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*Only for medical professionals to read for reference.
The 2021 American Society of Clinical Oncology Symposium on Urogenital Cancer (ASCO-) co-sponsored by the American Society of Clinical Oncology (ASCO), American Society of Radiation Oncology (ASTRO) and American Society of Urological Oncology (SUO) GU) takes the form of an online virtual meeting due to the global new crown epidemic, and it will be held from February 11th to 13th, 2021.
An important part of the conference, molecular imaging diagnosis, updated the research progress as a diagnostic method for prostate cancer.
Next, I will explain the progress of 3 clinical studies related to PET/CT.
Abstract 29] Application of 18F-Fluciclovin PET/CT (FluPET) in prostate cancer: preliminary results of a prospective study [1] 18F-Fluciclovin PET/CT (FluPET) is a new imaging detection technology approved in 2016 It is used for the auxiliary imaging diagnosis of prostate cancer after treatment, but its clinical practice and its influence on treatment decisions are unknown.
In order to explore whether the use of FluPET will lead to changes in expected treatment decisions, this prospective study included 50 patients to explore the reasons and plans for the application of FluPET before, 1-2 weeks after the application, and 1 year after the application.
The treatment plan and the treatment plan changed due to the application of FluPET.
The results of the study showed that among the reasons for the application of FluPET, "guided rescue local treatment after the first biochemical recurrence" accounted for the largest proportion, reaching 46.
9%; followed by "guided rescue after the second biochemical recurrence" "Treatment", accounting for 36.
7%; "Confirming whether metastasis occurred" accounted for 10.
2%; "Initial staging before local treatment" accounted for the least, reaching 6.
1% (Figure 1).Figure 1 Reasons for the application of FluPET Before the application of FluPET, 67.
3% of the treatments taken were watched and waited, and androgen deprivation treatment (ADT) alone accounted for 26.
5%, ADT + docetaxel or antiandrogen treatment accounted for 20.
4%, and local salvage treatment Accounted for 26.
5%; after the application of FluPET, the proportion of changes in the pre-treatment strategy reached 45.
5%.
In this part of the changed treatment, watchful waiting accounted for 6.
8%, systemic treatment accounted for 20.
5%, and local salvage treatment accounted for 13.
6%.
Local and systemic combined therapy accounted for 4.
5%.
Figure 2 The changes in treatment before and after the application of FluPET.
The results of this study suggest that FluPET can be used to guide the rescue treatment after biochemical recurrence, as well as to confirm metastatic disease and clarify the initial stage of the disease; the positive result of FluPET will change the clinician's pre-selected treatment Program.
Abstract 32 A prospective phase II/III study of 18F-DCFPyL-PSMA PET/CT in prostate cancer patients (OSPREY): a subgroup analysis of the changes in the disease stages of patients with locally recurring or metastatic prostate cancer in traditional imaging examinations [2] 18F-DCFPyL-PSMA PET/CT as a radioactive small molecule marker can target the extracellular domain of prostate membrane antigen.
The purpose of this study is to prospectively evaluate 18F-DCFPyL based on histopathology.
-The diagnostic value of PSMA PET/CT imaging.
In this subgroup analysis, 18F-DCFPyL-PSMA PET/CT was performed on 117 patients with locally recurring or metastatic prostate cancer diagnosed in traditional imaging examinations.
The key efficacy endpoints are: the sensitivity of 18F-DCFPyL-PSMA PET/CT in the detection of metastatic lesions (relative to histological evaluation) and the detection rate of 18F-DCFPyL-PSMA PET/CT and traditional imaging.
The results of the study show that traditional imaging tests can distinguish 29% of patients (33 persons) in M0 and 71% (82 persons) in M1.
Interestingly, under the 18F-DCFPyL-PSMA PET/CT assessment, 58% (19 people) of 33 people with M0 in the traditional imaging classification were diagnosed as M1, while 22% (18 people) of 82 people with M1 were diagnosed as M1.
) Was diagnosed as M0, and 12% (10 people) of the M1 subtype classification was revised (4 people with M1a revised to M1b/M1c, 6 people with M1b revised to M1c).
