^(18)F-前列腺特异性膜抗原(PSMA)-1007 PET/CT参数评估前列腺癌骨转移

^(18)F-prostate specific membrane antigen(PSMA)PET/CT parameters for evaluating bone metastasis of prostate cancer

目的观察^(18)F-前列腺特异性膜抗原(PSMA)-1007 PET/CT参数评估前列腺癌(PCa)骨转移的价值。方法根据有无骨转移将53例经病理确诊的PCa患者分为骨转移组(n=27)及无骨转移组(n=26)。于PET/CT三维图像上勾画PCa原发灶感兴趣容积,测量其最大标准摄取值(SUV max)、前列腺肿瘤PSMA表达体积(PSMA-TVp)和前列腺肿瘤病灶PSMA表达总量(TL-PSMAp);比较组间PSMA表达参数差异,采用单因素logistic回归分析预测PCa骨转移的独立因素,绘制受试者工作特征曲线,分析PSMA表达参数评估骨转移的效能。结果骨转移组PCa原发灶SUV max、PSMA-TVp及TL-PSMAp均高于无骨转移组(P均<0.01)。原发灶SUV max、PSMA-TVp及TL-PSMAp均为预测PCa骨转移的独立因素(OR=1.091、1.327、1.042,P均<0.05),其评估PCa骨转移的曲线下面积分别为0.734、0.908及0.929,PCa原发灶TL-PSMAp、PSMA-TVp的评估效能明显高于SUV max(P均<0.05)。结论^(18)F-PSMA-1007 PET/CT所示PCa原发灶PSMA表达参数可用于评估PCa骨转移,尤以体积参数如PSMA-TVp和TL-PSMAp更具价值。

Objective To investigate the value of ^(18)F-prostate specific membrane antigen(PSMA)-1007 PET/CT parameters of the primary lesion of prostate cancer(PCa)for evaluating bone metastasis.Methods Totally 53 patients with PCa proved pathologically were divided into bone metastasis group(n=27)or non-bone metastasis group(n=26)according to the existence of predicting bone metastasis or not.The volume of interest(VOI)of the primary lesion of prostate cancer was sketched on PET/CT 3D images,while the maximum standard uptake value(SUV max)of VOI,the volume of prostate PSMA tumor(PSMA-TVp)and the total prostate lesion PSMA(TL-PSMAp)were measured.Then PSMA expression parameters were compared between groups.Univariate logistic regression was performed to screen the independent factors of predicting bone metastasis of PCa,and PSMA expression parameters were analyzed using receiver operating characteristic curve to explore the efficiency of each parameter for evaluating bone metastasis of PCa.Results SUV max,PSMA-TVp,and TL-PSMAp of primary PCa lesions in bone metastasis group were higher than those in non-bone metastasis group(all P<0.01).SUV max,PSMA-TVp and TL-PSMAp of primary PCa lesions were all independent predictors of bone metastasis of PCa(OR=1.091,1.327,1.042,all P<0.05),with the area under the curve for assessing PCa bone metastasis of 0.734,0.908 and 0.929,respectively,of PSMA-TVp and TL-PSMAP were significantly higher than of SUV max of the primary PCa lesion(both P<0.05).Conclusion PSMA expression parameters of primary PCa lesions derived on ^(18)F-PSMA-1007 PET/CT could be used to evaluate bone metastasis of PCa,among which the volume parameters like PSMA-TVp and TL-PSMAp were more valuable.