Avaliação diagnóstica de neoplasia de próstata : 68Ga-PSMA PET e ressonância magnética multiparamétrica

Detalhes bibliográficos
Autor(a) principal: Roman, Diego Hermindo Henkes
Data de Publicação: 2020
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da PUC_RS
Texto Completo: http://tede2.pucrs.br/tede2/handle/tede/9580
Resumo: Background: Prostate malignancy is the third most common cancer in the world and the second most frequent in male patients. In Brazil, it represents the second most common cancer among men. The identification of local recurrence and metastatic disease of the prostate tumor remains a challenge for the attending physician and for conventional imaging methods in the evaluation of these patients. Positron emission tomography associated with computed tomography (PET / CT) with the use of gallium radioisotope marked with prostate specific membrane antigen (68Ga-PSMA) and multiparametric magnetic resonance imaging (mpMR) of the pelvis has shown rapid acceptance in staging of patients with biochemical recurrence. Objective: To demonstrate the increase in the identification of lesions related to prostate cancer in patients with biochemical recurrence when using 68GaPSMA-PET/CT associated with mpMR compared to 68GaPSMA-PET/CT alone. Methods: Prospective analysis of patients in investigation of biochemical recurrence due to prostate cancer at InsCer, with 68GaPSMA-PET / CT and mpMR of the pelvis, between 08/2018 and 08/2019, performing both methods less than 5 days apart. The scans were analyzed by two different groups of specialist physician, one of which analyzed both imaging methods and the other analyzed only PET/CT images. Positive findings for recurrence of prostate cancer were classified according to their location, with recurrence at the prostate, lymph node or metastasis sites. Results: 95 out of 123 evaluated patients were included, 57 of whom were identified with lesions in the prostate bed in the combined assessment (68GaPSMA-PET/CT + mpMR) and 33 in 68GaPSMA-PET / CT alone. 44 pathological lymph nodes were observed in the 68GaPSMA-PET/CT + mpMR analysis and 29 in the isolated PET/CT, this difference being mainly due to the individualization of small lymph nodes in the pelvic region in mpMR. There was no significant difference in the number of individualized bone lesions between the groups. Conclusion: The combined analysis of 68Ga-PSMA PET/CT with mpMR of the pelvis allowed to identify a greater number of lesions in the prostate bed compared to PET/CT alone. Both techniques have complementary information, as well as different limitations.
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spelling Hochhegger, BrunoRoman, Diego Hermindo Henkes2021-05-03T18:01:38Z2020-08-15http://tede2.pucrs.br/tede2/handle/tede/9580Background: Prostate malignancy is the third most common cancer in the world and the second most frequent in male patients. In Brazil, it represents the second most common cancer among men. The identification of local recurrence and metastatic disease of the prostate tumor remains a challenge for the attending physician and for conventional imaging methods in the evaluation of these patients. Positron emission tomography associated with computed tomography (PET / CT) with the use of gallium radioisotope marked with prostate specific membrane antigen (68Ga-PSMA) and multiparametric magnetic resonance imaging (mpMR) of the pelvis has shown rapid acceptance in staging of patients with biochemical recurrence. Objective: To demonstrate the increase in the identification of lesions related to prostate cancer in patients with biochemical recurrence when using 68GaPSMA-PET/CT associated with mpMR compared to 68GaPSMA-PET/CT alone. Methods: Prospective analysis of patients in investigation of biochemical recurrence due to prostate cancer at InsCer, with 68GaPSMA-PET / CT and mpMR of the pelvis, between 08/2018 and 08/2019, performing both methods less than 5 days apart. The scans were analyzed by two different groups of specialist physician, one of which analyzed both imaging methods and the other analyzed only PET/CT images. Positive findings for recurrence of prostate cancer were classified according to their location, with recurrence at the prostate, lymph node or metastasis sites. Results: 95 out of 123 evaluated patients were included, 57 of whom were identified with lesions in the prostate bed in the combined assessment (68GaPSMA-PET/CT + mpMR) and 33 in 68GaPSMA-PET / CT alone. 