摘要
目的探索^(18)F-PSMA-1007 PET/CT成像评估前列腺癌肿瘤原发灶及浸润范围的价值。方法前瞻性收集2019年3月至2021年6月在西安交通大学第一附属医院泌尿外科因怀疑或确诊前列腺癌行^(18)F-PSMA-1007 PET/CT全身成像、检查前未行任何治疗且检查后行根治性手术并得到完整病理学结果的患者51例。使用半自动方法勾画前列腺癌灶40%SUVmax感兴趣区(ROI),得到代谢参数SUVmax、SUVmean、肿瘤代谢体积(MTV)和肿瘤负荷(TLM),同时人工判断前列腺包膜、双侧精囊腺及膀胱是否受侵及范围。分析代谢参数与术后Gleason评分及肿瘤分级、分组的相关性,采用McNemar检验分析PSMA-PET/CT对前列腺癌浸润范围评估的准确度。结果PSMAPET/CT成像参数SUVmax、SUVmean、TLM与Gleason评分无相关性,但SUVmean与肿瘤分级呈正相关(r=0.306,P=0.041)。病理结果肿瘤最大径与MTV呈中等程度相关(r=0.479,P=0.003)。使用PSMA-PET/CT评估前列腺癌原发灶及对包膜、精囊腺、膀胱侵犯的灵敏度分别为72.00%、64.71%、83.33%、25.00%,特异度分别为88.46%、33.33%、84.61%、95.74%,准确度分别为80.39%、52.94%、86.27%、90.19%。结论^(18)F-PSMA-1007 PET/CT显像对于前列腺癌肿瘤原发灶及浸润范围的评估具有较高的准确性,适合临床推广应用。
Objective To explore the value of ^(18)F-PSMA-1007 PET/CT in evaluating the primary tumor and infiltration range of prostate cancer.Methods We retrospectively collected ^(18)F-PSMA-1007 PET/CT whole body imaging data of the patients who came to the Department of Urology,The First Affiliated Hospital of Xi’an Jiaotong University,from March 2019 to June 2021 due to suspected or diagnosed prostate cancer.No treatment was give before the examination.In addition,51 patients underwent radical surgery after examination and obtained complete pathological results.We used a semi-automatic method to delineate the region of interest(ROI)of 40%SUVmax of prostate cancer foci,and obtained the metabolic parameters,namely,SUVmax,SUVmean,tumor metabolic volume(MTV)and total lesion metabolic(TLM).We also observed for infiltration of bilateral seminal vesicle glands and bladder.Correlation analysis was used to analyze the correlation of metabolic parameters with Gleason score and tumor grade grouping;McNemar test was used to analyze the accuracy of PSMA in evaluating the extent of prostate invasion.Results The PET/CT parameters SUVmax,SUVmean,TLM and Gleason score were not significantly correlated,but SUVmean was positively correlated with tumor grade(r=0.306,P=0.041).The pathological results showed a moderate correlation between the maximum diameter of the tumor and MTV(r=0.479,P=0.003).The sensitivity evaluated by PSMA-PET/CT to primary prostate tumor,capsule invasion,seminal vesicle gland invasion,and bladder invasion was 72.00%,64.71%,83.33%,and 25.00%,respectively;the specificity was 88.46%,33.33%,84.61%,and 95.74%,respectively;the accuracy was 80.39%,52.94%,86.27%,and 90.19%,respectively.Conclusion has high accuracy in assessing primary tumor and the extent of invasion of prostate cancer,which indicates its value in clinical application.
作者
沈聪
李运轩
郑安琪
董伟璇
李阳
段小艺
SHEN Cong;LI Yunxuan;ZHENG Anqi;DONG Weixuan;LI Yang;DUAN Xiaoyi(PET‒CT Center,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)
出处
《西安交通大学学报(医学版)》
CAS
CSCD
北大核心
2022年第2期179-185,共7页
Journal of Xi’an Jiaotong University(Medical Sciences)
基金
西安交通大学第一附属医院临床研究项目(No.XJTU1AF-CRF-2020-008)
西安交通大学第一附属医院新医疗新技术项目(No.XJYFY-2019J1)。