<strong>METHOD:</strong> We carry out an observational study where reviewed the PET/CT studies with PSMA marked with Fluor-18 (<sup>18</sup>F) carried out from February 2019 to September 2020. ...<strong>METHOD:</strong> We carry out an observational study where reviewed the PET/CT studies with PSMA marked with Fluor-18 (<sup>18</sup>F) carried out from February 2019 to September 2020. We analyzed the average value of hepatic uptake SUV lean average (SUVlave), acquisition time, age, reason from the study, focal, multifocal and diffuse prostate uptake, analysis of the location of metastases, level of prostate specific antigen (PSA), we describe uptakes of non-prostate origin and focal uptakes in ribs without anatomical representation. <strong>RESULTS:</strong> The average hepatic SUVlave was 9.7, the acquisition times were variable (52 - 183 minutes) without alterations in the white-background relationship, the most frequent indication for the study was staging, the uptake in ribs without anatomical representation were considered benign with certain characteristics, PET/CT has the ability to detect neoplastic activity with low PSA levels in lymph nodes < 5 mm and bone metastatic status. <strong>CONCLUSION:</strong> PET/CT with <sup>18</sup>F-PSMA has advantages over bone scan and computed tomography of the abdomen and pelvis for the staging of prostate cancer.展开更多
This paper presents a meta-analysis regarding the detection rate(DR)of fluorine-18(^(18)F)-labeled prostate-specific membrane antigen positron emission tomography/computed tomography(PSMA PET/CT)in the management of p...This paper presents a meta-analysis regarding the detection rate(DR)of fluorine-18(^(18)F)-labeled prostate-specific membrane antigen positron emission tomography/computed tomography(PSMA PET/CT)in the management of patients with prostate cancer(PCa).Relevant studies regarding ^(18)F-PSMA PET/CT in the management of PCa published until June 1,2021,were electronically searched in online databases including EMBASE,PubMed,and Web of Science.The primary outcome was the DR of ^(18)F-PSMA PET/CT in managing PCa patients,while the secondary outcome was the DR of ^(18)F-PSMA PET/CT according to Gleason scores and serum prostate-specific antigen(PSA)level.The pooled DR was calculated on a per-patient basis,with pooled odd ratios and 95%confidence intervals(CIs).In total,17 observational studies evaluating 1019 patients with PCa met the inclusion criteria.The DR of ^(18)F-PSMA PET/CT was 0.83(95%CI:0.78-0.88),in the random-effects model.Subsequently,the analysis of DR of ^(18)F-PSMA PET/CT in PCa patients using Gleason score(≤7 vs≥8),showed a significant difference in PCa patients.Based on the above results,the higher Gleason score of PCa patients,the higher DR of ^(18)F-PSMA PET/CT.The DR of ^(18)F-PSMA PET/CT in PCa was 0.57 for PSA<0.5 ng ml^(-1);0.75 for PSA≥0.5 ng ml^(-1) and<1.0 ng ml^(-1);0.93 for PSA≥1.0 ng ml^(-1) and<2.0 ng ml^(-1);and 0.95 for PSA≥2.0 ng ml^(-1).Therefore,the significant diagnostic value was found in terms of the DR of ^(18)F-PSMA PET/CT in managing PCa patients and was associated with Gleason score and serum PSA level.展开更多
Background:Lymph node staging of prostate cancer(PCa)is important for planning and monitoring of treatment.^(18)F-prostate specific membrane antigen positron emission tomography/computerized tomography(^(18)F-PSMA PET...Background:Lymph node staging of prostate cancer(PCa)is important for planning and monitoring of treatment.