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CC BY-NC-ND 4.0 · Revista Argentina de Radiología / Argentinian Journal of Radiology 2020; 84(03): 085-092
DOI: 10.1055/s-0040-1708466
Artículo original

Relación de las cinéticas del PSA en la detección de la recurrencia del cáncer de próstata post prostatectomía radical con la 18f-colina tomografía por emisión de positrones/tomografía computada [PET/TC colina (PETC)]

Kinetic Relation Between PSA and 18F-choline PET/CT in the Detection of Recurrent Prostatic Cancer After Radical Prostatectomy
Miguel A. Bergero
1   Departamento de Urología, Sanatorio Privado San Gerónimo, Santa Fe, Argentina
,
Liliana Ríos
2   Departamento de Medicina Nuclear, Sanatorio Privado San Gerónimo, Santa Fe, Argentina
,
Carlos David
2   Departamento de Medicina Nuclear, Sanatorio Privado San Gerónimo, Santa Fe, Argentina
,
Carolina A. González Piccini
2   Departamento de Medicina Nuclear, Sanatorio Privado San Gerónimo, Santa Fe, Argentina
,
Enria Derian
2   Departamento de Medicina Nuclear, Sanatorio Privado San Gerónimo, Santa Fe, Argentina
,
Marcelo Fleurquin
2   Departamento de Medicina Nuclear, Sanatorio Privado San Gerónimo, Santa Fe, Argentina
,
Lucas Costa
3   Departamento de Bioestadística, Facultad de Ciencias Médicas, Universidad Nacional del Litoral, Santa Fe, Argentina
,
Fernando Faccio
2   Departamento de Medicina Nuclear, Sanatorio Privado San Gerónimo, Santa Fe, Argentina
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Resumen

Objetivo El objetivo de este estudio es evaluar la relación de las cinéticas del antígeno prostático específico (PSA por su sigla en inglés) con la positividad de la tomografía por emisión de positrones/tomografía computada [PET/TC colina (PETC)]en pacientes con una recaída de cáncer de próstata (RCP).

Materiales y métodos Se realizó un trabajo retrospectivo de 48 pacientes con RCP post prostatectomía radical (PR) evaluados con PETC.

Resultados La PETC negativa tuvo una mediana de 16,3 meses y la PETC positiva de 5,5 meses (p =  < 0,001) para el tiempo de doblaje de PSA (PSADT por su sigla en inglés); la PETC fue positiva en el 96% de los pacientes con un PSADT< 12 meses. La PETC negativa tuvo una mediana de 0,03 ng/ml/año y la PETC positiva de 4,1 ng/ml/año (p =  < 0,001) para la velocidad del PSA (PSAVpor su sigla en inglés); la PETC fue positiva en el 92% de los pacientes con un PSAV > 0,75 ng/ml/año. Lasáreas bajo la curva ROC para PSAV fue de 0,984 con un punto de corte de mayor discriminación de 0.785 ng/ml/año, mostrando razones de verosimilitud (LR por su sigla en inglés) LR +  = 25 y LR-= 0,1. Para PSADT el ROC fue de 0,992 con un punto de corte de mayor discriminación de 11 meses, mostrando LR +  = 11 y LR- = 0.

Discusión El PSA es un indicador inespecífico de PETC positiva. Un estudio inicial demostró que los pacientes con una RCP con una PETC positiva tenían un menor PSADT y una mayor PSAV que los pacientes con una PETC negativa.

Conclusión La positividad de la PETC se vio influenciada por las cinéticas del PSA, observándose que a menor PSADT y que a mayor PSAV mayor fue la probabilidad de la positividad de la PETC.

Abstract

Purpose The aim of this study is to evaluate the relationship between Prostate-Specific Antigen (PSA) kinetics and the detection of Prostate Cancer Relapse (PCR) with Positron-Emission Tomography (PETC).

Material and methods A retrospective study of 48 patients with a PCR after a radical prostatectomy evaluated with PETC was performed.

Results PSA Doubling Time (PSADT), with negative PETC, had a median of 16.3 months and the positive PETC a median of 5.5 months (p =  < 0.001); 96% of patients with a PSADT <12 months had positive PETC. PSA Velocity (PSAV), negative PETC, had a median of 0.03 ng/ml/year and positive PETC a median of 4.1 ng/ml/year (p =  < 0.001); 92% of patients who had a PSAV > 0.75 ng/ml/year had positive PETC. The ROC for PSAV was 0.984 with a cut-off value of 0.785 ng/ml/year, Showing Likelihood Ratios (LR) LR +  = 25 and LR-= 0.1. The ROC for PSADT was 0.992 with a cut off value of 11 months, showing LR +  = 11 and LR-= 0.

Discussion PSA is a nonspecific indicator of positive PETC. An initial study demonstrated that patients with a PCR and positive PETC had lower PSADT and higher PSAV than patients with a negative PETC.

Conclusion The rate of detection of PCR with PETC was influenced by the kinetics of PSA, and it was observed that the lower the PSADT and the higher the PSAV, the greater the probability of the positivity of the PETC.

Palabras clave

tomografía por emisión de positrones - colina - neoplasia prostática - antígeno prostático específico - recurrencia

Keywords

positron-emission tomography - choline - prostatic neoplasms - prostate-specific antigen - recurrence

Responsabilidades éticas

Protección de personas y animales


Los autores declaran que los procedimientos seguidos se conformaron a las normas éticas del comité de experimentación humana responsable y de acuerdo con la Asociación Médica Mundial y la Declaración de Helsinki.


Confidencialidad de los datos

Los autores declaran que han seguido los protocolos de su centro de trabajo sobre la publicación de datos de pacientes.


Derecho a la privacidad y consentimiento informado

Los autores han obtenido el consentimiento informado de los pacientes y/o sujetos referidos en el artículo. Este documento obra en poder del autor de correspondencia.




Publication History

Received: 06 January 2019

Accepted: 07 February 2020

Article published online:
25 November 2020

© 2020. Sociedad Argentina de Radiología. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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