Disputation: Naresh Kumar Regula
- Datum: –13.00
- Plats: Akademiska sjukhuset H:son Holmdahl-salen, ing 100, bv
- Doktorand: Doktorand: Naresh Kumar Regula, opponent: Katrine Wiklund, Umeå universitet.
- Om avhandlingen
- Kontaktperson: Jens Sörensen
Naresh Kumar Regula försvarar sin avhandling "PET in Prostate Cancer – Detection, Tumour Biology and Prognosis".
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Prostate cancer (PCa) is the most common non-cutaneous malignancy in men and the leading cause of cancer-related deaths in Sweden. Despite the major advances, the current diagnostic modalities fall short of standards, specifically, precise localization required for effective management of the PCa. positron emission tomography (PET) combined with computed tomography (CT) has evolved as a promising diagnostic imaging technique for PCa. The progression of the PCa is often associated with metabolic alterations and overexpression of several proteins. Increased de novo fatty acid synthesis and prostate-specific membrane antigen (PSMA) overexpression are some of the distinctive features linked with PCa growth and the potential targets for the development of PET radiotracers.
This thesis is based on four original articles and focuses on the utilization of some of several different PET tracers available to visualize PCa spread. The work can be divided into two distinctive parts: (1) evaluate the prognostic value of 11C-acetate PET/CT towards survival in the setting of biochemical relapse after surgery, investigate tumour biology using single-tissue compartment model derived parametric images of 11C-acetate dynamic PET/CT both at patient and cell level and (2) the comparison of 68Ga-PSMA-11 PET/CT with 11C-acetate PET/CT and 18F-NaF PET/CT in patients with PCa relapse depicting different aspects of PCa biology.
We demonstrated that quantification of 11C-acetate accumulation in PCa lesions was a strong predictor of survival in patients with biochemical relapse. Furthermore, parametric images of 11C-acetate dynamic PET/CT enabled visualization of tumour biology exhibiting elevated extraction of 11C-acetate associated with cancer aggressiveness also confirmed in in-vitro studies. 68Ga-PSMA-11 PET/CT located more widespread disease and performed significantly better in locating lymph node and bone metastases compared to 11C-acetate PET/CT. Similarly, 68Ga-PSMA-11 PET/CT was able to detect most of the bone lesions detected with 18F-NaF PET/CT along with additional soft tissue lesions.
In conclusion, we showed the role of 11C-acetate PET/CT in PCa prognosis with additional understanding of tumour biology. Further, we successfully showed better performance of 68Ga-PSMA-11 PET/CT in locating PCa relapse and established it as a promising option for PCa re-staging.