الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 175 |  |  |
| | | from | 175 | | |
Abstract
Prostate cancer is a common health problem that in the majority of cases starts to develop at the age of 50 years, reaching its peak at 60–70 years of age. A variation in its incidence and prevalence exists between western, Asian and Arabic populations. Serum PSA is a widely used parameter for the early detection and monitoring of prostate cancer. Men with total PSA <2.5 ng/ml have a low probability of having prostate cancer, while those with PSA >10 ng/ml have >50% chance of having prostate cancer. PSMA is a type II transmembrane protein, which has a 19-amino-acid intracellular portion, a 24-amino-acid transmembrane portion and a 707- amino-acid extracellular portion. PSMA is an ideal target for molecular imaging of prostate cancer owing to its biological characteristics, including: considerable (100-fold to 1,000-fold) over expression on the cell membrane of nearly all prostatic cancer cells compared with normal non target expression. Several research groups have reported the use of small-molecule inhibitors of PSMA labeled with 123I, 99mTc, 18F, 111In and 68Ga. The development of 18F-labelled PSMA compounds offers potential advances with regard to increasing the number of examinations possible, owing to a higher available amount of the radioisotope 18F produced by a cyclotron compared with 68Ga eluted from a generator. The goal of this study is to assess the role of 18F PSMA PET CT in the diagnosis and staging of cancer prostate in correlation with prostate specific antigen serum level. To achieve this goal, we conducted this study on 30 patients referred to International Medical Centre in Cairo with histological proven prostate cancer. All patients were scanned using PET/CT scanners and PSA was done for all patients. from the results of this study, we could conclude the following: PSMA PET/CT can detect cancer prostate metastasis in non-enlarged lymph nodes which can be missed on conventional imaging (CT and MRI) PSMA PET/CT can detect bony deposits even with no apparent CT morphological changes. PSMA PET/CT performed for recently diagnosed cancer prostate patients changed the staging made by other conventional modalities. PSMA PET/CT is the modality of choice in recurrent cancer prostate, it can assess the site of recurrence and determine the disease burden, so it is essential for adequate treatment plan. Mean age for prostate cancer in our study was 71.7±7.05 years. PSA was performed for all patients and it had median value of 56.2 with minimum 0.02 and maximum 211ng/mL. After performing PET/SCAN, twenty patients out of 30 were diagnosed as metastatic cancer prostate (66.7%). Median SUV max of PSMA expression of active prostatic lesions was 7.75 with minimum 0 and maximum 40 while of metastatic prostatic lesions was 6.1 with minimum 0 and maximum 75. There was positive correlation between PSA values and SUV max of PSMA expression at prostate. On the other hand, there were no statistically significant correlations between PSA and age or SUV max of PSMA expression of metastatic lesions of prostate cancer. At cut-off value equal to 1.5, SUVmax of PSMA expression at prostate had 100% sensitivity and specificity win diagnosis of active local cancer prostatic lesions with higher AUC than PSA. PSA was higher among metastatic prostate cancer patients with statistically significant difference. At cut-off value equal to 5.3, PSA had 95% sensitivity and 71.4% specificity in prediction of metastasis.