^(18)F-PSMA-1007 PET-MRI与mpMRI对前列腺癌诊断价值的比较

Diagnosis value of^(18)F-PSMA-1007 PET-MRI compared with that of mpMRI for the detection of prostate cancer

目的比较^(18)F-前列腺特异性膜抗原(PSMA)-1007 PET-MRI与多参数MRI(mpMRI)对前列腺癌的诊断价值。方法回顾性分析2021年2月至2022年6月同济大学附属东方医院同期行^(18)F-PSMA-1007 PET-MRI、mpMRI检查的37例前列腺癌临床病理资料。核医学、放射科、病理医生分别按照4段法(左、右侧外周带,左、右侧移行带)对图像、穿刺病理进行定位评估。根据穿刺病理结果分析两种检查分段诊断前列腺癌的敏感性、特异性、阳性预测值和阴性预测值,分析比较两者的诊断和定位能力,采用McNear检验比较两者敏感性、特异性的差异。结果37例穿刺病理均为前列腺癌,^(18)F-PSMA-1007 PET-MRI发现100%阳性,mpMRI发现95%阳性。37例按4段法共148段,其中64.2%(95段)确诊前列腺癌。^(18)F-PSMA-1007 PET-MRI分段诊断的敏感性、特异性、阳性预测值、阴性预测值分别为73.7%、56.6%、75.3%、54.5%,mpMRI分段诊断的分别为60.0%、86.8%、89.1%、54.8%。两种方法分段诊断的敏感性、特异性差异有统计学意义(P<0.05)。结论在患者水平,^(18)F-PSMA-1007 PET/MRI和mpMRI对前列腺癌都有较高的检出能力。在段水平,^(18)F-PSMA-1007 PET/MRI诊断的敏感性更高,mpMRI特异性更高。

Objective To compare the diagnostic value of^(18)F-prostatespecific membrane antigen(PSMA)-1007 PET-MRI and multiparametric magnetic resonance(mpMRI)in the detection of prostate cancer(PCa).Methods The clinicopathological data of 37 patients with PCa who underwent^(18)F-PSMA-1007 PET-MRI and mpMRI examinations in our Hospital from February 2021 to June 2022 were retrospectively analyzed.Nuclear medicine physicians,radiologists,pathologist assessed tumor localization on^(18)F-PSMA-1007 PET-MRI,mpMRI and biopsy specimen respectively according to the 4-segment model(left peripheral zone,right peripheral zone,left transition zone,right transition zone).According to the biopsy histopathology,the efficacy of the two examinations for diagnosing and localizing PCa were analyzed,and the McNear test was used to compare the sensitivity and specificity of the two.Results The 37 cases were all PCa after biopsy,100%cases were positive by^(18)F-PSMA-1007 PET-MRI,and 95%cases were positive by mpMRI.37 patients had a total of 148 segments according to the 4-segment model,of which 64.2%(95 segments)were pathologically confirmed to be PCa.The sensitivity,specificity,positive predictive value and negative predictive value for the detection of PCa per segment using^(18)F-PSMA-1007 PET-MRI were 73.7%,56.6%,75.3%,and 54.5%,respectively.The results were 60.0%,86.8%,89.1%and 54.8%,respectively,for mpMRI.There were significant differences in the sensitivity,specificity of the two methods for segmental diagnosis of PCa(P<0.05).Conclusions At patient level,both^(18)F-PSMA-1007 PET/MRI and mpMRI have high diagnostic performance for PCa.At segment level,^(18)F-PSMA-1007 PET/MRI has higher sensitivity,and mpMRI has higher specificity.