BACKGROUND^(68)Ga(gallium)-PSMA PET-CT(prostate-specific membrane antigen-directed Positron emission tomography-computed tomography)has established its role in prostate cancer management as targeted molecular imaging....BACKGROUND^(68)Ga(gallium)-PSMA PET-CT(prostate-specific membrane antigen-directed Positron emission tomography-computed tomography)has established its role in prostate cancer management as targeted molecular imaging.However,limited studies are available on the diagnostic accuracy of^(99m)Tc(Technetium)-PSMASPECT/CT.Due to its cost effectiveness and better feasibility,it needs to be explored more extensively for its incorporation into routine clinical practice.AIM To analyse the diagnostic accuracy of^(99m)Tc-PSMA-SPECT/CT for detection of primary prostate carcinoma.METHODS As a prospective study in a tertiary hospital,^(99m)Tc-PSMA-SPECT/CT was performed in 29 outpatients with suspected prostate cancer,with a median age of 66(range:50-82)years.The findings were compared to histopathology as the gold standard.RESULTS Nineteen of twenty-nine patients were positive on^(99m)Tc-PSMA-SPECT/CT,of which 16(84.2%)had prostate cancer on histopathology,while the remaining ten were negative on imaging,of which three had prostate cancer,leading to an overall sensitivity,specificity,and accuracy of 84.2%,70%,and 79.3%,respectively,on visual analysis.Prostate:background and prostate:liver ratios were 37.18±48.85 and 5.35±7.35 in the malignant group,while 6.65±5.17 and 1.14±0.56 in the benign group,respectively.The area under the curve values for prostate:background and prostate:liver ratios were 0.833(95%confidence interval[CI]:0.677-0.990,P=0.005)and 0.767(95%CI:0.596-0.937,P=0.024),respectively,on receiver operator curve analysis.A cut-off value>10.45 for prostate:background ratio(sensitivity 85%and specificity 88.9%),and>1.15 for prostate:liver ratio(sensitivity 75%and specificity of 77.8%respectively)was found to be pertinent to differentiate between the malignant vs benign groups.CONCLUSION^(99m)Tc-PSMA-SPECT/CT shows a promising role in the diagnosis of primary prostate cancer.展开更多
BACKGROUND Ligament flavum(LF)hypertropy is the main etiopathogenesis of lumbar canal stenosis(LCS).The purely elastic LF undergoes a morphological adaptation including a reduction in the elastic fibers and a conseque...BACKGROUND Ligament flavum(LF)hypertropy is the main etiopathogenesis of lumbar canal stenosis(LCS).The purely elastic LF undergoes a morphological adaptation including a reduction in the elastic fibers and a consequent increase in the collagen content,fibrosis,cicatrization,and calcification.However,the morphometric analysis can delineate the LF in patients with LCS from those without LCS,which would help in better understanding LCS pathogenesis.AIM To compare the histopathological changes in LF between the degenerative LCS and non-stenotic(non-LCS)group.METHODS The present prospective study was conducted in 82 patients who were divided into two groups,namely LCS and non-LCS.Demographic details of the patients such as duration of symptoms,level of involvement,and number of segments were recorded.The LF obtained from both groups was histopathologically examined for the fibrosis score,elastic fiber degeneration,calcification,and chondroid metaplasia.Morphometrical details included a change in elastin and collagen percentages,elastin/collagen ratio,elastic fiber fragmentation,and ligamentocyte numbers.All parameters were compared between the two groups by using the independent t test,Chi-square test,and Pearson’s correlation test.RESULTS Out of 82 cases,74 were analysed,34 in LCS and 40 in non-LCS group.The mean±SD age of presentation in LCS and non-LCS group was 49.2±8.9 and 43.1±14.3 respectively.The LCS group(n=34)exhibited significant differences in fibrosis(P=0.002),elastic fiber degeneration(P=0.01),%elastic fragmentation(66.5±16.3 vs 29.5±16.9),%elastic,content(26.9±6.7 vs 34.7±8.4),%collagen content(63.6±10.4 vs 54.9±6.4),reduction of elastic/collagen(0.4±0.1 vs 0.6±0.1),and ligamentocyte number(39.1±19.1 vs 53.5±26.9)as compared to non-LCS group(n=40).The calcification(P=0.08)and Pearson’s correlation between duration and loss of elastin was not significant.The difference in LF morphology is consistent in patient’s≥40 years of age among the groups as found in subgroup analysis.Similarly in the patents<40 and>40 in the non-LCS group.CONCLUSION LF is vital in the pathogenesis of LCS.The purely elastic LF undergoes a morphological adaptation that includes a reduction in the elastic fibers with a consequent increase in the collagen content,fibrosis,cicatrization,and calcification.The present study provides a detailed morphometric analysis to semiquantitatively delineate the LF changes in patients with LCS from those in patients without LCS.展开更多
