leventis K., Shariat S. F., Slawin K. M. Local recurrence after radical prostatectomy: correlation of US features with prostatic fossa biopsy findings. Radiology 2001;219(2):432–9.

11. Schmid D. T., John H., Zweifel R. et al. Fluorocholine PET/CT in patients with prostate cancer: initial experience. Radiology 2005;235:623–8.

12. Schmid H. P., McNeal J. E., Stamey T. A. Observations on the doubling time of prostate cancer. The use of serial prostate-specific antigen in patients with untreated disease as a measure of increasing cancer volume. Cancer 1993;71(6):2031–40.

13. Sanz G., Rioja J., Zudaire J. et al. PET and prostate cancer. World J Urol 2004;22:351–2.

14. Karam J. A., Mason R. P., Koeneman K. S. et al. Molecular imaging in prostate cancer. J Cell Biochem 2003;90:473–83.

15. Turkbey B., Pinto P. A., Mani H. et al. Prostate cancer: value of multiparametric MR imaging at 3 T for detection – histopathologic correlation. Radiology 2010;255(1):89–99.

16. Turkbey B., Mani H., Shah V. et al. Multiparametric 3T prostate magnetic resonance imaging to detect cancer: histopathological correlation using prostatectomy specimens processed in customized magnetic resonance imaging based molds. J Urol 2011;186(5):1818–24.

17. Selnaes K. M., Heerschap A., Jensen L. R. et al. Peripheral zone prostate cancer localization by multiparametric magnetic resonance at 3 T: unbiased cancer identification by matching to histopathology. Invest Radiol 2012;47(11):624–33.

18. Bratan F., Niaf E., Melodelima C. et al. Influence of imaging and histological factors on prostate cancer detection and localisation on multiparametric MRI: a prospective study. Eur Radiol 2013;23(7):2019–29.

19. Hoeks C. M., Schouten M. G., Bomers J. G. et al. Three-Tesla magnetic resonance-guided prostate biopsy in men with increased prostate-specific antigen and repeated, negative, random, systematic, transrectal ultrasound biopsies: detection of clinically significant prostate cancers. Eur Urol 2012;62(5):902–9.

20. Puech P., Rouviere O., Renard-Penna R. et al. Prostate Cancer Diagnosis: Multiparametric MR-targeted Biopsy with Cognitive and Transrectal US-MR Fusion Guidance versus Systematic Biopsy- Prospective Multicenter Study. Radiology 2013;268(2):461–9.

21. Apolo A. B., Pandit-Taskar N., Morris M. J. Novel tracers and their development for the imaging of metastatic prostate cancer. J Nucl Med 2008;49:2031–41.

22. Husarik D. B., Miralbell R., Dubs M. et al. Evaluation of [(18)F]-choline PET/CT for staging and restaging of prostate cancer. Eur J Nucl Med Mol Imaging 2008;35:253–63.

23. Effert P. J., Bares R., Handt S. et al. Metabolic imaging of untreated prostate cancer by positron emission tomography with 18fluorine-labeled deoxyglucose. J Urol 1996;155:994–8.

24. Wetter A., Lipponer C., Nensa F. et al. Evaluation of the PET component of simultaneous [18F] choline PET/MRI in prostate cancer: comparison with [18F] choline PET/CT. Eur J Nucl Med Mol Imaging 2014;41(1):79–88.

25. Wu L. M., Xu J. R., Gu H. Y. et al. Role of magnetic resonance imaging in the detection of local prostate cancer recurrence after external beam radiotherapy and radical prostatectomy. Clin Oncol 2013;25(4):252–64.

26. Джужа Д. А. Позитронная эмиссионная томография в онкоурологии. Лучевая диагностика, лучевая терапия 2013;2(3):67–75.

27. Mease R. C. Radionuclide based imaging of prostate cancer. Curr Top Med Chem 2010;10:1600–16.

28. Heidenreich A., Bellmunt J., Bolla M. et al. EAU guidelines on prostate cancer – part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol 2011;59(1):61–71.

29. Emonds K. M., Swinnen J. V., Mortelman s.L., Mottaghy F. M. Molecular imaging of rostate cancer. Methods 2009;48:193–9. 30. Gutman F., Afl alo-Hazan V., Kerrou K. et al. 8F-Choline PET/CT for initial staging of advanced prostate cancer. AJR 2006;187:618–21.