Figure 3 The results of 18F-DCFPyL-PSMA PET/CT and traditional imaging detection results suggest that compared with conventional imaging, 18F-DCFPyL-PSMA PET/CT can detect hidden lesions and perform more accurate disease staging ; Routine imaging examinations for patients with local recurrence and distant metastasis can change their treatment decisions based on the clinical application of 18F-DCFPyL-PSMA PET/CT.
Abstract 36: Comparison of 18F-DCFPyL-PSMA PET and traditional imaging to detect pelvic lymph node metastasis in patients with locally advanced or oligometastatic prostate cancer [3] UW17009 is an exploration of neoadjuvant chemotherapy combined with ADT for advanced prostate cancer patients Clinical trials on efficacy and safety.
The study enrolled 26 patients with locally advanced or oligometastatic prostate cancer, and performed 18F-DCFPyL-PSMA PET/CT and traditional imaging examinations before randomization of the trial and after radical surgery with neoadjuvant chemotherapy.
Compare the ability of the two detection methods to detect lymph node metastasis.
Figure 4 The results of the UW17009 study showed that before the randomization of the trial, the positive rate of pelvic lymph nodes in traditional imaging examinations was 23% (6/26); 18F-DCFPyL-PSMA PET showed that the positive rate of pelvic lymph nodes was 46% (12/ 26).
Calculated based on the 6 lymph node regions of each patient, there are 156 evaluable regions, and a total of 65 positive lymph node regions were found; PSMA detected 14 positive lymph node regions and 102 negative lymph node regions, which were also traditionally imaged and analyzed.
The final pathological confirmation; a total of 5 lymph node areas were missed, and the average tumor diameter of the missed lymph nodes was 2.
3mm (1-4mm); the sensitivity of the detection was 73.
7% (95%CI 48.
8-90.
8), and the specificity was 85.
7% (95%CI) 78.
1-91.
4), the negative predictive value was 95.
3% (95% CI 90.
5-97.
7).
The results of the study suggest that compared with traditional imaging, the rate of positive lymph node diagnosis based on 18F-DCFPyL-PSMA PET is twice that of traditional imaging.
The follow-up analysis of 18F-DCFPyL-PSMA PET imaging diagnosis after neoadjuvant chemotherapy combined with ADT is underway, and it is expected that it will bring more information to the tumor response.
Experts comment that PET/CT is a new molecular imaging diagnostic method that has recently emerged and emerged.
With the continuous advancement of its technology and the continuous verification of clinical research, it has played an increasingly important role in the field of prostate cancer diagnosis and treatment.
PET is called Positron Emission Tomography (Positron Emission Tomography).
It uses positron nuclides to label human metabolites such as glucose as imaging agents.
The imaging agent is taken by the lesion to reflect its metabolic changes, thus providing Provide clinical biometabolic information of diseases [4].
In the field of prostate cancer, various PET/CT types have been developed by different imaging agents, including 18F-choline PET/CT, 11C-choline PET/CT, 18F-sodium fluoride PET/CT (18F- NaF PET/CT), fluciclovir PET/CT (18F-Fluciclovin PET/CT), and 18F and 68Ga PSMA PET/CT targeting prostate specific membrane antigen (PSMA).
Among them, 18F-choline and 11C-choline can be used to detect the proliferation status of prostate cancer cells.
When the prostate-specific antigen (PSA) level is low, it has a certain ability to detect some recurring lesions [5]. 18F-sodium fluoride PET/CT has high sensitivity and specificity in the diagnosis of early and mild bone metastases [5].
The sensitivity of fluciclovir PET/CT to detect the site of biochemical recurrence (BCR) is slightly higher than that of choline PET/CT [6].
In recent years, 18F and 68Ga PSMA PET/CT has also received more and more attention, because PSMA is highly expressed in almost all types of prostate cancer, while there is almost no PSMA expression in normal human cells, so it can significantly improve the accuracy of the diagnosis of metastatic lesions.
Rate [7].
The results of the three studies released by ASCO-GU also show the clinical application value of this new type of molecular imaging diagnostic method: it can not only distinguish local recurrence and distant metastasis in patients with biochemical recurrence after radical surgery, but also The clinical staging of patients who are about to be treated can be more accurately assessed.
