ojrdrtОнкологический журнал: лучевая диагностика, лучевая терапияJournal of oncology: diagnostic radiology and radiotherapy2587-75932713-167XНЕКОММЕРЧЕСКОЕ ПАРТНЕРСТВО «ОБЩЕСТВО ИНТЕРВЕНЦИОННЫХ ОНКОРАДИОЛОГОВ»10.37174/2587-7593-2024-7-2-15-26ojrdrt-360Research ArticleЯДЕРНАЯ МЕДИЦИНАNUCLEAR MEDICINEПЭТ/КТ с 18F-PSMA-1007 в диагностике первичного очага и местного рецидива светлоклеточного почечно-клеточного рака в сравнении с 18F-ФДГ: проспективное исследованиеPET/CT with 18F-PSMA-1007 in Diagnostics of Primary and Recurrent Lesions of Clear-cell Renal Cell Carcinoma in Comparison with 18F-FDG: Prospective Studyhttps://orcid.org/0000-0002-5375-2498ИльяковВ. С.IlyakovV. S.

Ильяков Вадим Сергеевич — врач- радиолог отделения радионуклидной диагностики № 2 отдела радионуклидной диагностики и терапии НИИ КиЭР, аспирант.

115478 Москва, Каширское шоссе, 24

Vadim S. Ilyakov.

24 Kashirskoye Shosse, Moscow, 115478

vadimilakov075@gmail.comhttps://orcid.org/0000-0003-1632-351XПронинА. И.ProninA. I.

Пронин Артем Игоревич — к.м.н., врач-радиолог, заведующий отделом радионуклидной диагностики и терапии, заведующий отделением радионуклидной диагностики № 2.

115478 Москва, Каширское шоссе, 24

Artem I. Pronin.

24 Kashirskoye Shosse, Moscow, 115478

https://orcid.org/0000-0002-2963-4176ПарнасА. В.ParnasA. V.

Парнас Александр Вадимович — врач-радиолог отделения радионуклидной диагностики № 2 отдела радионуклидной диагностики и терапии, аспирант.

115478 Москва, Каширское шоссе, 24

Alexander V. Parnas.

24 Kashirskoye Shosse, Moscow, 115478

alexandrparnas@gmail.comhttps://orcid.org/0000-0002-4648-2362СубботинА. С.SubbotinA. S.

Субботин Алексей Сергеевич — м.н.с., врач-рентгенолог, отделения радионуклидной диагностики № 2.

115478 Москва, Каширское шоссе, 24

Alexey S. Subbotin.

24 Kashirskoye Shosse, Moscow, 115478

https://orcid.org/0000-0002-8476-7879КрыловА. С.KrylovA. S.

Крылов Александр Сергеевич — к.м.н., доцент, заведующий отделением радионуклидной диагностики № 1.

115478 Москва, Каширское шоссе, 24

Alexander S. Krylov.

24 Kashirskoye Shosse, Moscow, 115478

krilovas@rambler.ruhttps://orcid.org/0000-0003-4122-9285ГелиашвилиТ. М.GeliashviliT. M.

Гелиашвили Тамара Мамуковна — к.м.н., заведующая отделением радионуклидной терапии, врач-радиолог, врач-онколог.

115478 Москва, Каширское шоссе, 24

Tamara M. Geliashvili.

24 Kashirskoye Shosse, Moscow, 115478

geliashvili_tata@mail.ruhttps://orcid.org/0000-0002-3975-1130БезумоваЕ. В.BezumovaE. V.

Безумова Елизавета Витальевна — инженер и медицинский физик отделения радионуклидной диагностики № 2.

115478 Москва, Каширское шоссе, 24

Elizaveta V. Bezumova.

24 Kashirskoye Shosse, Moscow, 115478

Liza_bz@mail.ruhttps://orcid.org/0000-0002-8260-3520МехедоваО. В.MehedovaO. V.

