摘要
目的 比较^(18)F-PSMA-1007和^(68)Ga-PSMA-11及^(18)F-FDG PET/CT在2个初诊可疑前列腺癌患者队列中的诊断效能。资料与方法 连续纳入2018年8月—2020年12月于广州医科大学附属第一医院行^(68)Ga-PSMA-11和^(18)F-FDG、^(18)F-PSMA-1007PET/CT检查的初诊可疑前列腺癌患者46例进行回顾性分析,其中23例2周内同时接受^(68)Ga-PSMA-11和^(18)F-FDG PET/CT检查,23例接受^(18)F-PSMA-1007 PET/CT检查。以病理结果和临床/影像随访为“金标准”,比较^(68)Ga-PSMA-11、^(18)F-PSMA-1007和^(18)F-FDG在肿瘤病灶(原发灶、淋巴结转移、骨转移灶)中的放射性摄取差异,以及与前列腺特异性抗原的相关性。使用受试者工作特征曲线比较3种示踪剂对初诊前列腺癌的诊断效能。结果 ^(68)Ga-PSMA-11和^(18)F-FDG PET分别检出前列腺癌总病灶数134个和65个(Z=-3.069,P=0.002)。^(18)F-PSMA-1007和^(68)Ga-PSMA-11在肿瘤病灶中的摄取均高于^(18)F-FDG(H=28.956、28.956,P<0.001),2种PSMA示踪剂在肿瘤病灶中的摄取差异无统计学意义(P=1.000)。受试者工作特征曲线分析显示,^(18)FPSMA-1007和^(68)Ga-PSMA-11的诊断效能均高于^(18)F-FDG(Z=2.230、2.123,P<0.05)。^(18)F-PSMA-1007和^(68)Ga-PSMA-11半定量参数最大标准化摄取值诊断前列腺癌原发病灶的最佳截断值分别为8.2和8.5,对应的曲线下面积分别为0.892和0.897,敏感度均为70.6%,特异度均为100%,两者诊断效能差异无统计学意义(P>0.05)。^(18)F-PSMA-1007和^(68)Ga-PSMA-11在前列腺部位病灶的最大标准化摄取值与前列腺特异性抗原均呈正相关(r=0.638、0.517,P<0.05),而^(18)F-FDG的最大标准化摄取值与前列腺特异性抗原无相关性(r=0.402,P=0.057)。结论 ^(18)F-PSMA-1007和^(68)Ga-PSMA-11对初诊前列腺癌的诊断效能均高于^(18)F-FDG,^(68)Ga-PSMA-11 PET/CT对前列腺癌原发灶和淋巴结转移灶检出数优于^(18)F-FDG PET/CT。
Purpose To compare the diagnostic efficacy of ^(18)F-PSMA-1007,^(68)Ga-PSMA-11 and ^(18)F-FDG in two cohorts of newly diagnosed prostate cancer.Materials and Methods Forty-six patients with newly diagnosed prostate cancer who underwent ^(68)Ga-PSMA-11,^(18)F-FDG and ^(18)F-PSMA-1007 PET/CT from August 2018 to December 2020 were retrospectively analyzed.A total of 23 patients underwent both ^(68)Ga-PSMA-11 and ^(18)F-FDG PET/CT within two weeks,and 23 patients underwent ^(18)F-PSMA-1007 PET/CT.Taken the results of pathology and clinical/imaging follow-up as the gold standard,the difference of radioactive uptake of ^(68)Ga-PSMA-11,^(18)F-PSMA-1007 and ^(18)F-FDG in tumor lesions(primary lesions,lymph node metastasis and bone metastasis) was compared,respectively.Its correlation with prostate specific antigen was also analyzed.The receiver operating characteristic curve was used to compare the diagnostic efficacy of three imaging agents in newly diagnosed prostate cancer patients.Results In prostate cancer patients,the total number of lesions detected by ^(68)Ga-PSMA-11 and ^(18)F-FDG PET was 134 and 65,respectively(Z=-3.069,P=0.002).The uptake of ^(18)F-PSMA-1007 and ^(68)Ga-PSMA-11in tumor lesions was significantly higher than that of ^(18)F-FDG(H=28.956,28.956,P<0.001),and there was no statistically significant difference in the uptake of the two PSMA tracers in tumor lesions(P=1.000).Receiver operating characteristic curve analysis showed that the diagnostic efficacy of ^(18)F-PSMA-1007 and ^(68)Ga-PSMA-11 was significantly higher than that of ^(18)F-FDG(Z=2.230,2.123,P<0.05).The optimal cutoff values for the maximum standard uptake value of semi quantitative parameters ^(18)F-PSMA-1007 and ^(68)Ga-PSMA-11 in the diagnosis of primary prostate cancer lesions were 8.2 and 8.5,respectively,with corresponding area under the curve of 0.892 and 0.897,sensitivity of 70.6% and specificity of 100%.There was no statistically significant difference in diagnostic efficacy between the two(P<0.05).The maximum standard uptake value of ^(18)F-PSMA-1007 and ^(68)Ga-PSMA-11 in prostate lesions was positively correlated with prostate specific antigen(r=0.638,0.517,P<0.05),while the maximum standard uptake value of ^(18)F-FDG was not significantly correlated with prostate specific antigen(r=0.402,P=0.057).Conclusion The diagnostic efficacy of ^(18)F-PSMA-1007 and ^(68)Ga-PSMA-11 for newly diagnosed prostate cancer is significantly higher than that of ^(18)F-FDG.^(68)Ga-PSMA-11 PET/CT is superior to ^(18)F-FDG PET/CT in the detection of primary lesions and lymph node metastases of prostate cancer.
作者
钟凯翔
侯鹏
吕杰
柯渺
王欣璐
ZHONG Kaixiang;HOU Peng;LV Jie;KE Miao;WANG Xinlu(Department of Nuclear Medicine,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2023年第8期865-871,共7页
Chinese Journal of Medical Imaging
