摘要
目的探讨PSMA靶向分子探针^(68)Ga-THP-PSMA的制备,并初步评价该探针在诊断国内前列腺癌患者术后复发和转移中的价值。资料与方法采用THP-PSMA药盒室温一步法制备^(68)Ga-THP-PSMA标记物,经0.22μm无菌微孔滤膜过滤除菌,测定标记物细菌内毒素、放化纯和体外稳定性;前瞻性纳入2019年11月—2020年3月上海交通大学医学院附属第一人民医院前列腺癌患者10例,静脉注射^(68)Ga-THP-PSMA后行1 h常规全身PET/CT显像和2 h延迟PET/CT显像,比较常规显像和延迟显像病灶的最大标准化摄取值(SUVmax),分析^(68)Ga-THP-PSMA阳性率与前列腺特异性抗原水平的关系。结果THP-PSMA与^(68)GaCl3室温混合5 min后,标记率>95%[(98.74±1.06)%,n=10],在室温PBS体系和37℃血清中具有良好的体外稳定性。10例前列腺癌患者的PET/CT显像显示,^(68)Ga-THP-PSMA在肾脏和膀胱分布最高,其次为肝脏、脾脏和小肠,提示显像剂主要通过泌尿系统排泄;唾液腺、泪腺有较多生理性摄取;4例患者共21个病灶具有明显摄取,判定为局部复发或转移灶;病灶的SUVmax值在1 h和2 h显像差异无统计学意义(12.74±1.68比13.44±1.67,t=0.59,P=0.28);经^(68)Ga-THP-PSMA判定为PET/CT显像阳性患者的前列腺特异性抗原水平显著高于PET/CT阴性患者(t=0.81,P=0.04)。结论^(68)Ga-THP-PSMA制备简单、快速、标记率稳定,可浓聚于前列腺癌病灶,信噪比高,对诊断前列腺癌术后复发或转移具有临床潜力。
Purpose To preliminarily evaluate the preparation of^(68)Ga-THP-PSMA and its application for diagnosis of recurrence and metastasis in patient with prostate cancer after surgery via PET/CT.Materials and Methods^(68)Ga-THP-PSMA was conveniently radiolabeled with^(68)Ga by adding generator eluate directly to a THP-PSMA kit.The mixture was filtered through 0.22μm sterile.The bacterial endotoxin,radiochemical purity and in vitro stability of the markers were determined.Ten patients with prostate cancer recurrence or metastasis after radical surgery from the First People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from November 2019 to March 2020 were prospectively included.After intravenous injection of^(68)Ga-THP-PSMA,1 h conventional PET/CT imaging and 2 h delayed PET/CT imaging were performed.SUVmax of conventional and delayed lesions were compared.The relationship between the positive rate of^(68)Ga-THP-PSMA and the level of prostate-specific antigen was analyzed.Results THP-PSMA mixed with^(68)GaCl3 at room temperature for 5 min,the labeling rate was>95%[(98.74±1.06)%,n=10],and had good stability in vitro in PBS system at room temperature and serum at 37℃.PET/CT imaging of 10 patients with prostate cancer showed that^(68)Ga-THP-PSMA had the highest distribution in kidney and bladder,followed by liver,spleen and small intestine,suggesting that the imaging agent was mainly excreted through urinary system.Salivary glands and lacrimal glands have more physiologic uptake.A total of 21 lesions in 4 patients had significant uptake and were judged to be local recurrence or metastasis.There was no significant difference in SUVmax between 1 h and 2 h imaging(12.74±1.68 vs.13.44±1.67;t=0.59,P=0.28).The level of prostate-specific antigen in PET/CT positive patients determined by^(68)Ga-THPPSMA was significantly higher than that in PET/CT negative patients(t=0.81,P=0.04).Conclusion^(68)Ga-THP-PSMA has the advantages of simple,rapid preparation,stable labeling rate,high signal-to-noise ratio and high concentration in prostate cancer foci.It has clinical potential in the diagnosis of prostate cancer recurrence or metastasis.
作者
赵凌舟
刘长存
赵晋华
邢岩
ZHAO Lingzhou;LIU Changcun;ZHAO Jinhua;XING Yan(Department of Nuclear Medicine,Shanghai General Hospital,Shanghai Jiao Tong University,Shanghai 200080,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2023年第6期642-647,共6页
Chinese Journal of Medical Imaging
基金
上海市卫生和计划生育委员会临床研究专项面上项目(201840076)。