30. Schillaci O., Calabria F., Tavolozza M., Ciccio C. et al. 18F-choline PET/CT physiological distribution and pitfalls in image interpretation: experience in 80 patients with prostate cancer. Nucl Med Commun 2010;31:39–4.

31. Sutinen E., Nurmi M., Roivainen A. et al. Kinetics of 11C Choline uptake in prostate cancer: a PET study. Eur J Nucl Med Mol Imaging 2004;31:317–24.

32. Chiti A. The rising PET: the increasing use of choline PET/CT in prostate cancer. Eur J Nucl Med 2011;38:53–54.

33. Greco C., Cascini O., Tamburini G. et al. Is there a role for positron emission tomography imaging in the early evaluation of prostate cancer relapse? Prostate Cancer and Prostatic Diseases 2008;11:121–8.

34. Piccardo A., Paparo F., Picazzo R. et al. Value of Fused 18F-Choline-PET/MRI to Evaluate Prostate Cancer Relapse in Patients Showing Biochemical Recurrence after EBRT: Preliminary Results. BioMed Research International 2014. http://www.ncbi.nlm.nih. gov/pmc/articles/PMC4022120/.

35. Beheshti M., Langsteger W., Fogelman I. Prostate cancer: role of SPECT and PET in imaging bone metastases. Semin Nucl Med 2009;39(6):396–407.

36. Beheshti M., Imamovic L., Broiger G. et al. 18F choline PET/CT in the preoperative staging of prostate cancer in patients with intermediate or high risk of extracapsular disease: a prospective study of 130 patients. Radiology 2010;254:925–33.

37. Tilki D., Reich O., Graser A. et al. 18FFluoroethylcholine PET/CT identifies lymph node etastasis in patients with prostatespecific antigen failure after radical prostatectomy but underestimates its extent. Eur Urol 2013;63:792–6.

38. Kwee S. A., Wei H., Sesterhenn I. et al. Localization of primary prostate cancer with dual-phase 18F-fluorocholine PET. J Nucl Med 2006; 47(2): 262–9.

39. O»Brien M. F., Cronin A. M., Fearn P. A. et al. Pretreatment prostate-specific antigen (PSA) velocity and doubling time are associated with outcome but neither improves prediction of outcome beyond pretreatment PSA alone in patients treated with radical prostatectomy. J Clin Oncol 2009;27(22):3591–7.

40. Zeisel S. H. Dietary choline: biochemistry, physiology, and pharmacology. Ann Rev Nutr 1981;1:95–121.

41. Carolan P., Hunt C., McConnell D. et al. Radiation exposure reduction to PET technologists with the use of an automated dosage infusion system. J Nucl Med 2012;53:2185.

42. Massaro A., Ferretti A., Secchiero C. et al. Optimising 18F-choline PET/CT acquisition protocol in prostate cancer patients. North Am J Med Sci 2012;4(9):416.

43. Von Eyben F. E., Kairemo K. Metaanalysis of 11C-choline and 18F-choline PET/CT for management of patients with rostate cancer. Nucl Med Commun 2014;35(3):221–30.

44. Pinaquy J. B., Clermont–Galleran D., Pasticier G. et al. Comparative effectiveness of [18F]-fluorocholine PET-CT and pelvic MRI with diffusion-weighted imaging for staging in patients with high-risk prostate cancer. Prostate 2015;75(3):323–31.

45. Kjölhede H., Ahlgren G., Almquist H. et al. 18F-fluorocholine PET/CT compared with extended pelvic lymph node dissection in high-risk prostate cancer. World J Urol 2014;32(4):965–70.

46. Agarwal N., Sonpavde G., Sternberg C. N. Novel molecular targets for the therapy of castrationresistant prostate cancer. Eur Urol 2012;61:950–60.

47. Holland-Letz T., Giesel F. L., Kratochwil C., Haufe S. PET imaging with a [68Ga] gallium-labelled PSMA ligand for the diagnosis of prostate cancer: Biodistribution in humans and first evaluation of tumour lesions. Eur J Nucl Med Mol Imaging 2013;40:486–95.

48. Hong H., Zhang Y., Sun J., Cai W. Positron emission tomography imaging of prostate cancer. Amino Acids 2010;39:11–27.