Мехедова Ольга В. — руководитель блока, инженер-радиохимик циклотронно-радиохимического блока отделения радионуклидной диагностики № 2.

115478 Москва, Каширское шоссе, 24

Olga V. Mehedova.

24 Kashirskoye Shosse, Moscow, 115478

olga-mehedova@mail.ruhttps://orcid.org/0000-0003-2312-6020НестероваН. И.NesterovaN. I.

Нестерова Наталия Игоревна — инженер-радиохимик группы научно-технических разработок отдела радионуклидной диагностики и терапии.

115478 Москва, Каширское шоссе, 24

Natalia I. Nesterova.

24 Kashirskoye Shosse, Moscow, 115478

n_i_nesterova@mail.ruhttps://orcid.org/0000-0001-7748-9527МатвеевВ. Б.MatveevV. B.

Матвеев Всеволод Борисович — д.м.н., заместитель директора по научной и инновационной работе, заведующий отделением онкоурологии, профессор, член-корреспондент РАН.

115478 Москва, Каширское шоссе, 24

Vsevolod B. Matveev.

24 Kashirskoye Shosse, Moscow, 115478

Национальный медицинский исследовательский центр онкологии им. Н.H. Блохина Минздрава РоссииРоссияN.N. Blokhin National Medical Research Center of OncologyRussian Federation202404072024721526Copyright © Ильяков В.С., Пронин А.И., Парнас А.В., Субботин А.С., Крылов А.С., Гелиашвили Т.М., Безумова Е.В., Мехедова О.В., Нестерова Н.И., Матвеев В.Б., 20242024Ильяков В.С., Пронин А.И., Парнас А.В., Субботин А.С., Крылов А.С., Гелиашвили Т.М., Безумова Е.В., Мехедова О.В., Нестерова Н.И., Матвеев В.Б.Ilyakov V.S., Pronin A.I., Parnas A.V., Subbotin A.S., Krylov A.S., Geliashvili T.M., Bezumova E.V., Mehedova O.V., Nesterova N.I., Matveev V.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.oncoradjournal.ru/jour/article/view/360Введение

Введение: Предпринимались попытки использовать различные ПЭТ-трейсеры, помимо 18F-ФДГ, в диагностике почечно-клеточного рака (ПКР), перспективные результаты демонстрируют PSMA-специфичные РФЛП, в частности 18F-PSMA-1007. Проведено проспективное исследование, посвященное возможностям ПЭТ/КТ с 18F-ФДГ и 18F-PSMA-1007 в диагностике первичного сПКР и его местного рецидива.

Материал и методы

Материал и методы: В исследование включено 48 пациентов, 28 — с образованиями почек, 20 — с подозрением на местный рецидив сПКР. У всех пациентов были доступны результаты биопсии. Всем пациентам была проведена ПЭТ/КТ с 18F-PSMA-1007 и 18F-ФДГ.

Результаты

Результаты: У 28 пациентов выявлено 39 новообразований почек. 24 из 39 очагов (21 пациент) оказались PSMA-положительными, 18 из 39 очагов (16 пациентов) — ФДГ-положительными. Ложноположительных очагов выявлено не было. Чувствительность, специфичность, положительная и отрицательная прогностическая ценность в диагностике первичного очага сПКР составили: 18F-PSMA-1007 — 75, 100, 100 и 85 % соответственно; 18Ғ-ФДГ — 57, 100, 100 и 76 % соответственно. Уровень SUVmax 18F-PSMA-1007 превышал таковой для 18F-ФДГ у 27 из 28 пациентов (38 очагов), соот­ношение опухоль/фон было выше у 16 из 28 пациентов (24 очага). Опухолевый тромбоз выявлен у 6 пациентов (PSMA- положительные — 6 из 6, ФДГ — 5 из 6). Уровень SUVmax 18F-PSMA-1007 в тромбах превышал 18F-ФДГ у всех пациентов, соотношение опухоль/фон — у 5 из 6 пациентов. Местный рецидив выявлен у 13 из 20 пациентов (27 очагов). 10 очагов у оставшихся 7 пациентов расценены как ложноположительные. Ложноотрицательных результатов получено не было. Чувствительность, специфичность, положительная и отрицательная прогностическая ценность в диагностике местного рецидива сПКР: 18F-PSMA-1007 — 100, 94, 81 и 100 % соответственно; 18F-ФДГ — 100, 89, 68 и 100 % соответственно.

