{"title":"99mTc-PSMA SPECT/CT对原发性前列腺癌的诊断价值。","authors":"Kanhaiyalal Agrawal, P Sai Sradha Patro, Tejasvini Singhal, Drishty Satpati, Prasant Nayak, Swarnendu Mandal, Navneet Kumar, Biswa Mohan Padhy, Mukund Sable, Bikash Ranjan Meher","doi":"10.12998/wjcc.v13.i24.107555","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong><sup>68</sup>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 <sup>99m</sup>Tc (Technetium)-PSMA-SPECT/CT. Due to its cost effectiveness and better feasibility, it needs to be explored more extensively for its incorporation into routine clinical practice.</p><p><strong>Aim: </strong>To analyse the diagnostic accuracy of <sup>99m</sup>Tc-PSMA-SPECT/CT for detection of primary prostate carcinoma.</p><p><strong>Methods: </strong>As a prospective study in a tertiary hospital, 99mTc-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.</p><p><strong>Results: </strong>Nineteen of twenty-nine patients were positive on <sup>99m</sup>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, <i>P</i> = 0.005) and 0.767 (95%CI: 0.596-0.937, <i>P</i> = 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 <i>vs</i> benign groups.</p><p><strong>Conclusion: </strong><sup>99m</sup>Tc-PSMA-SPECT/CT shows a promising role in the diagnosis of primary prostate cancer.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 24","pages":"107555"},"PeriodicalIF":1.0000,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207555/pdf/","citationCount":"0","resultStr":"{\"title\":\"Diagnostic performance of <sup>99m</sup>Tc-PSMA SPECT/CT in primary prostate carcinoma.\",\"authors\":\"Kanhaiyalal Agrawal, P Sai Sradha Patro, Tejasvini Singhal, Drishty Satpati, Prasant Nayak, Swarnendu Mandal, Navneet Kumar, Biswa Mohan Padhy, Mukund Sable, Bikash Ranjan Meher\",\"doi\":\"10.12998/wjcc.v13.i24.107555\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong><sup>68</sup>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 <sup>99m</sup>Tc (Technetium)-PSMA-SPECT/CT. Due to its cost effectiveness and better feasibility, it needs to be explored more extensively for its incorporation into routine clinical practice.</p><p><strong>Aim: </strong>To analyse the diagnostic accuracy of <sup>99m</sup>Tc-PSMA-SPECT/CT for detection of primary prostate carcinoma.</p><p><strong>Methods: </strong>As a prospective study in a tertiary hospital, 99mTc-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.</p><p><strong>Results: </strong>Nineteen of twenty-nine patients were positive on <sup>99m</sup>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, <i>P</i> = 0.005) and 0.767 (95%CI: 0.596-0.937, <i>P</i> = 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 <i>vs</i> benign groups.</p><p><strong>Conclusion: </strong><sup>99m</sup>Tc-PSMA-SPECT/CT shows a promising role in the diagnosis of primary prostate cancer.</p>\",\"PeriodicalId\":23912,\"journal\":{\"name\":\"World Journal of Clinical Cases\",\"volume\":\"13 24\",\"pages\":\"107555\"},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2025-08-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207555/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Clinical Cases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.12998/wjcc.v13.i24.107555\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Clinical Cases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.12998/wjcc.v13.i24.107555","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景:68Ga(镓)-PSMA PET-CT(前列腺特异性膜抗原定向正电子发射断层扫描-计算机断层扫描)已经确立了其作为靶向分子成像在前列腺癌治疗中的作用。然而,99mTc(锝)-PSMA-SPECT/CT的诊断准确性研究有限。由于其成本效益和较好的可行性,需要更广泛的探索将其纳入常规临床实践。目的:分析99mTc-PSMA-SPECT/CT对原发性前列腺癌的诊断准确性。方法:在某三级医院进行前瞻性研究,对29例门诊疑似前列腺癌患者行99mTc-PSMA-SPECT/CT检查,患者中位年龄66岁(50 ~ 82岁)。将结果与组织病理学作为金标准进行比较。结果:29例患者中有19例99mTc-PSMA-SPECT/CT阳性,其中16例(84.2%)组织病理学为前列腺癌,其余10例影像学阴性,其中3例为前列腺癌,视觉分析的总体敏感性、特异性和准确性分别为84.2%、70%和79.3%。恶性组前列腺:背景比为37.18±48.85,前列腺:肝比为5.35±7.35,良性组前列腺:背景比为6.65±5.17,前列腺:肝比为1.14±0.56。前列腺:背景比和前列腺:肝比曲线下面积分别为0.833(95%可信区间[CI]: 0.677 ~ 0.990, P = 0.005)和0.767 (95%CI: 0.596 ~ 0.937, P = 0.024)。前列腺:背景比值(敏感性85%,特异性88.9%)的临界值> 10.45和前列腺:肝脏比值(敏感性75%,特异性77.8%)的临界值> 1.15被发现与区分恶性组和良性组相关。结论:99mTc-PSMA-SPECT/CT在原发性前列腺癌的诊断中具有很好的应用价值。
Diagnostic performance of 99mTc-PSMA SPECT/CT in primary prostate carcinoma.
Background: 68Ga (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 99mTc (Technetium)-PSMA-SPECT/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 99mTc-PSMA-SPECT/CT for detection of primary prostate carcinoma.
Methods: As a prospective study in a tertiary hospital, 99mTc-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 99mTc-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: 99mTc-PSMA-SPECT/CT shows a promising role in the diagnosis of primary prostate cancer.
期刊介绍:
The World Journal of Clinical Cases (WJCC) is a high-quality, peer reviewed, open-access journal. The primary task of WJCC is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of clinical cases. In order to promote productive academic communication, the peer review process for the WJCC is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJCC are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in clinical cases.