44 pathological lymph nodes were observed in the 68GaPSMA-PET/CT + mpMR analysis and 29 in the isolated PET/CT, this difference being mainly due to the individualization of small lymph nodes in the pelvic region in mpMR. There was no significant difference in the number of individualized bone lesions between the groups. Conclusion: The combined analysis of 68Ga-PSMA PET/CT with mpMR of the pelvis allowed to identify a greater number of lesions in the prostate bed compared to PET/CT alone. Both techniques have complementary information, as well as different limitations.Introdução: A neoplasia maligna de próstata é o terceiro tipo de câncer mais comum no mundo e o segundo mais frequente em pacientes masculinos. No Brasil, representa o segundo câncer mais comum entre os homens. A identificação da recidiva local e da doença metastática do tumor de próstata permanece sendo um desafio para o médico assistente e para os métodos de imagem convencionais na avaliação destes pacientes. A tomografia por emissão de pósitrons associada à tomografia computadorizada (PET/CT) com uso de radioisótopo de gálio marcado com antígeno de membrana específico da próstata (68Ga-PSMA) e a ressonância magnética multiparamétrica (RMmp) da pelve tem demonstrado rápida aceitação no estadiamento dos pacientes com recidiva bioquímica. Objetivo: Demonstrar o aumento na identificação de lesões relacionadas a neoplasia de próstata nos pacientes com recidiva bioquímica quando utilizado o 68GaPSMA-PET/CT associado a RMmp em comparação ao 68GaPSMA-PET/CT isolado. Métodos: Análise prospectiva de pacientes em investigação de recidiva bioquímica por neoplasia de próstata no InsCer, com 68GaPSMA-PET/CT e RMmp da pelve, entre 08/2018 e 08/2019, realizando ambos os métodos com intervalo inferior a 5 dias. Os exames foram analisados por dois grupos diferentes de médicos especialista, sendo que um analisou de forma conjunta ambos os métodos de imagem e o outro analisou somente as imagens de PET/CT. Os achados positivos para recidiva de neoplasia de próstata foram classificados de acordo com sua localização, sendo recidiva no sítio prostático, linfonodal ou metástase. Resultados: Foram incluídos 95 de 123 pacientes avaliados, sendo identificados 57 com lesão no leito prostático na avaliação combinada (68GaPSMA-PET/CT + MRmp) e 33 no 68GaPSMA-PET/CT isolado. Observaram-se 44 linfonodos patológicos na analise 68GaPSMA-PET/CT + MRmp e 29 no PET/CT isolado, sendo esta diferença devido, principalmente, a individualização de pequenos linfonodos na região pélvica na RMmp. Não houve diferença significativa no número de lesões ósseas individualizadas entre os grupos. Conclusão: A análise conjunta de 68Ga-PSMA PET/CT com RMmp da pelve permitiu identificar maior número de lesões no leito da próstata em comparação ao PET/CT isolado. Ambas técnicas apresentam informações complementares, bem como diferentes limitações.Submitted by PPG Medicina e Ciências da Saúde (medicina-pg@pucrs.br) on 2021-04-20T14:47:36Z No. of bitstreams: 1 Dissertacao_Diego_Roman.pdf: 1540699 bytes, checksum: e045641b2b40ac6a5f407a704b219808 (MD5)Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2021-05-03T17:51:14Z (GMT) No. of bitstreams: 1 Dissertacao_Diego_Roman.pdf: 1540699 bytes, checksum: e045641b2b40ac6a5f407a704b219808 (MD5)Made available in DSpace on 2021-05-03T18:01:38Z (GMT). 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dc.title.por.fl_str_mv Avaliação diagnóstica de neoplasia de próstata : 68Ga-PSMA PET e ressonância magnética multiparamétrica