^(18)F-prostate specific membrane antigen positron emission tomography/computerized tomography(^(18)F-PSMA PET/CT)has several advantages over^(68)Ga-PSMA PET/CT,but its diagnostic value requires further investigation.This meta-analysis focused on establishing the diagnostic utility of^(18)F-PSMA PET/CT for lymph node staging in medium/high-risk PCa.Methods:We searched the EMBASE,PubMed,Cochrane library,and Web of Science databases from inception to October 1,2022.Prostate cancer,^(18)F,lymph node,PSMA,and PET/CT were used as search terms and the language was limited to English.We additionally performed a manual search using the reference lists of key articles.Patients and study characteristics were extracted and the QUADAS-2 tool was employed to evaluate the quality of included studies.Sensitivity,specificity,the positive and negative likelihood ratio(PLR and NLR),diagnostic odds ratio(DOR),area under the curve(AUC),and 95%confidence interval(CI)were used to evaluate the diagnostic value of^(18)F-PSMA PET/CT.Stata 17 software was employed for calculation and statistical analyses.Results:A total of eight diagnostic tests including 734 individual samples and 6346 lymph nodes were included in this meta-analysis.At the patient level,the results of each consolidated summary were as follows:sensitivity of 0.57(95%CI 0.39-0.73),specificity of 0.95(95%CI 0.92-0.97),PLR of 11.2(95%CI 6.6-19.0),NLR of 0.46(95%CI 0.31-0.68),DOR of 25(95%CI 11-54),and AUC of 0.94(95%CI 0.92-0.96).At the lesion level,the results of each consolidated summary were as follows:sensitivity of 0.40(95%CI 0.21-0.62),specificity of 0.99(95%CI 0.95-1.00),PLR of 40.0(95%CI 9.1-176.3),NLR of 0.61(95%CI 0.42-0.87),DOR of 66(95%CI 14-311),and AUC of 0.86(95%CI 0.83-0.89).Conclusions:^(18)F-PSMA PET/CT showed moderate sensitivity but high specificity in lymph node staging of medium/high-risk PCa.The diagnostic efficacy was almost equivalent to that reported for^(68)Ga-PSMA PET/CT.Registration:International Prospective Register of Systematic Reviews(PROSPERO),No.CRD42023391101.展开更多
文摘目的探讨^(18)F-PSMA PET/CT最大标准化摄取值(SUV max)在前列腺癌(PCa)与增生病变的鉴别诊断,以及在PCa预后预测中的价值。方法回顾性收集经病理证实、未经治疗的PCa同时伴有腺体增生的患者59例,治疗前行^(18)F-PSMA PET/CT全身显像,其中PCa灶86个,前列腺增生灶35个。比较良恶性病灶SUV max组间差异,绘制受试者工作特性曲线(ROC),获得cut-off值。进一步根据Gleason评分对PCa灶进行分组(≤6分为低危组,=7分为中危组,≥8为高危组),比较组间SUV max并进行事后检验分析,同时对癌灶SUV max与Gleason评分、前列腺特异性抗原(PSA)水平进行相关性分析。结果PCa灶的SUV max显著高于增生灶,两组间差异具有显著统计学意义(F=27.659,P<0.001),以SUV max 8.85作为cut-off值,ROC曲线下面积为0.843,诊断PCa的敏感性和特异性分别为69.77%和91.43%。PCa低、中、高危组SUV max差异无统计学意义(F=1.857,P=0.163),事后检验两两组间均未见统计学差异(P=0.744,P=0.191,P=0.075)。此外,PCa灶SUV max与Gleason评分、PSA之间差异均无统计学意义(P=0.248,P=0.101,P=0.064)。结论初步研究显示,^(18)F-PSMA PET/CT SUV max对前列腺病变良恶性鉴别具有较高价值,以SUV max 8.85作为cut-off值可获得较为理想的诊断效能。对于PCa分级及预后预测,^(18)F-PSMA PET/CT SUV max价值有限。
文摘<strong>METHOD:</strong> We carry out an observational study where reviewed the PET/CT studies with PSMA marked with Fluor-18 (<sup>18</sup>F) carried out from February 2019 to September 2020. We analyzed the average value of hepatic uptake SUV lean average (SUVlave), acquisition time, age, reason from the study, focal, multifocal and diffuse prostate uptake, analysis of the location of metastases, level of prostate specific antigen (PSA), we describe uptakes of non-prostate origin and focal uptakes in ribs without anatomical representation. <strong>RESULTS:</strong> The average hepatic SUVlave was 9.7, the acquisition times were variable (52 - 183 minutes) without alterations in the white-background relationship, the most frequent indication for the study was staging, the uptake in ribs without anatomical representation were considered benign with certain characteristics, PET/CT has the ability to detect neoplastic activity with low PSA levels in lymph nodes < 5 mm and bone metastatic status. <strong>CONCLUSION:</strong> PET/CT with <sup>18</sup>F-PSMA has advantages over bone scan and computed tomography of the abdomen and pelvis for the staging of prostate cancer.
基金supported by grants from Nanjing Medical Science and Technology Development Foundation(YKK16138)Jiangsu Provincial Medical Youth Talent(QNRC2016072)Science and Technology Development Fund of Nanjing Medical University(NMUB2018317).
