Diagnostic Value of 18F-FDG and 18F-PSMA-1007 PET/CT in Bone Metastases from Prostate Cancer: Retrospective Comparative Analysis.

Abstract

Objective: The early and accurate diagnosis of prostate cancer (PCa) bone metastases is of great importance for formulating the best treatment plan and improving the prognosis of patients. This work aimed to compare and analyse the application value of ¹⁸F-fludeoxyglucose (FDG) and ¹⁸F-prostate-specific membrane antigen-1007 (¹⁸F-PSMA-1007) positron emission tomography/computed tomography (PET/CT) in the diagnosis of PCa bone metastases.

Methods: Data from the pathological specimens from patients diagnosed with PCa admitted to the Xingtai People's Hospital from October 2021 to October 2024 were retrospectively collected. These patients underwent ¹⁸F-FDG PET/CT and ¹⁸F-PSMA-1007 PET/CT scans, with an interval not exceeding 3 days between the two examinations. The sensitivity, specificity, negative and positive predictive values and diagnostic coincidence rate of the two imaging methods were evaluated by comparing the lesion count and anatomical distribution of prostatic bone metastases after the two examinations. The pathological diagnosis results of prostate lesion needle biopsy or radical PCa resection specimens were taken as the gold standard.

Results: Seventy-eight patients with PCa were admitted during the study. A total of 418 positive lesions, 78 primary prostatic lesions, 340 bone metastases and 12 negative lesions were detected by prostate lesion biopsy as the gold standard. A total of 410 positive foci were found in ¹⁸F-PSMA-1007, including 78 primary prostatic foci and 332 bone metastases. A total of 376 positive lesions, 76 prostate lesions and 300 bone metastases were found in ¹⁸F-FDG. ¹⁸F-PSMA-1007 detected more PCa bone metastases in different bone regions than ¹⁸F-FDG, but the difference was not statistically significant (p > 0.05). The sensitivity, specificity, positive and negative predictive values and diagnostic coincidence rate of ¹⁸F-PSMA-1007 were significantly higher than those of ¹⁸F-FDG (p < 0.01).

Conclusions: ¹⁸F-PSMA-1007 PET/CT has high sensitivity and diagnostic coincidence rate and is expected to become a new standard for the diagnosis of PCa bone metastases.