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| 68Ga-PSMA-11 PET-CT与全身磁共振成像诊断前列腺癌远处转移的效能比较 |
| 吴涵潇1△,宋子健1△,程超2,阳青松3,陈锐1,高旭1* |
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(1. 海军军医大学(第二军医大学)长海医院泌尿外科, 上海 200433;
2. 海军军医大学(第二军医大学)长海医院核医学科, 上海 200433;
3. 海军军医大学(第二军医大学)长海医院影像医学科, 上海 200433
△共同第一作者
*通信作者) |
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| 摘要: |
| 目的 对比分析以68镓（68Ga）标记的靶向前列腺特异性膜抗原（PSMA）分子探针PSMA-11为示踪剂的PET-CT（68Ga-PSMA-11 PET-CT）与全身磁共振成像（WB-MRI）诊断前列腺癌远处转移的效能。方法 回顾性分析2019年1月至12月我院收治的行68Ga-PSMA-11 PET-CT及WB-MRI的52例前列腺癌患者的临床资料。由核医学科及影像医学科主治医师各2名分别对患者的68Ga-PSMA-11 PET-CT和WB-MRI检查结果进行盲法分析，并以最佳比较标准（BVC）为金标准对患者进行分组。根据结果绘制ROC曲线并计算AUC，对2种检查方法的灵敏度、特异度等进行统计分析。结果 入组的52例前列腺癌患者中20例无远处转移、32例发生远处转移。WB-MRI检测远处转移的AUC为0.844（95% CI 0.719~0.968），灵敏度为93.75%（30/32）、特异度为75.00%（15/20）；68Ga-PSMA-11 PET-CT检测远处转移的AUC为0.959（95% CI 0.893~1.000），灵敏度为96.88%（31/32）、特异度为95.00%（19/20），2种方法的灵敏度及特异度差异均无统计学意义（P均>0.05）。远处转移患者中有25例发生骨转移、29例发生淋巴结转移。68Ga-PSMA-11 PET-CT检测前列腺癌骨转移灶的灵敏度为92.00%（23/25）、特异度为100.00%（27/27），WB-MRI检测灵敏度为60.00%（15/25）、特异度为88.89%（24/27），2种方法灵敏度差异有统计学意义（P=0.04）；2种方法对淋巴结转移检测的灵敏度[89.66%（26/29）vs 86.21%（25/29）]及特异度[95.65%（22/23）vs 91.30%（21/23）]差异均无统计学意义（P均>0.05）。结论 68Ga-PSMA-11 PET-CT与WB-MRI检测前列腺癌远处转移均具有较高的诊断效能。在骨转移的诊断方面，68Ga-PSMA-11 PET-CT的诊断效能优于WB-MRI。 |
| 关键词: 前列腺肿瘤 前列腺特异性膜抗原 正电子发射断层显像计算机体层摄影术 磁共振成像 肿瘤转移 |
| DOI：10.16781/j.0258-879x.2021.04.0366 |
| 投稿时间：2020-09-22修订日期：2021-02-03 |
| 基金项目:上海市卫生健康委员会先进适宜技术推广项目（2019SY029），促进市级医院临床技能与临床创新三年行动计划（SHDC2020CR6007）. |
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| 68Ga-PSMA-11 PET-CT in comparison with whole-body magnetic resonance imaging for dignosis of distant metastasis in prostate cancer patients |
| WU Han-xiao1△,SONG Zi-jian1△,CHENG Chao2,YANG Qing-song3,CHEN Rui1,GAO Xu1* |
(1. Department of Urology, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China;
2. Department of Nuclear Medicine, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China;
3. Department of Radiology, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China
△Co-first authors.
* Corresponding author) |
| Abstract: |
| Objective To compare the diagnostic efficacies of 68gallium-labelled prostate-specific membrane antigen (PSMA) ligand PSMA-11 (68Ga-PSMA-11) positron emission tomography-computed tomography (PET-CT) and whole-body magnetic resonance imaging (WB-MRI) for detecting distant metastasis in prostate cancer patients. Methods The clinical data of 52 patients with prostate cancer who underwent 68Ga-PSMA-11 PET-CT and WB-MRI in our hospital from Jan. to Dec. 2019 were retrospectively analyzed. The images of 68Ga-PSMA-11 PET-CT and WB-MRI were reviewed with blinding by professional nuclear medicine physicians and radiologists, respectively, and then the patients were grouped according to the best valuable comparator (BVC). The receiver operator characteristic (ROC) curve was drawn according to the result, and the area under the curve (AUC) was calculated. The sensitivity and specificity of the two tests were statistically analyzed. Results Of the 52 patients, 20 were diagnosed without distant metastasis, 32 with distant metastasis. The AUC of WB-MRI and 68Ga-PSMA-11 PET-CT in detecting distant metastasis were 0.844 (95% CI 0.719-0.968) and 0.959 (95% CI 0.719-0.968), respectively; the sensitivity and specificity were WB-MRI (93.75%[30/32], 75.00%[15/20]) and 68Ga-PSMA-11 PET-CT (96.88%[31/32], 95.00%[19/20]), showing no significant differences (all P>0.05). There were 25 cases of bone metastasis and 29 cases of lymph node metastasis in patients with distant metastasis. The sensitivity and specificity in detecting bone metastasis were 68Ga-PSMA-11 PET-CT (92.00%[23/25], 100.00%[27/27]) and WB-MRI (60.00%[15/25], 88.89%[24/27]), showing significant difference in sensitivity (P=0.04). The sensitivity and specificity of the two tests in detecting lymph node metastasis were (89.66%[26/29] vs 86.21%[25/29]) and (95.65%[22/23] vs 91.30%[21/23]), showing no significant differences (both P>0.05). Conclusion Both 68Ga-PSMA-11 PET-CT and WB-MRI have high diagnostic efficacy for the detection of distant metastasis. 68Ga-PSMA-11PET-CT is significantly more advantageous compared to WB-MRI for the detection of bone metastasis. |
| Key words: prostatic neoplasms prostate-specific membrane antigen positron emission tomography-computed tomography magnetic resonance imaging neoplasm metastasis |
