Nuklearnomedicinske pretrage u bolesnika s karcinomom prostate

master's thesis

• Title (english): Nuclear medicine diagnostics in patients with prostatic cancer
• Author: Matej Pavanić
• Mentor: Dražen Huić (mentor)
• Committee member: Sanja Kusačić Kuna (predsjednik povjerenstva)
• Committee member: Sanja Dolanski-Babić (član povjerenstva)
• Committee member: Dražen Huić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Nuclear Medicine); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Nuclear Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Oncology

Abstract

Karcinom prostate najčešći je karcinom u muškaraca uopće. Prvenstveno pogađa stariju populaciju, a gotovo nikad se ne javlja prije 50. godine. Pravodobno dijagnosticiranje karcinoma prostate uvelike poboljšava prognozu i preživljenje. Izvorna dijagnostika karcinoma prostate započinje digitorektalnim pregledom, nalazom razine PSA, a karcinom se potvrđuje nalazom bioptata iglom s transrektalnom ultrasonografijom. Nuklearnomedicinska dijagnostika karcinoma prostate temelji se na scintigrafiji, SPECT
dijagnostici i PET dijagnostici, često uparenima s CT-om i MR-om. Fokus se stvara na dijagnostici prvenstveno koštanih metastaza, razlog kojemu je dostupnost radiofarmaka koji se vežu na kost. Ostali radiofarmaci koji pokazuju višu osjetljivost i bolju specifičnost, poput PSMA biljega i kolina bivaju korišteni većinom za procjenu proširenosti bolesti nakon nejasnih rezultata dobiveni konvencionalnom dijagnostikom. Danas najviše korišteni radiofarmaci za prikaz koštanih metastaza su 99mTc–difosfonati, dok razvoj novih radiofarmaka koji ciljano djeluju na membrane neoplastičnih stanica, 68Ga-PSMA, 18F-fluciklovin i 18F-kolin, pokazuju tkivnospecifičnu perspektivu dijagosticiranja karcinoma prostate. Uz nove metode javlja se i dijagnostičko-terapijska mogućnost teranostike, prominentno s 177Lu-PSMA.

Abstract (english)

Prostate cancer is the most common cancer in men in general. It primarily affects the elderly population and almost never occurs before the age of 50. Timely diagnosis of prostate cancer greatly improves prognosis and survival. The original diagnosis of prostate cancer begins with a digital rectal examination, findings of PSA serum levels, and the cancer is confirmed by biopsy with a needle with transrectal ultrasonography. Nuclear medicine diagnosis of prostate cancer is based on scintigraphy, SPECT diagnostics, and PET diagnostics, often paired with CT and MR. Focus is on the diagnosis of primarily bone metastases, and the reason for that is the availability of radiopharmaceuticals that bind to bone. Other radiopharmaceuticals that show greater sensitivity and better specificity, such as PSMA markers and choline, are mostly used to assess disease prevalence following unclear results obtained by conventional diagnostics. Today, the most widely used radiopharmaceuticals for the display of bone metastases are 99mTc-bisphosphonates, while the development of new radiopharmaceuticals is concentrated on the membrane of neoplastic cells. 68Ga-PSMA, 18F-flucyclovin and 18F-choline are showing a tissue-specific perspective of prostate cancer diagnostics. In addition to new methods, diagnosticly-therapeutic possibilities of theranostics are highlighted with 177Lu-PSMA.

• Keywords: karcinom prostate; scintigrafija; PET; radiofarmaci; PSMA
• Keywords (english): prostate cancer; scintigraphy; PET; radiopharmaceuticals; PSMA
• Language: croatian
• URN:NBN: urn:nbn:hr:105:072859
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-03-31 09:15:40