title Avaliação diagnóstica de neoplasia de próstata : 68Ga-PSMA PET e ressonância magnética multiparamétrica
spellingShingle Avaliação diagnóstica de neoplasia de próstata : 68Ga-PSMA PET e ressonância magnética multiparamétrica
Roman, Diego Hermindo Henkes
Câncer de Próstata
RMmp
PET/CT
PSMA
Recidiva Bioquímica
Prostate Cancer
RMmp
PSMA
68Ga-PSMA
Biochemical Recurrence
CIENCIAS DA SAUDE::MEDICINA
title_short Avaliação diagnóstica de neoplasia de próstata : 68Ga-PSMA PET e ressonância magnética multiparamétrica
title_full Avaliação diagnóstica de neoplasia de próstata : 68Ga-PSMA PET e ressonância magnética multiparamétrica
title_fullStr Avaliação diagnóstica de neoplasia de próstata : 68Ga-PSMA PET e ressonância magnética multiparamétrica
title_full_unstemmed Avaliação diagnóstica de neoplasia de próstata : 68Ga-PSMA PET e ressonância magnética multiparamétrica
title_sort Avaliação diagnóstica de neoplasia de próstata : 68Ga-PSMA PET e ressonância magnética multiparamétrica
author Roman, Diego Hermindo Henkes
author_facet Roman, Diego Hermindo Henkes
author_role author
dc.contributor.advisor1.fl_str_mv Hochhegger, Bruno
dc.contributor.author.fl_str_mv Roman, Diego Hermindo Henkes
contributor_str_mv Hochhegger, Bruno
dc.subject.por.fl_str_mv Câncer de Próstata
RMmp
PET/CT
PSMA
Recidiva Bioquímica
topic Câncer de Próstata
RMmp
PET/CT
PSMA
Recidiva Bioquímica
Prostate Cancer
RMmp
PSMA
68Ga-PSMA
Biochemical Recurrence
CIENCIAS DA SAUDE::MEDICINA
dc.subject.eng.fl_str_mv Prostate Cancer
RMmp
PSMA
68Ga-PSMA
Biochemical Recurrence
dc.subject.cnpq.fl_str_mv CIENCIAS DA SAUDE::MEDICINA
description Background: Prostate malignancy is the third most common cancer in the world and the second most frequent in male patients. In Brazil, it represents the second most common cancer among men. The identification of local recurrence and metastatic disease of the prostate tumor remains a challenge for the attending physician and for conventional imaging methods in the evaluation of these patients. Positron emission tomography associated with computed tomography (PET / CT) with the use of gallium radioisotope marked with prostate specific membrane antigen (68Ga-PSMA) and multiparametric magnetic resonance imaging (mpMR) of the pelvis has shown rapid acceptance in staging of patients with biochemical recurrence. Objective: To demonstrate the increase in the identification of lesions related to prostate cancer in patients with biochemical recurrence when using 68GaPSMA-PET/CT associated with mpMR compared to 68GaPSMA-PET/CT alone. Methods: Prospective analysis of patients in investigation of biochemical recurrence due to prostate cancer at InsCer, with 68GaPSMA-PET / CT and mpMR of the pelvis, between 08/2018 and 08/2019, performing both methods less than 5 days apart. The scans were analyzed by two different groups of specialist physician, one of which analyzed both imaging methods and the other analyzed only PET/CT images. Positive findings for recurrence of prostate cancer were classified according to their location, with recurrence at the prostate, lymph node or metastasis sites. Results: 95 out of 123 evaluated patients were included, 57 of whom were identified with lesions in the prostate bed in the combined assessment (68GaPSMA-PET/CT + mpMR) and 33 in 68GaPSMA-PET / CT alone. 44 pathological lymph nodes were observed in the 68GaPSMA-PET/CT + mpMR analysis and 29 in the isolated PET/CT, this difference being mainly due to the individualization of small lymph nodes in the pelvic region in mpMR. There was no significant difference in the number of individualized bone lesions between the groups. Conclusion: The combined analysis of 68Ga-PSMA PET/CT with mpMR of the pelvis allowed to identify a greater number of lesions in the prostate bed compared to PET/CT alone. Both techniques have complementary information, as well as different limitations.
publishDate 2020
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