ПЭТ/КТ с ¹⁸F-фторхолином при рецидивах рака предстательной железы

Позитронная эмиссионная томография с ¹⁸F-фторхолином, совмещенная с компьютерной томографией (ПЭТ/КТ), основанная на оценке биораспределения фосфатидилхолина, является эффективным методом диагностики при биохимических рецидивах рака предстательной железы (РПЖ). По результатам нашего исследования, основанном на анализе 79 наблюдений пациентов с биохимическим рецидивом РПЖ (уровень простатспецифического антигена в сыворотке крови 1,775 нг/мл), чувствительность двухэтапной ПЭТ/КТ с ¹⁸F-фторхолином составила 66,7 %, доверительный интервал 95 % (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. Аксель Е.М. Статистика злокачественных новообразований в России и странах СНГ в 2008 г. // Вестник РОНЦ им. Н.Н. Блохина РАМН. 2010. № 21.

2. Злокачественные новообразования в России в 2010 году (заболеваемость и смертность). Под. ред. В.И. Чиссова, В.В. Старинского, Г.В. Петровой. – М.: ФГУ «МНИОИ им. П.А. Герцена Росмедтехнологий». 2011. 256 с.

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. 2014.

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. Vol. 60. P. 125–130.

5. Etzioni R., Cha R., Feuer E.J., Davidov O. Asymptomaticincidence and duration of prostate cancer // Amer. J. Epidemiol. 1998. Vol. 148. № 8. P. 775–785.

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. Vol. 33. № 12. P. 1387–1398.

7. Hara T., Kosaka N., Kishi H. PET imaging of prostate cancer using carbon-11-choline / // J. Nucl. Med. 1998. Vol. 39. № 6. P. 990–995.

8. Basch E. et al. Systemic therapy in men with metastatic castrationresistant prostate cancer: American Society of Clinical Oncology and Cancer Care Ontario clinical practice guideline // J. Clin. Oncol. 2014. Vol. 32. №. 30. P. 3436–3448.

9. Котляров П.М. Лучевая диагностика рака предстательной железы // Росс. онкол. журнал. 2008. № 2. C. 49–53.

10. Carter H.B., Pearson J.D., Metter E.J. et al. Longitudinal evaluation of prostate-specific antigen levels in men with and without prostate disease // JAMA. 1992. Vol. 267. № 16. P. 2215– 2020.

11. Leventis K., Shariat S.F., Slawin K.M. Local recurrence after radical prostatectomy: correlation of US features with prostatic fossa biopsy findings // Radiology. 2001. Vol. 219. № 2. P. 432– 439.

12. Hudson M.A., Bahnson R.R., Catalona W.J. Clinical use of PSA in patients with prostate cancer // J. Urol. 1989. Vol. 142. № 4. P. 1011–1017.

13. 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/online-guidelines/. Accessed 25 April 2014.

14. Arlen P.M., Bianco F., Dahut W.L. et al. Prostate Specific Antigen Working Group guidelines on prostate specific antigen doubling time // J. Urol. 2012. Vol. 179. № 6. P. 2181–2185.

15. Schmid D.T., John H., Zweifel R. et al. Fluorocholine PET/CT in patients with prostate cancer: initial experience // Radiology. 2005. Vol. 235. P. 623–628.

16. Schmid H.-P., McNeal J.E., Stamey T.A. Observations on the doubling time of prostate cancer. The use of serial prostatespecific antigen in patients with untreated disease as a measure of increasing cancer volume // Cancer. 1993. Vol. 71. № 6. P. 2031–2040.

17. Sanz G., Rioja J., Zudaire J. et al. PET and prostate cancer // World J. Urol. 2004. Vol. 22. P. 351–352.

18. Theodorescu D., Broder S.R., Boyd J.C. et al. p53, bcl-2 and retinoblastoma proteins as long-term prognostic markers in localized carcinoma of the prostate // J. Urol. 1997. Vol. 158. № 1. P. 131–137.

19. MacGrogan D., Bookstein R. Tumour suppressor genes in prostate cancer // Semin. Cancer Biol. 1997. Vol. 8. № 1. P. 11–19.

20. Karam J.A., Mason R.P., Koeneman K.S. et al. Molecular imaging in prostate cancer // J. Cell Biochem. 2003. Vol. 90. P. 473–483.

21. Turkbey B., Pinto P.A., Mani H. et al. Prostate cancer: value of multiparametric MR imaging at 3T for detection – histopathologic correlation // Radiology. 2010. Vol. 255. № 1. P. 89–99.

22. 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. Vol. 186. № 5. P. 1818–1824.

23. Selnaes K.M., Heerschap A., Jensen L.R. et al. Peripheral zone prostate cancer localization by multiparametric magnetic resonance at 3T: unbiased cancer identification by matching to histopathology // Invest. Radiol. 2012. Vol. 47. № 11. P. 624–633.

24. 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. Vol. 23. № 7. P. 2019–29

25. 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. Vol. 62. № 5. P. 902–909.

26. 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. Vol. 268. № 2. P. 461–469.

27. 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. Vol. 49. P. 2031–2041.

28. 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. Vol. 35. P. 253–263.

