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Heterogeneity of prostate-specific membrane antigen (PSMA) and PSMA-ligand uptake detection combining autoradiography and postoperative pathology in primary prostate cancer

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机构： [1]Department of Nuclear Medicine, West China Hospital, Sichuan University, Guo Xue Xiang 37, Chengdu, 610040, Sichuan, China. [2]Department of Nuclear Medicine, Klinikum Rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany. [3]Institute of Pathology, School of Medicine, Technical University Munich, Munich, Germany. [4]Department of Urology, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany. [5]Departments of Mathematics and Life Sciences, Technical University Munich, Munich, Germany. [6]German Cancer Consortium (DKTK), Heidelberg, Germany. [7]Pharmaceutical Radiochemistry, Technical University Munich, Munich, Germany. [8]Translational Radiopharmaceutical Sciences, Departments of Nuclear Medicine and of Oncology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland. [9]Agora, Pole de Recherche Sur Le Cancer, Lausanne, Switzerland.

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关键词： Primary prostate cancer Heterogeneity 99mTc-PSMA-I&S ARG Immunohistochemistry

摘要：

Targeting prostate-specific membrane antigen (PSMA) has been highly successful for imaging and treatment of prostate cancer. However, heterogeneity in immunohistochemistry indicates limitations in the effect of imaging and radionuclide therapy of multifocal disease. 99mTc-PSMA-I&S is a γ-emitting probe, which can be used for intraoperative lesion detection and postsurgical autoradiography (ARG). We aimed to study its intraprostatic distribution and compared it with (immuno)-histopathology.Seventeen patients who underwent RGS between 11/2018 and 01/2020 with a total of 4660 grids were included in the preliminary analysis. Marked intratumor and intra-patient heterogeneity of PSMA expression was detected, and PSMA negative foci were observed in all samples (100%). Heterogeneous intra-patient PSMA-ligand uptake was observed, and no significant correlation was present between the degree of heterogeneity of PSMA expression and PSMA-ligand uptake. Higher PSMA-ligand uptake was observed in GS ≥ 8 than GS < 8 (p < 0.001). The appearance of Gleason Pattern (GP) 4 was strongly associated with higher uptake (coefficient: 0.43, p < 0.001), while GP 5 also affected the uptake (coefficient: 0.07, p < 0.001).PSMA expression and PSMA-ligand uptake show marked heterogeneity. Prostate carcinoma with GP 4 showed significantly higher uptake compared with non-neoplastic prostate tissue. Our analyses extend the scope of applications of radiolabeled PSMA-ligands to ARG for identifying high-grade disease and using its signal as a noninvasive biomarker in prostate cancer.© 2023. The Author(s).

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出版当年[2023]版：

大类 | 3 区医学

小类 | 3 区核医学

最新[2023]版：

大类 | 3 区医学

小类 | 3 区核医学

第一作者：

第一作者机构： [1]Department of Nuclear Medicine, West China Hospital, Sichuan University, Guo Xue Xiang 37, Chengdu, 610040, Sichuan, China. [2]Department of Nuclear Medicine, Klinikum Rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany.

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通讯机构： [1]Department of Nuclear Medicine, West China Hospital, Sichuan University, Guo Xue Xiang 37, Chengdu, 610040, Sichuan, China. [2]Department of Nuclear Medicine, Klinikum Rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675, Munich, Germany.

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