This value is also reflected in the latest guidelines.
The 2020 European Association of Urology (EAU) guidelines mentions the imaging of recurrence after N staging, M staging, radical prostatectomy and radical radiotherapy for prostate cancer patients PET/CT can be used for more accurate diagnosis in the medical examination [8].
Compared with the results of traditional imaging, the positive diagnosis rate of PET/CT is higher, which has changed the clinical stage of some prostate cancer patients, which can help our doctors make more active clinical treatment decisions.
Based on the results of the Stampede study, patients with oligometastasis can benefit from ADT combined with radiotherapy.
The Titan study also suggests that patients with low tumor burden will have longer-term benefits using ADT+APA, so for patients with prostate cancer who have recurred biochemically after radical surgery.
If PET/CT can be used to detect distant metastases in time, so that the combined treatment can be given in time, it is believed that it will bring greater survival benefits to patients.
At present, more clinical evidence is based on treatment decisions based on traditional imaging evaluation.
New detection methods such as PET/CT still lack long-term and large amounts of clinical data to verify.
We also look forward to seeing applications based on new detection methods in the future.
There is evidence that active treatment can bring greater benefits to patients. 2021 ASCO GU.
Abstract 36.
[4] Wang Rongfu, Liu Hongjie, Zhang Chunli.
Progress in the research and application of PET receptor imaging[J].
China Medical Imaging Technology, 2006,10:1599-1603.
[5] Li R, et al .
The use of PET/CT in prostate cancer.
Prostate Cancer Prostatic Dis, 2018, 21(1): 4-21.
[6] Nanni, C.
, et al.
(18)F-FACBC (anti1-amino-3- (18)F-fluorocyclobutane-1-carboxylic acid) versus(11)C-choline PET/CT in prostate cancer relapse: results of a prospective trial.
Eur J Nucl Med MolImaging, 2016.
43: 1601.
[7] Janssen JC , Et al.
Comparison of hybrid (68) GaPSMA-PET/CT and (99m) Tc-DPD-SPECT/CT for the detection of bone metastases in prostate cancer patients: Additional value of morphologic information from low dose CT.
Eur Radiol, 2018, 28(2): 610-619.
[8] The Prostate Cancer Guidelines.
The European Association of Urology(EAU).
2020.
[5] Li R, et al.
The use of PET/CT in prostate cancer.
Prostate Cancer Prostatic Dis, 2018, 21(1): 4-21.
[6] Nanni, C.
, et al.
(18)F-FACBC (anti1-amino-3- (18)F-fluorocyclobutane-1-carboxylic acid) versus(11)C-choline PET/CT in prostate cancer relapse: results of a prospective trial.
Eur J Nucl Med MolImaging, 2016.
43: 1601.
[7] Janssen JC , Et al.
Comparison of hybrid (68) GaPSMA-PET/CT and (99m) Tc-DPD-SPECT/CT for the detection of bone metastases in prostate cancer patients: Additional value of morphologic information from low dose CT.
Eur Radiol, 2018, 28(2): 610-619.
[8] The Prostate Cancer Guidelines.
The European Association of Urology(EAU).
2020.
[5] Li R, et al.
The use of PET/CT in prostate cancer.
Prostate Cancer Prostatic Dis, 2018, 21(1): 4-21.
[6] Nanni, C.
, et al.
(18)F-FACBC (anti1-amino-3- (18)F-fluorocyclobutane-1-carboxylic acid) versus(11)C-choline PET/CT in prostate cancer relapse: results of a prospective trial.
Eur J Nucl Med MolImaging, 2016.
43: 1601.
[7] Janssen JC , Et al.
Comparison of hybrid (68) GaPSMA-PET/CT and (99m) Tc-DPD-SPECT/CT for the detection of bone metastases in prostate cancer patients: Additional value of morphologic information from low dose CT.
Eur Radiol, 2018, 28(2): 610-619.
[8] The Prostate Cancer Guidelines.
The European Association of Urology(EAU).
2020.
