PET-CT com PSMA-Ga68 no câncer de mama triplo negativo metastático
68GA-PSMA PET-CT in triple negative metastatic breast cancer
Rodrigo de Almeida, Vinicius Viotto Berto, Miguel Vieira Paschoal, Humberto Pinto de Matos, Gilson Luchesi Delgado, Luís Antônio Pires, Fabiana Trevisan Mori, Beatriz Birelli do Nascimento
Resumo
OBJETIVOS: O câncer de mama triplo negativo carece de marcadores e tratamentos-alvo específicos. Nesse contexto, o objetivo deste trabalho foi avaliar, por meio de estudos de casos, o comportamento da tomografia por emissão de pósitrons combinada à tomografia computadorizada (PET-CT) com PSMA-Ga68 para detectar metástases em pacientes com câncer de mama triplo negativo.
MÉTODOS: Foram selecionadas e avaliadas seis pacientes com diagnóstico inicial de câncer de mama triplo negativo metastático ou que apresentaram metástases devido à progressão da doença. As participantes foram submetidas ao exame de PET-CT com PSMA- -Ga68 e suas lesões foram classificadas em graus de 0 a 5 quanto à intensidade de captação tumoral do radiofármaco e quanto à sua localização antatômica.
RESULTADOS: em relação à distribuição de cada tipo de lesão, uma paciente apresentou recidiva local com captação grau 3; uma paciente apresentou linfonodos locorregionais com captação grau 4; duas pacientes apresentaram linfonodos à distância, uma com captação grau 2 e outra com captação grau 3; quatro pacientes apresentaram metástases ósseas, duas com captação grau 2 e duas com captação grau 3; três pacientes apresentaram metástases pulmonares, uma com captação grau 1, uma com captação grau 2 e uma com captação grau 3; uma paciente apresentou metástases hepáticas com captação grau 3; e uma paciente não apresentou nenhuma lesão com captação do radiofármaco (grau 0).
CONCLUSÃO: O trabalho demonstrou que o PSMA-Ga68, embora originalmente descrito como marcador prostático, é captado por lesões neoplásicas associadas ao câncer de mama triplo negativo.
Palavras-chave
Abstract
OBJECTIVES: Triple negative breast cancer lacks specific markers and targeted treatments. In this context, the objective of this study is to evaluate, through case studies, the behavior of 68Ga-PSMA PET-CT to detect metastases in patients with triple negative breast cancer.
METHODS: Six patients with metastatic triple-negative breast cancer at initial diagnosis or who presented metastases due to disease progression were selected and evaluated. The participants underwent 68Ga-PSMA PET-CT, and the lesions were classified regarding their anatomical location and in grades ranging from 0 to 5 according to the intensity of tumor uptake.
RESULTS: As for the distribution of each type of lesion, one patient had local recurrence with grade 3 uptake; one patient had locoregional lymph nodes showing grade 4 uptake; two patients had distant lymph nodes, one with grade 2 uptake and the other with grade 3 utake; four patients had bone metastases, two of them with grade 2 uptake and two with grade 3 uptake; three patients had lung metastases (one with grade 1 uptake, one with grade 2 uptake and one with grade 3 uptake); one patient had liver metastases with grade 3 uptake. One patient did not have any detectable radiopharmaceutical uptake (grade 0).
CONCLUSION: This study demonstrated that 68Ga-PSMA, although originally described as a prostatic marker, is taken up by neoplastic lesions associated with triple negative breast cancer.
Keywords
References
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Submitted date:
09/25/2021
Accepted date:
12/12/2022
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