^(68)Ga-PSMA-11 PET/CT 双时相SUVmax 与前列腺癌临床病 理特征的相关性

Correlation Analysis between SUVmax in Dual-phase ^(68)Ga-PSMA-11 PET/CT and the Clini⁃copathologic Features of Patients with Prostate Cancer

【目的】探讨68Ga-PSMA-11 PET/CT双时相前列腺癌原发病灶最大标准摄取值(SUVmax)与初诊前列腺癌患者各项临床病理特征的相关性。【方法】回顾性收集我院2017年11月至2020年9月期间初次确诊为前列腺癌的患者,共19例,年龄(69.0±7.4)岁。所有患者均行68Ga-PSMA-11 PET/CT双时相检查,检查后两周内均行前列腺癌根治术。通过阈值自动分割法,计算出前列腺癌原发病灶在标准相SUVmax1、延迟相SUVmax2、双时相SUVmax差值SUVmax3。收集所有病人的临床、病理资料。采用Mann-Whitney U检验、受试者工作特征(ROC)曲线分析SUVmax值与患者临床病理特点的关系,以P<0.05标准为差异有统计学意义。【结果】SUVmax1、SUVmax2、SUVmax3在格林森评分(GS)≤7组与GS>7组的组间差异均有统计学意义(P<0.05),ROC曲线下面积分别为0.845、0.845、0.893。SUVmax1、SUVmax2、SUVmax3在国际泌尿病理学会(International Society of Urological Pathology,ISUP)分级≤2组与ISUP>2组的组间差异均有统计学意义(P<0.05),ROC曲线下面积分别为0.773、0.784、0.852。SUVmax3在T分期≤T2组与T分期>T2组的组间差异有统计学意义(P<0.05),而SUVmax1、SUVmax2在T分期≤T2组与T分期>T2组的组间差异均没有统计学意义(P>0.05)。SUVmax3在D’Amico低中危组与高危组的组间差异有统计学意义(P<0.05),而SUVmax1、SUVmax2在D’Amico低中危组与高危组的组间差异均没有统计学意义(P>0.05)。SUVmax1、SUVmax2、SUVmax3在总PSA≤20 ng/mL组与>20 ng/mL组的组间差异均没有统计学意义(P>0.05)。SUVmax1、SUVmax2、SUVmax3在神经侵犯阳性组与阴性组的组间差异均有统计学意义(P<0.05),ROC曲线下面积分别为0.872、0.923、0.974。【结论】SUVmax2、SUVmax3与前列腺癌多项临床、病理特征呈密切正相关,与标准相比较,68Ga-PSMA-11 PET/CT双时相显像在前列腺癌术前的临床、病理特征的预测方面或许可提供更有利的价值。

【Objective】The purpose of this study was to analyze the correlation between SUVmax on primary prostate lesion of two-phase 68Ga-PSMA-11 PET/CT and the clinicopathological features of patients with preliminary diagnosis of prostate cancer.【Methods】PET/CT images of 19 patients with prostate cancer first diagnosed in our hospital from November 2017 to September 2020,aged 69.0±7.4 years,were collected.All patients underwent 68Ga-PSMA-11 PET/CT dualphase examination,and radical resection of prostate cancer was performed within two weeks.Semi-quantitative parameters of 68Ga-PSMA-11 PET/CT on primary prostate cancer,SUVmax1 in the standard phase imaging,SUVmax2 in the delayed phase imaging and SUVmax3(difference between SUVmax2 and SUVmax1),were measured by automatic segmentation algorithm method.Clinical and pathological data of each patient were collected.Mann-Whitney U test and ROC curve analysis were used to compare SUVmax and the clinicopathological characteristics of patients in two independent samples.P<0.05 was considered as statistically significant difference.【Results】The differences of SUVmax1,SUVmax2 and SUVmax3 between GS≤7 group and>7 group were statistically significant(P<0.05),and the areas under the ROC curves were 0.845,0.845 and 0.893,respectively.SUVmax1,SUVmax2 and SUVmax3 were significantly different between ISUP grade≤2 group and>2 group(P<0.05),and the areas under the ROC curve were 0.773,0.784 and 0.852,respectively.The difference of SUVmax3 between T stage≤T2 group and>T2 group was statistically significant(P<0.05),while the difference of SUVmax1 and SUVmax2 between T stage≤T2 group and>T2 group was not statistically significant(P>0.05).The difference of SUVmax3 between D’Amico low-medium-risk group and high-risk group was statistically significant(P<0.05),while the difference of SUVmax1 and SUVmax2 between D’Amico low-medium-risk group and high-risk group was not statistically significant(P>0.05).There was no significant difference in SUVmax1,SUVmax2 and SUVmax3 between total PSA≤20 ng/mL group and>20 ng/mL group(P>0.05).SUVmax1,SUVmax2 and SUVmax3 were significantly different between positive nerve invasion group and negative group(P<0.05),and the areas under the ROC curves were 0.872,0.923 and 0.974,respectively.【Conclusions】SUVmax2 and SUVmax3 were positively correlated with multiple clinical and pathological features of prostate cancer.Compared with standard phase imaging,dual-phase imaging of 68Ga-PSMA-11 PET/CT may provide more favorable value in predicting the clinical and pathological features of prostate cancer patients before surgery.