(18)F-FACBC (anti1-amino-3-(18)F-fluorocyclobutane-1-carboxylic acid) versus(11)C-choline PET/CT in prostate cancer relapse: results of a prospective trial.
Eur J Nucl Med MolImaging, 2016.
43: 1601.
[7] Janssen JC, et al.
Comparison of hybrid (68) GaPSMA-PET/CT and (99m) Tc-DPD-SPECT/CT for the detection of bone metastases in prostate cancer patients: Additional value of morphologic information from low dose CT.
Eur Radiol, 2018, 28(2): 610-619.
[8] The Prostate Cancer Guidelines.
The European Association of Urology(EAU).
2020.
(18)F-FACBC (anti1-amino-3-(18)F-fluorocyclobutane-1-carboxylic acid) versus(11)C-choline PET/CT in prostate cancer relapse: results of a prospective trial.
Eur J Nucl Med MolImaging, 2016.
43: 1601.
[7] Janssen JC, et al.
Comparison of hybrid (68) GaPSMA-PET/CT and (99m) Tc-DPD-SPECT/CT for the detection of bone metastases in prostate cancer patients: Additional value of morphologic information from low dose CT.
Eur Radiol, 2018, 28(2): 610-619.
[8] The Prostate Cancer Guidelines.
The European Association of Urology(EAU).
2020.
[7] Janssen JC, et al.
Comparison of hybrid (68) GaPSMA-PET/CT and (99m) Tc-DPD-SPECT/CT for the detection of bone metastases in prostate cancer patients: Additional value of morphologic information from low dose CT.
Eur Radiol, 2018, 28(2): 610-619.
[8] The Prostate Cancer Guidelines.
The European Association of Urology(EAU).
2020.
[7] Janssen JC, et al.
Comparison of hybrid (68) GaPSMA-PET/CT and (99m) Tc-DPD-SPECT/CT for the detection of bone metastases in prostate cancer patients: Additional value of morphologic information from low dose CT.
Eur Radiol, 2018, 28(2): 610-619.
[8] The Prostate Cancer Guidelines.
The European Association of Urology(EAU).
2020.
The 2021 American Society of Clinical Oncology Symposium on Urogenital Cancer (ASCO-) co-sponsored by the American Society of Clinical Oncology (ASCO), American Society of Radiation Oncology (ASTRO) and American Society of Urological Oncology (SUO) GU) takes the form of an online virtual meeting due to the global new crown epidemic, and it will be held from February 11th to 13th, 2021.
An important part of the conference, molecular imaging diagnosis, updated the research progress as a diagnostic method for prostate cancer.
Next, I will explain the progress of 3 clinical studies related to PET/CT.
Abstract 29] Application of 18F-Fluciclovin PET/CT (FluPET) in prostate cancer: preliminary results of a prospective study [1] 18F-Fluciclovin PET/CT (FluPET) is a new imaging detection technology approved in 2016 It is used for the auxiliary imaging diagnosis of prostate cancer after treatment, but its clinical practice and its influence on treatment decisions are unknown.
In order to explore whether the use of FluPET will lead to changes in expected treatment decisions, this prospective study included 50 patients to explore the reasons and plans for the application of FluPET before, 1-2 weeks after the application, and 1 year after the application.
The treatment plan and the treatment plan changed due to the application of FluPET.
The results of the study showed that among the reasons for the application of FluPET, "guided rescue local treatment after the first biochemical recurrence" accounted for the largest proportion, reaching 46.
9%; followed by "guided rescue after the second biochemical recurrence" "Treatment", accounting for 36.
7%; "Confirming whether metastasis occurred" accounted for 10.
2%; "Initial staging before local treatment" accounted for the least, reaching 6.
1% (Figure 1).Figure 1 Reasons for the application of FluPET Before the application of FluPET, 67.
3% of the treatments taken were watched and waited, and androgen deprivation treatment (ADT) alone accounted for 26.
5%, ADT + docetaxel or antiandrogen treatment accounted for 20.
4%, and local salvage treatment Accounted for 26.
5%; after the application of FluPET, the proportion of changes in the pre-treatment strategy reached 45.
5%.
