Keywords
biochemical failure
PET-CT tracers
How to Cite
Abstract
Rak prostaty jest drugim co do częstości nowotworem u mężczyzn w Polsce i na świecie. Wskaźniki zachorowalności ciągle rosną, dlatego dane szacunkowe mówią, że w najbliższych latach będzie to najczęściej występujący nowotwór u mężczyzn w Polsce i prawdopodobnie wyprzedzi obecnie najczęściej występującego raka płuca. Wznowa raka prostaty po leczeniu radykalnym może nawet dotyczyć ponad 50% u chorych w grupie wysokiego ryzyka i najczęściej manifestuje w postaci wzrostu stężenia antygenu sterczowego PSA (z ang. Prostate Specific Antigen). Badanie PET-CT z zastosowaniem najpopularniejszego znacznika fluror-18-dezoksy-glukozy (18F-FDG) ma słabą czułość w badaniu raka gruczołowego prostaty, dlatego jest rzadko stosowany w tym rozpoznaniu. Obecnie najczęściej stosowanym znacznikiem w diagnostyce rak prostaty w Polsce jest 11C – cholina, ale jej czułość przy stężeniu PSA poniżej 1 ng/ml nie jest dostatecznie wysoka. Pacjenci coraz częściej są poddawani badaniu PET- CT ze znakowanym galem 68 (68Ga) inhibitorem sterczowego antygenu błonowego (PSMA z ang. prostate specific membrane antygen) lub z 18-F- fluorocyclobutane-1-carboxilic acid fluciclovine (FACBC z ang. fluxiclovine), które dają możliwość zlokalizowania wznowy raka prostaty w bardzo wczesnym stadium, gdy wartość PSA jest bardzo niska (poniżej 1 ng/ml). Ponadto czułość i specyficzność badania PET-CT z zastosowaniem znacznika 68Ga-PSMA jest bardzo wysoka mimo prowadzonego leczenia antyandrogenowego, jest jednym z najbardziej obiecujących znaczników w badaniu PET.
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