文摘BACKGROUND^(68)Ga(gallium)-PSMA PET-CT(prostate-specific membrane antigen-directed Positron emission tomography-computed tomography)has established its role in prostate cancer management as targeted molecular imaging.However,limited studies are available on the diagnostic accuracy of^(99m)Tc(Technetium)-PSMASPECT/CT.Due to its cost effectiveness and better feasibility,it needs to be explored more extensively for its incorporation into routine clinical practice.AIM To analyse the diagnostic accuracy of^(99m)Tc-PSMA-SPECT/CT for detection of primary prostate carcinoma.METHODS As a prospective study in a tertiary hospital,^(99m)Tc-PSMA-SPECT/CT was performed in 29 outpatients with suspected prostate cancer,with a median age of 66(range:50-82)years.The findings were compared to histopathology as the gold standard.RESULTS Nineteen of twenty-nine patients were positive on^(99m)Tc-PSMA-SPECT/CT,of which 16(84.2%)had prostate cancer on histopathology,while the remaining ten were negative on imaging,of which three had prostate cancer,leading to an overall sensitivity,specificity,and accuracy of 84.2%,70%,and 79.3%,respectively,on visual analysis.Prostate:background and prostate:liver ratios were 37.18±48.85 and 5.35±7.35 in the malignant group,while 6.65±5.17 and 1.14±0.56 in the benign group,respectively.The area under the curve values for prostate:background and prostate:liver ratios were 0.833(95%confidence interval[CI]:0.677-0.990,P=0.005)and 0.767(95%CI:0.596-0.937,P=0.024),respectively,on receiver operator curve analysis.A cut-off value>10.45 for prostate:background ratio(sensitivity 85%and specificity 88.9%),and>1.15 for prostate:liver ratio(sensitivity 75%and specificity of 77.8%respectively)was found to be pertinent to differentiate between the malignant vs benign groups.CONCLUSION^(99m)Tc-PSMA-SPECT/CT shows a promising role in the diagnosis of primary prostate cancer.
基金Institutional research grant(AIIMS Bhubaneswar).
文摘BACKGROUND Ligament flavum(LF)hypertropy is the main etiopathogenesis of lumbar canal stenosis(LCS).The purely elastic LF undergoes a morphological adaptation including a reduction in the elastic fibers and a consequent increase in the collagen content,fibrosis,cicatrization,and calcification.However,the morphometric analysis can delineate the LF in patients with LCS from those without LCS,which would help in better understanding LCS pathogenesis.AIM To compare the histopathological changes in LF between the degenerative LCS and non-stenotic(non-LCS)group.METHODS The present prospective study was conducted in 82 patients who were divided into two groups,namely LCS and non-LCS.Demographic details of the patients such as duration of symptoms,level of involvement,and number of segments were recorded.The LF obtained from both groups was histopathologically examined for the fibrosis score,elastic fiber degeneration,calcification,and chondroid metaplasia.Morphometrical details included a change in elastin and collagen percentages,elastin/collagen ratio,elastic fiber fragmentation,and ligamentocyte numbers.All parameters were compared between the two groups by using the independent t test,Chi-square test,and Pearson’s correlation test.RESULTS Out of 82 cases,74 were analysed,34 in LCS and 40 in non-LCS group.The mean±SD age of presentation in LCS and non-LCS group was 49.2±8.9 and 43.1±14.3 respectively.The LCS group(n=34)exhibited significant differences in fibrosis(P=0.002),elastic fiber degeneration(P=0.01),%elastic fragmentation(66.5±16.3 vs 29.5±16.9),%elastic,content(26.9±6.7 vs 34.7±8.4),%collagen content(63.6±10.4 vs 54.9±6.4),reduction of elastic/collagen(0.4±0.1 vs 0.6±0.1),and ligamentocyte number(39.1±19.1 vs 53.5±26.9)as compared to non-LCS group(n=40).The calcification(P=0.08)and Pearson’s correlation between duration and loss of elastin was not significant.The difference in LF morphology is consistent in patient’s≥40 years of age among the groups as found in subgroup analysis.Similarly in the patents<40 and>40 in the non-LCS group.CONCLUSION LF is vital in the pathogenesis of LCS.The purely elastic LF undergoes a morphological adaptation that includes a reduction in the elastic fibers with a consequent increase in the collagen content,fibrosis,cicatrization,and calcification.The present study provides a detailed morphometric analysis to semiquantitatively delineate the LF changes in patients with LCS from those in patients without LCS.