In this part of the changed treatment, watchful waiting accounted for 6.
8%, systemic treatment accounted for 20.
5%, and local salvage treatment accounted for 13.
6%.
Local and systemic combined therapy accounted for 4.
5%.
Figure 2 The changes in treatment before and after the application of FluPET.
The results of this study suggest that FluPET can be used to guide the rescue treatment after biochemical recurrence, as well as to confirm metastatic disease and clarify the initial stage of the disease; the positive result of FluPET will change the clinician's pre-selected treatment Program.
Abstract 32 A prospective phase II/III study of 18F-DCFPyL-PSMA PET/CT in prostate cancer patients (OSPREY): a subgroup analysis of the changes in the disease stages of patients with locally recurring or metastatic prostate cancer in traditional imaging examinations [2] 18F-DCFPyL-PSMA PET/CT as a radioactive small molecule marker can target the extracellular domain of prostate membrane antigen.
The purpose of this study is to prospectively evaluate 18F-DCFPyL based on histopathology.
-The diagnostic value of PSMA PET/CT imaging.
In this subgroup analysis, 18F-DCFPyL-PSMA PET/CT was performed on 117 patients with locally recurring or metastatic prostate cancer diagnosed in traditional imaging examinations.
The key efficacy endpoints are: the sensitivity of 18F-DCFPyL-PSMA PET/CT in the detection of metastatic lesions (relative to histological evaluation) and the detection rate of 18F-DCFPyL-PSMA PET/CT and traditional imaging.
The results of the study show that traditional imaging tests can distinguish 29% of patients (33 persons) in M0 and 71% (82 persons) in M1.
Interestingly, under the 18F-DCFPyL-PSMA PET/CT assessment, 58% (19 people) of 33 people with M0 in the traditional imaging classification were diagnosed as M1, while 22% (18 people) of 82 people with M1 were diagnosed as M1.
) Was diagnosed as M0, and 12% (10 people) of the M1 subtype classification was revised (4 people with M1a revised to M1b/M1c, 6 people with M1b revised to M1c).
Figure 3 The results of 18F-DCFPyL-PSMA PET/CT and traditional imaging detection results suggest that compared with conventional imaging, 18F-DCFPyL-PSMA PET/CT can detect hidden lesions and perform more accurate disease staging ; Routine imaging examinations for patients with local recurrence and distant metastasis can change their treatment decisions based on the clinical application of 18F-DCFPyL-PSMA PET/CT.
Abstract 36: Comparison of 18F-DCFPyL-PSMA PET and traditional imaging to detect pelvic lymph node metastasis in patients with locally advanced or oligometastatic prostate cancer [3] UW17009 is an exploration of neoadjuvant chemotherapy combined with ADT for advanced prostate cancer patients Clinical trials on efficacy and safety.
The study enrolled 26 patients with locally advanced or oligometastatic prostate cancer, and performed 18F-DCFPyL-PSMA PET/CT and traditional imaging examinations before randomization of the trial and after radical surgery with neoadjuvant chemotherapy.
Compare the ability of the two detection methods to detect lymph node metastasis.
Figure 4 The results of the UW17009 study showed that before the randomization of the trial, the positive rate of pelvic lymph nodes in traditional imaging examinations was 23% (6/26); 18F-DCFPyL-PSMA PET showed that the positive rate of pelvic lymph nodes was 46% (12/ 26).
Calculated based on the 6 lymph node regions of each patient, there are 156 evaluable regions, and a total of 65 positive lymph node regions were found; PSMA detected 14 positive lymph node regions and 102 negative lymph node regions, which were also traditionally imaged and analyzed.
The final pathological confirmation; a total of 5 lymph node areas were missed, and the average tumor diameter of the missed lymph nodes was 2.
3mm (1-4mm); the sensitivity of the detection was 73.
7% (95%CI 48.
8-90.
8), and the specificity was 85.
7% (95%CI) 78.
1-91.
4), the negative predictive value was 95.
3% (95% CI 90.
5-97.
7).
The results of the study suggest that compared with traditional imaging, the rate of positive lymph node diagnosis based on 18F-DCFPyL-PSMA PET is twice that of traditional imaging.
