O uso do radiofármaco PSMA-Ga68 no diagnóstico do câncer de próstata: relato de caso

Abstract

Cancer is the main public health problem and a major cause of death in the world. The number of new cases in men is 53%, while in women it is 47%. Lifestyle, smoking, overweight, physical inactivity, population growth and aging are some of the associated risk factors. Prostate cancer is the second most common type of cancer in men with 13.5% of the total number of cases, representing 1.3 million cases per year worldwide. In the Federal District, at least 840 new cases will be registered in 2020. In addition to biochemical markers, imaging tests such as Computed Tomography (CT) and Magnetic Resonance (MR) can be used, however due to the low sensitivity and specificity of the methods, especially in early stages, prostate-specific membrane antigen (PSMA) has received greater prominence in recent years, through the radiopharmaceutical PSMA-Ga68 used with Positron Emission Tomography (PET) coupled to CT. The objective of the study was to report the use of the radiopharmaceutical PSMA-Ga68 in the staging of prostate cancer submitted to prostatectomy. The type of study was descriptive of a case report carried out at Hospital SírioLibanês in Brasília in July 2020. After the PET/CT examination with PSMA-Ga68, it was possible to identify signs of radical prostatectomy and important injuries, as in prostatic bed (SUV = 8.4), lung (SUV = 2.0), bone lesions in the costal arches (SUV = 2.2) and in the right inguinal lymph node (SUV = 3.0). It was also possible to identify some findings, such as cortical cysts in both kidneys, aortoiliac and coronary atheromatosis, signs of sternorrhaphy and denegative changes in the spine. This demonstrates the high sensitivity and specificity of the PET/CT technique with PSMA-Ga68. With an increase in prostate specific antigen (PSA) associated with positivity in the positron emission tomography technique, it was possible to suggest the diagnosis of prostate cancer recurrence. The PET/CT technique with PSMA-Ga68 can be useful in the diagnosis, staging, restoring, prognosis and definition of the treatment of prostate cancer.