29. Effert P.J., Bares R., Handt S et al. Metabolic imaging of untreated prostate cancer by positron emission tomography with 18F-labeled deoxyglucose // J. Urol. 1996. Vol. 155. P. 994–998.

30. 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. Vol. 41. № 1. P. 79–88.

31. 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. Vol. 25. № 4. P. 252–264.

32. Джужа Д.А. Позитронная эмиссионная томография в онкоурологии // Лучевая диагностика и терапия. 2013. № 2/3. С. 67–75.

33. Mease R.C. Radionuclide based imaging of prostate cancer // Curr. Top Med. Chem. 2010. Vol. 10. P. 1600–1616.

34. Heidenreich J., Bellmunt M., Bolla K. et al. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease // Eur. Urol. 2011. Vol. 59. № 1. P. 61– 71.

35. Emonds K.M., Swinnen J.V., Mortelmans L., Mottaghy F.M. Molecular imaging of prostate cancer // Methods. 2009. Vol. 48. P. 193–199.

36. Gutman F., Afl alo-Hazan V., Kerrou K. et al. 18F-choline PET/ CT for initial staging of advanced prostate cancer // AJR. 2006. Vol. 187. P. W618–W621.

37. Schillaci O., Calabria F., Tavolozza M. et al. 18F-choline PET/CT physiological distribution and pitfalls in image interpretation: experience in 80 patients with prostate cancer // Nucl. Med. Commun. 2010. Vol. 31. P. 39–44.

38. 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. Vol. 31. P. 317–324.

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

40. Greco C., Cascini G. L., Tamburini O. Is there a role for positron emission tomography imaging in the early evaluation of prostate cancer relapse? // Prostate Cancer and Prostatic Diseases. 2008. Vol. 11. P. 121–128.

41. Piccardo A., Paparo F., Picazzo R.et al. Value of fused 18F-cholinePET/MRI to evaluate prostate cancer relapse in patients showing biochemical recurrence after EBRT: Preliminary results // BioMed. Res. Intern. Article ID 103718, 9 pages, 2014. doi:10.1155/2014/103718

42. Beheshti M., Langsteger W., Fogelman I. Prostate cancer: role of SPECT and PET in imaging bone metastases // Semin. Nucl. Med. 2015. Vol. 48. P. 73–79.

43. 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. Vol. 254. P. 925–933

44. Tilki D., Reich O., Graser A. et al. 18F-fluoroethylcholine PET/CT identifies lymph node metastasis in patients with prostate-specific antigen failure after radical prostatectomy but underestimates its extent // Eur. Urol. 2013. Vol. 63. P. 792–796.

45. Kwee S. A. et al. Localization of primary prostate cancer with dual-phase 18F-fluorocholine PET // J. Nucl. Med. 2006. Vol. 47. № 2. P. 262–269.

46. 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. Vol. 27. № 22. P. 3591–3597.

47. Zeisel S.H. Dietary choline: biochemistry, physiology, and pharmacology // Ann. Rev. Nutr. 1981. Vol. 1. P. 95–121.

48. 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. Meeting Abstracts. 2012. Vol. 53. P. 2185.

49. Massaro A. et al. Optimising 18F-choline PET/CT acquisition protocol in prostate cancer patients // N. Amer. J. Med. Sci. 2012. Vol. 4. № 9. P. 416–424.

50. Vali R., Loidl W., Pirich C. et al. Imaging of prostate cancer with PET/CT using 18F-Fluorocholine // Amer. J. Nucl. Med. Mol. Imaging. 2015. Vol. 5. № 2. P. 96–108.

51. Beauregard J.-M., Pouliot F. New developments in the imaging of metastatic prostate cancer // Curr. Opin. Support. Palliat. Care. 2014. Vol. 8. № 3. P. 265–270.

52. Evangelista L., Cervino A.R., Guttilla A. et al. 18F-fluoromethylcholine or 18F-fluoroethylcholine PET for prostate cancer imaging: which is better? A literature revision // Nucl. Med. Biol. 2015. Vol. 42. № 4. P. 340–348.

53. Beheshti M., Haroon A., Bomanji J.B., Langsteger W. Fluorocholine PET/computed tomography: physiologic uptake, benign findings, and pitfalls // PET Clin. 2014. Vol. 9. № 3. P. 299–306.

54. Beauregard J.-M., Beaulieu A. How we read FCH-PET/CT for prostate cancer? // Cancer Imaging. 2016. Vol. 16. № 1. P. 44–51.

55. Agarwal N., Sonpavde G., Sternberg C.N. Novel molecular targets for the therapy of castrationresistant prostate cancer // Eur. Urol. 2012. Vol. 61. P. 950–960.

56. 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. Vol. 40. P. 486–495.

57. Hong H., Zhang Y., Sun J., Cai W. Positron emission tomography imaging of prostate cancer // Amino Acids. 2010. Vol. 39. P. 11– 27.

58. Rauscher I., Maurer T., Fendler W.P et al. 68Ga-PSMA ligand PET/CT in patients with prostate cancer: How we review and report // Cancer Imaging. 2016. Vol. 16. P. 14. doi:10.1186/s40644-016-0072-6.