The follow-up analysis of 18F-DCFPyL-PSMA PET imaging diagnosis after neoadjuvant chemotherapy combined with ADT is underway, and it is expected that it will bring more information to the tumor response.
Experts comment that PET/CT is a new molecular imaging diagnostic method that has recently emerged and emerged.
With the continuous advancement of its technology and the continuous verification of clinical research, it has played an increasingly important role in the field of prostate cancer diagnosis and treatment.
PET is called Positron Emission Tomography (Positron Emission Tomography).
It uses positron nuclides to label human metabolites such as glucose as imaging agents.
The imaging agent is taken by the lesion to reflect its metabolic changes, thus providing Provide clinical biometabolic information of diseases [4].
In the field of prostate cancer, various PET/CT types have been developed by different imaging agents, including 18F-choline PET/CT, 11C-choline PET/CT, 18F-sodium fluoride PET/CT (18F- NaF PET/CT), fluciclovir PET/CT (18F-Fluciclovin PET/CT), and 18F and 68Ga PSMA PET/CT targeting prostate specific membrane antigen (PSMA).
Among them, 18F-choline and 11C-choline can be used to detect the proliferation status of prostate cancer cells.
When the prostate-specific antigen (PSA) level is low, it has a certain ability to detect some recurring lesions [5]. 18F-sodium fluoride PET/CT has high sensitivity and specificity in the diagnosis of early and mild bone metastases [5].
The sensitivity of fluciclovir PET/CT to detect the site of biochemical recurrence (BCR) is slightly higher than that of choline PET/CT [6].
In recent years, 18F and 68Ga PSMA PET/CT has also received more and more attention, because PSMA is highly expressed in almost all types of prostate cancer, while there is almost no PSMA expression in normal human cells, so it can significantly improve the accuracy of the diagnosis of metastatic lesions.
Rate [7].
The results of the three studies released by ASCO-GU also show the clinical application value of this new type of molecular imaging diagnostic method: it can not only distinguish local recurrence and distant metastasis in patients with biochemical recurrence after radical surgery, but also The clinical staging of patients who are about to be treated can be more accurately assessed.
This value is also reflected in the latest guidelines.
The 2020 European Association of Urology (EAU) guidelines mentions the imaging of recurrence after N staging, M staging, radical prostatectomy and radical radiotherapy for prostate cancer patients PET/CT can be used for more accurate diagnosis in the medical examination [8].
Compared with the results of traditional imaging, the positive diagnosis rate of PET/CT is higher, which has changed the clinical stage of some prostate cancer patients, which can help our doctors make more active clinical treatment decisions.
Based on the results of the Stampede study, patients with oligometastasis can benefit from ADT combined with radiotherapy.
The Titan study also suggests that patients with low tumor burden will have longer-term benefits using ADT+APA, so for patients with prostate cancer who have recurred biochemically after radical surgery.
If PET/CT can be used to detect distant metastases in time, so that the combined treatment can be given in time, it is believed that it will bring greater survival benefits to patients.
At present, more clinical evidence is based on treatment decisions based on traditional imaging evaluation.
New detection methods such as PET/CT still lack long-term and large amounts of clinical data to verify.
We also look forward to seeing applications based on new detection methods in the future.
There is evidence that active treatment can bring greater benefits to patients. 2021 ASCO GU.
Abstract 36.
[4] Wang Rongfu, Liu Hongjie, Zhang Chunli.
Progress in the research and application of PET receptor imaging[J].
China Medical Imaging Technology, 2006,10:1599-1603.
[5] Li R, et al .
The use of PET/CT in prostate cancer.
Prostate Cancer Prostatic Dis, 2018, 21(1): 4-21.
[6] Nanni, C.
, et al.
(18)F-FACBC (anti1-amino-3- (18)F-fluorocyclobutane-1-carboxylic acid) versus(11)C-choline PET/CT in prostate cancer relapse: results of a prospective trial.
Eur J Nucl Med MolImaging, 2016.
43: 1601.
[7] Janssen JC , Et al.
