18F-PSMA-1007 PET/CT 与 18F-FDG PET/CT 对前列腺癌骨转移的诊断价值比较

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摘要 目的： 比较18F-前列腺特异性膜抗原（PSMA）-1007标记的正电子发射断层显像融合计算机体层摄影技术（PET/CT）、18F-脱氧葡萄糖（FDG） PET/CT显像对前列腺癌骨转移的诊断价值。方法: 回顾性分析2020年12月至2022年12月北部战区总医院核医学科收治的30例前列腺癌患者的临床资料，所有患者行18FPSMA-1007 PET/CT及18F-FDG PET/CT显像检查。采用ROC曲线分析两种方法最大标准摄取值（SUVmax）对骨转移灶的诊断阈值和诊断效能的差异；采用加权Kappa检验分析两位医师诊断结果的一致性。结果: 30例患者阳性病灶共215个，前列腺癌原发病灶30个、骨转移灶185个。18F-PSMA-1007和18F-FDG PET/CT显像前列腺癌原发病灶、骨转移灶SUVmax的ROC 曲线下面积分别为0.88、0.96和0.81、0.93。18F-PSMA-1007和18F-FDG PET/CT诊断前列腺癌骨转移的敏感度、特异度、阳性预测值、阴性预测值和准确度分别为94.62%、66.67%、98.32%、37.50%、93.33%和82.35%、50.00%、97.47%、10.81%、81.02%，两种方法在敏感度、阴性预测值、诊断符合率的差异均有统计学意义(P均＜0.05）。结论: 18F-PSMA-1007 PET/CT是原发性前列腺癌骨转移良好的诊断工具，对前列腺骨转移诊断的敏感度和准确性高于18F-FDG PET/CT。

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关键词 ：前列腺特异性膜抗原, 脱氧葡萄糖, 前列腺癌, 骨转移, PET/CT

Abstract：Objective： To compare the diagnostic value of 18F-prostate specific membrane antigen (PSMA)-1007-labeled positron emission tomography fusion computed tomography (PET/CT) and 18F-deoxyglucose (FDG) PET/CT imaging for bone metastasis of prostate cancer. Methods： The clinical data of 30 prostate cancer patients admitted to the department of nuclear medicine of the General Hospital of Northern Theater Command from December 2020 to December 2022 were retrospectively analyzed, and all patients underwent 18F-PSMA-1007 PET/CT imaging and 18F-FDG PET/CT imaging test. The ROC curves were used to analyze the difference in diagnostic threshold and diagnostic efficacy of the maximum standardized uptake value (SUVmax) for bone metastases between the two methods; the weighted Kappa test was used to analyze the agreement between the diagnostic results of the two physicians. Results： A total of 215 positive lesions were found in 30 patients, including 30 prostate cancer lesions and 185 bone metastases. The area under the ROC curve for SUVmax of prostate cancer lesions and bone metastases visualized by 18F-PSMA-1007 and 18FFDG PET/CT were 0.88, 0.96 and 0.81, 0.93, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 18F-PSMA-1007 and 18F-FDG PET/CT in diagnosing prostate cancer bone metastases were 94.62%, 66.67%, 98.32%, 37.50%, 93.33% and 82.35%，50.00%，97.47%，10.81%，81.02%, respectively. The differences in sensitivity, negative predictive value, and diagnostic compliance between two methods were statistically significant (all P<0.05). Conclusion： 18F-PSMA-1007 PET/CT is a better diagnostic tool for primary prostate cancer bone metastasis, which is evidenced by that the sensitivity and accuracy of the diagnosis of prostate bone metastasis were higher than those of 18F-FDG PET/CT.

收稿日期: 2023-01-10

基金资助:辽宁省应用基础研究计划（联合计划）项目（2022JH2/101500021）

通讯作者: 张国旭(通讯作者)，主任医师，E-mail：zhangguoxu502@sina.com

作者简介: 丁婷婷（1995—），女，硕士，住院医师；

引用本文:

丁婷婷，郝珊瑚，王治国，张文文，张国旭. 18F-PSMA-1007 PET/CT 与 18F-FDG PET/CT 对前列腺癌骨转移的诊断价值比较[J]. 江苏大学学报:医学版, 2023, 33(05): 369-373,379. DING Tingting, HAO Shanhu, WANG Zhiguo, ZHANG Wenwen, ZHANG Guoxu. Diagnostic value of 18F-prostate-specific membrane antigen-1007 PET/CT versus 18F-deoxyglucose PET/CT for bone metastasis in prostate cancer. Journal of Jiangsu University(Medicine Edition), 2023, 33(05): 369-373,379.

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http://zzs.ujs.edu.cn/xbyxb/CN/ 或 http://zzs.ujs.edu.cn/xbyxb/CN/Y2023/V33/I05/369

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