基于psma的18F-DCFPyL PET/CT与骨盆多参数MRI在前列腺癌患者骨盆病变检测中的比较

IF 2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Trinh T Nguyen, Priya R Bhosale, Guofan Xu, Tinsu Pan, Peng Wei, Yang Lu
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引用次数: 0

摘要

目的:直接比较盆腔mpMRI与最近批准和越来越多使用的基于psma的18F-DCFPyL PET/CT在中高危和生化复发前列腺癌患者队列中的表现,同时探索它们在特定临床场景中的潜在不同应用。方法:回顾性分析2021年9月至2022年1月在同一家机构接受18F-DCFPyL PET/CT和骨盆mpMRI检查的患者。纳入标准为间隔3个月的配对检查。排除标准是检查之间的干预治疗,PSA变化超过50%,绝对差异超过1 ng/mL,或同时有其他恶性肿瘤病史。我们回顾了这两种影像学检查的异常病变,并确定了一致和不一致的影像学结果。在至少5个月的临床随访中,病理或其他影像学技术证实了这些发现。结果:共纳入57例患者,57次配对检查。检查符合率为43/57(75.4%)。mpMRI和18F-DCFPyL PET/CT在前列腺床的敏感性、特异性、PPV和NPV分别为96%、94%、98%、89%和96%、100%、100%、90%。对于盆腔淋巴结转移,mpMRI和18F-DCFPyL PET/CT的敏感性、特异性、PPV和NPV分别为52%、100%、100%、55%和100%、100%、100%、100%。对于骨转移,mpMRI和18F-DCFPyL PET/CT的敏感性、特异性、PPV和NPV分别为86%、73%、50%、94%和100%、98%、95%、100%。配对数据的精确McNemar检验显示,18F-DCFPyL PET/CT与mpMRI在前列腺床的诊断效能差异无统计学意义(p值= 1.00),但在盆腔淋巴结(p值< 0.0001)和骨病变(p值= 0.0026)的诊断效能差异有统计学意义。结论:我们的研究表明基于psma的18F-DCFPyL PET/CT与盆腔mpMRI对原发性或复发性前列腺疾病的检出率具有良好的一致性,在前列腺床性病变的临床评估中具有互补作用。然而,它们的表现存在关键差异,基于psma的18F-DCFPyL PET/CT在检测小转移结节病和骨转移方面的表现明显优于psma。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Comparison of PSMA-based <sup>18</sup>F-DCFPyL PET/CT and pelvic multiparametric MRI for lesion detection in the pelvis in patients with prostate cancer.

Comparison of PSMA-based <sup>18</sup>F-DCFPyL PET/CT and pelvic multiparametric MRI for lesion detection in the pelvis in patients with prostate cancer.

Comparison of PSMA-based 18F-DCFPyL PET/CT and pelvic multiparametric MRI for lesion detection in the pelvis in patients with prostate cancer.

Purpose: To directly compare the performance of pelvic mpMRI versus recently approved and increasingly used PSMA-based 18F-DCFPyL PET/CT in intermediate-high risk and biochemical recurrent prostate cancer patient cohort while exploring their potential differing applications in specific clinical scenarios.

Methods: A retrospective analysis was performed on patients who had 18F-DCFPyL PET/CT and pelvic mpMRI done from September 2021 to January 2022 at a single institution. The inclusion criteria were paired exams within a 3-month interval. Exclusion criteria were intervening treatment between exams, a change in PSA by more than 50% and absolute difference more than 1 ng/mL, or concurrent history of other malignancy. Abnormal lesions on these 2 imaging exams were reviewed with the identification of concordant and discordant imaging findings. The findings were verified by pathology or other imaging techniques within minimal 5-month clinical follow-up.

Results: A total of 57 patients with 57 paired exams were included. The rate of concordant exams was 43/57 or 75.4%. Lesion-based analyses of sensitivity, specificity, PPV and NPV for mpMRI and 18F-DCFPyL PET/CT in the prostate bed were 96%, 94%, 98%, 89% and 96%, 100%, 100%, 90% respectively. For pelvic lymph node metastases, the sensitivity, specificity, PPV and NPV for mpMRI and 18F-DCFPyL PET/CT were 52%, 100%, 100%, 55% and 100%, 100%, 100%, 100% respectively. For bone metastases, the sensitivity, specificity, PPV and NPV for mpMRI and 18F-DCFPyL PET/CT were 86%, 73%, 50%, 94% and 100%, 98%, 95%, 100% respectively. Exact McNemar's test for paired data suggested that in diagnostic performance between 18F-DCFPyL PET/CT and mpMRI was not statistically significant in prostate bed (p-value = 1.00), but significantly in pelvic lymph nodes (p-value < 0.0001) and bone lesions (p-value = 0.0026).

Conclusion: Our study demonstrated that PSMA-based 18F-DCFPyL PET/CT and pelvic mpMRI have a good concordance rate in the detection of primary or recurrence prostate disease and can have complementary roles in the clinical assessment of the prostate bed lesions. However, there are key differences in their performance, with the notably superior performance of PSMA-based 18F-DCFPyL PET/CT in the detection of small metastatic nodal disease and bone metastases.

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来源期刊
American journal of nuclear medicine and molecular imaging
American journal of nuclear medicine and molecular imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
自引率
4.00%
发文量
4
期刊介绍: The scope of AJNMMI encompasses all areas of molecular imaging, including but not limited to: positron emission tomography (PET), single-photon emission computed tomography (SPECT), molecular magnetic resonance imaging, magnetic resonance spectroscopy, optical bioluminescence, optical fluorescence, targeted ultrasound, photoacoustic imaging, etc. AJNMMI welcomes original and review articles on both clinical investigation and preclinical research. Occasionally, special topic issues, short communications, editorials, and invited perspectives will also be published. Manuscripts, including figures and tables, must be original and not under consideration by another journal.
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