Comparison of hybrid (68) GaPSMA-PET/CT and (99m) Tc-DPD-SPECT/CT for the detection of bone metastases in prostate cancer patients: Additional value of morphologic information from low dose CT.
Eur Radiol, 2018, 28(2): 610-619.
[8] The Prostate Cancer Guidelines.
The European Association of Urology(EAU).
2020.
[5] Li R, et al.
The use of PET/CT in prostate cancer.
Prostate Cancer Prostatic Dis, 2018, 21(1): 4-21.
[6] Nanni, C.
, et al.
(18)F-FACBC (anti1-amino-3- (18)F-fluorocyclobutane-1-carboxylic acid) versus(11)C-choline PET/CT in prostate cancer relapse: results of a prospective trial.
Eur J Nucl Med MolImaging, 2016.
43: 1601.
[7] Janssen JC , Et al.
Comparison of hybrid (68) GaPSMA-PET/CT and (99m) Tc-DPD-SPECT/CT for the detection of bone metastases in prostate cancer patients: Additional value of morphologic information from low dose CT.
Eur Radiol, 2018, 28(2): 610-619.
[8] The Prostate Cancer Guidelines.
The European Association of Urology(EAU).
2020.
[5] Li R, et al.
The use of PET/CT in prostate cancer.
Prostate Cancer Prostatic Dis, 2018, 21(1): 4-21.
[6] Nanni, C.
, et al.
(18)F-FACBC (anti1-amino-3- (18)F-fluorocyclobutane-1-carboxylic acid) versus(11)C-choline PET/CT in prostate cancer relapse: results of a prospective trial.
Eur J Nucl Med MolImaging, 2016.
43: 1601.
[7] Janssen JC , Et al.
Comparison of hybrid (68) GaPSMA-PET/CT and (99m) Tc-DPD-SPECT/CT for the detection of bone metastases in prostate cancer patients: Additional value of morphologic information from low dose CT.
Eur Radiol, 2018, 28(2): 610-619.
[8] The Prostate Cancer Guidelines.
The European Association of Urology(EAU).
2020.
(18)F-FACBC (anti1-amino-3-(18)F-fluorocyclobutane-1-carboxylic acid) versus(11)C-choline PET/CT in prostate cancer relapse: results of a prospective trial.
Eur J Nucl Med MolImaging, 2016.
43: 1601.
[7] Janssen JC, et al.
Comparison of hybrid (68) GaPSMA-PET/CT and (99m) Tc-DPD-SPECT/CT for the detection of bone metastases in prostate cancer patients: Additional value of morphologic information from low dose CT.
Eur Radiol, 2018, 28(2): 610-619.
[8] The Prostate Cancer Guidelines.
The European Association of Urology(EAU).
2020.
(18)F-FACBC (anti1-amino-3-(18)F-fluorocyclobutane-1-carboxylic acid) versus(11)C-choline PET/CT in prostate cancer relapse: results of a prospective trial.
Eur J Nucl Med MolImaging, 2016.
43: 1601.
[7] Janssen JC, et al.
Comparison of hybrid (68) GaPSMA-PET/CT and (99m) Tc-DPD-SPECT/CT for the detection of bone metastases in prostate cancer patients: Additional value of morphologic information from low dose CT.
Eur Radiol, 2018, 28(2): 610-619.
[8] The Prostate Cancer Guidelines.
The European Association of Urology(EAU).
2020.
[7] Janssen JC, et al.
Comparison of hybrid (68) GaPSMA-PET/CT and (99m) Tc-DPD-SPECT/CT for the detection of bone metastases in prostate cancer patients: Additional value of morphologic information from low dose CT.
Eur Radiol, 2018, 28(2): 610-619.
[8] The Prostate Cancer Guidelines.
The European Association of Urology(EAU).
2020.
[7] Janssen JC, et al.
Comparison of hybrid (68) GaPSMA-PET/CT and (99m) Tc-DPD-SPECT/CT for the detection of bone metastases in prostate cancer patients: Additional value of morphologic information from low dose CT.
Eur Radiol, 2018, 28(2): 610-619.
[8] The Prostate Cancer Guidelines.
The European Association of Urology(EAU).
2020.