文摘This paper presents a meta-analysis regarding the detection rate(DR)of fluorine-18(^(18)F)-labeled prostate-specific membrane antigen positron emission tomography/computed tomography(PSMA PET/CT)in the management of patients with prostate cancer(PCa).Relevant studies regarding ^(18)F-PSMA PET/CT in the management of PCa published until June 1,2021,were electronically searched in online databases including EMBASE,PubMed,and Web of Science.The primary outcome was the DR of ^(18)F-PSMA PET/CT in managing PCa patients,while the secondary outcome was the DR of ^(18)F-PSMA PET/CT according to Gleason scores and serum prostate-specific antigen(PSA)level.The pooled DR was calculated on a per-patient basis,with pooled odd ratios and 95%confidence intervals(CIs).In total,17 observational studies evaluating 1019 patients with PCa met the inclusion criteria.The DR of ^(18)F-PSMA PET/CT was 0.83(95%CI:0.78-0.88),in the random-effects model.Subsequently,the analysis of DR of ^(18)F-PSMA PET/CT in PCa patients using Gleason score(≤7 vs≥8),showed a significant difference in PCa patients.Based on the above results,the higher Gleason score of PCa patients,the higher DR of ^(18)F-PSMA PET/CT.The DR of ^(18)F-PSMA PET/CT in PCa was 0.57 for PSA<0.5 ng ml^(-1);0.75 for PSA≥0.5 ng ml^(-1) and<1.0 ng ml^(-1);0.93 for PSA≥1.0 ng ml^(-1) and<2.0 ng ml^(-1);and 0.95 for PSA≥2.0 ng ml^(-1).Therefore,the significant diagnostic value was found in terms of the DR of ^(18)F-PSMA PET/CT in managing PCa patients and was associated with Gleason score and serum PSA level.
基金National High Level Hospital Clinical Research Funding(Nos.BJ-2022-115,BJ-2022-098,BJ-2020-171,BJ-2022-158,and BJ-2022-143)
文摘Background:Lymph node staging of prostate cancer(PCa)is important for planning and monitoring of treatment.^(18)F-prostate specific membrane antigen positron emission tomography/computerized tomography(^(18)F-PSMA PET/CT)has several advantages over^(68)Ga-PSMA PET/CT,but its diagnostic value requires further investigation.This meta-analysis focused on establishing the diagnostic utility of^(18)F-PSMA PET/CT for lymph node staging in medium/high-risk PCa.Methods:We searched the EMBASE,PubMed,Cochrane library,and Web of Science databases from inception to October 1,2022.Prostate cancer,^(18)F,lymph node,PSMA,and PET/CT were used as search terms and the language was limited to English.We additionally performed a manual search using the reference lists of key articles.Patients and study characteristics were extracted and the QUADAS-2 tool was employed to evaluate the quality of included studies.Sensitivity,specificity,the positive and negative likelihood ratio(PLR and NLR),diagnostic odds ratio(DOR),area under the curve(AUC),and 95%confidence interval(CI)were used to evaluate the diagnostic value of^(18)F-PSMA PET/CT.Stata 17 software was employed for calculation and statistical analyses.Results:A total of eight diagnostic tests including 734 individual samples and 6346 lymph nodes were included in this meta-analysis.At the patient level,the results of each consolidated summary were as follows:sensitivity of 0.57(95%CI 0.39-0.73),specificity of 0.95(95%CI 0.92-0.97),PLR of 11.2(95%CI 6.6-19.0),NLR of 0.46(95%CI 0.31-0.68),DOR of 25(95%CI 11-54),and AUC of 0.94(95%CI 0.92-0.96).At the lesion level,the results of each consolidated summary were as follows:sensitivity of 0.40(95%CI 0.21-0.62),specificity of 0.99(95%CI 0.95-1.00),PLR of 40.0(95%CI 9.1-176.3),NLR of 0.61(95%CI 0.42-0.87),DOR of 66(95%CI 14-311),and AUC of 0.86(95%CI 0.83-0.89).Conclusions:^(18)F-PSMA PET/CT showed moderate sensitivity but high specificity in lymph node staging of medium/high-risk PCa.The diagnostic efficacy was almost equivalent to that reported for^(68)Ga-PSMA PET/CT.Registration:International Prospective Register of Systematic Reviews(PROSPERO),No.CRD42023391101.