Была выявлена корреляция SUVmax и отношения опухоль/фон с размерами первичной опухоли и рецидивных узлов для обоих РФЛП.

Обсуждение и выводы

Обсуждение и выводы: На данный момент роль 18F-PSMA-1007 в диагностике ПКР не определена. Можно отметить высокую эффективность данного РФЛП в оценке первичного очага и рецидива сПКР, его применение обосновано в случаях, когда рутинные методы диагностики не дают однозначного ответа.

Наибольший интерес представляют возможности 18F-PSMA-1007 в диагностике метастатического сПКР. В нашем отделении собран значительный проспективный материал, который станет основой для дальнейшего изучения данного РФЛП в диагностике метастатического сПКР.

Introduction

Introduction: Attempts have been made to use various RPs, other than 18F-FDG in the diagnostics of renal cell carcinoma (RCC), with promising results demonstrated by PSMA-specific RPs, in particular 18F-PSMA-1007.

A prospective study was conducted at N.N. Blokhin NMRCO to establish capabilities of PET/CT with 18F-FDG and 18F-PSMA-1007 in primary and recurrent ccRCC diagnostics.

Material and methods

Material and methods: Forty-eight patients were included in the study, 28 with renal masses and 20 with suspected local recurrence of ccRCC. Biopsy results were available in all patients. All patients underwent PET/CT with 18F-PSMA-1007 and 18F-FDG.

Results

Results: Thirty-nine renal neoplasms were identified in 28 patients. 24 of 39 foci (21 patients) were PSMA-positive and 18 of 39 foci (16 patients) were FDG-positive. No false-positive foci were identified. The sensitivity, specificity, positive and negative predictive value in primary RCC were: for 18F-PSMA-1007 — 75, 100, 100 and 85 %, respectively; for 18FDG — 57, 100, 100 and 76 %, respectively. The SUVmax level of 18F-PSMA-1007 exceeded 18FDG in 27 of 28 patients (38 foci); the tumor/background ratio was higher in 16 of 28 patients (24 foci). Tumor thrombosis was detected in 6 patients (PSMA-positive 6 of 6, FDG-positive 5 of 6). PSMA-SUVmax levels in thrombi exceeded 18FDG in all patients, tumor/background ratio in 5 out of 6 patients. Local recurrence was detected in 13 of 20 patients (27 foci). 10 foci in the remaining 7 patients were considered as false positives. No false-negative results were obtained. Sensitivity, specificity, positive and negative predictive value in the diagnosis of local recurrence of ccPCC: 18F-PSMA-1007 — 100, 94, 81 and 100 %, respectively; 18FDG -100, 89, 68 and 100 %, respectively.

SUVmax and tumor/background ratio were found to correlate with primary tumor and recurrent node sizes for both RPs.

Discussion and conclusions: At the moment, the role of 18F-PSMA-1007 in RCC diagnostics has not been defined. We can note the high efficiency of this RP in the assessment of the primary focus and recurrence of ccRCC, its usage is justified in cases, when routine diagnostic methods do not give an unambiguous answer.

The possibilities of 18F-PSMA-1007 in metastatic ccRCC diagnostics are of the greatest interest. A significant prospective material has been collected in our department, which will be the basis for further study of this RP in the diagnostics of metastatic ccRCC.

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The authors declare that there are no conflicts of interest present.