王一宁; 陈若华; 陈虞梅; 刘建军

doi:10.3760/cma.j.cn321828-20200201-00032

点赞 0
分享 0
收藏 0
纠错

• 临床研究 •

⁶⁸Ga－PSMA－11 PET/CT与¹⁸F－FDG PET/CT诊断前列腺癌生化复发的对比研究

中华核医学与分子影像杂志, 2020,40(8) : 470-474. DOI: 10.3760/cma.j.cn321828-20200201-00032

摘要

目的

比较⁶⁸Ga－前列腺特异膜抗原(PSMA)－11 PET/CT与¹⁸F－脱氧葡萄糖(FDG)PET/CT对前列腺癌根治术术后生化复发患者的诊断效能。

方法

回顾性纳入2018年6月至2019年8月间上海交通大学医学院附属仁济医院82例[年龄(76.7±7.1)岁]前列腺癌根治术后、临床诊断生化复发的患者(均于2周内行⁶⁸Ga－PSMA－11 PET/CT与¹⁸F－FDG PET/CT检查)。对比⁶⁸Ga－PSMA－11 PET/CT与¹⁸F－FDG PET/CT的诊断效能，另比较当血清总前列腺特异抗原(tPSA)≤0.5 μg/L、0.5 μg/L<tPSA≤1.0 μg/L、1.0 μg/L<tPSA≤2.0 μg/L、2.0 μg/L<tPSA≤4.0 μg/L、4.0 μg/L<tPSA≤10.0 μg/L和tPSA>10.0 μg/L时两者对生化复发的检出率。采用logistic回归分析影响⁶⁸Ga－PSMA－11 PET/CT检出率的因素。

结果

⁶⁸Ga－PSMA－11 PET/CT与¹⁸F－FDG PET/CT共检出57例患者中98处区域病灶。随访2～12个月，50例前列腺癌复发或转移(病灶81处)。⁶⁸Ga－PSMA－11 PET/CT对复发或转移的检出率为68.29%(56/82)，灵敏度为96.00%(48/50)，阳性预测值为85.71%(48/56)；¹⁸F－FDG PET/CT的相应数据分别为36.59%(30/82)、52.00%(26/50)、86.67%(26/30)；两者检出率差异有统计学意义(χ²＝19.756，P<0.05)。不同tPSA水平下，⁶⁸Ga－PSMA PET/CT对生化复发患者的检出率高于¹⁸F－FDG PET/CT，尤其是0.5 μg/L<tPSA≤1.0 μg/L时(10/18与2/18)。⁶⁸Ga－PSMA PET/CT的检出率与血清tPSA水平[比值比(OR)＝1.319，95% CI：1.088～1.598]、患者年龄(OR＝1.141，95% CI：1.051～1.238)、术前分期(OR＝1.357, 95% CI：1.052～2.439)、术后治疗方法(OR＝1.134, 95% CI：1.020～1.917)有关(均P<0.05)。

结论

⁶⁸Ga－PSMA PET/CT检测前列腺癌根治术术后生化复发较¹⁸F－FDG PET/CT更有优势。

引用本文: 王一宁, 陈若华, 陈虞梅, 等. ⁶⁸Ga－PSMA－11 PET/CT与¹⁸F－FDG PET/CT诊断前列腺癌生化复发的对比研究 [J] . 中华核医学与分子影像杂志, 2020, 40(8) : 470-474. DOI: 10.3760/cma.j.cn321828-20200201-00032.

参考文献导出: Endnote NoteExpress RefWorks NoteFirst 医学文献王

扫描看全文

正文

作者信息

基金 0 关键词 0

English Abstract

阅读 0 评论 0

相关资源

引用 | 论文 | 视频

版权归中华医学会所有。

未经授权，不得转载、摘编本刊文章，不得使用本刊的版式设计。

除非特别声明，本刊刊出的所有文章不代表中华医学会和本刊编委会的观点。

前列腺癌是最常见的恶性肿瘤之一，发病率位居全球男性恶性肿瘤第2位^[1]。近年来，我国前列腺癌的发病率呈持续增长趋势，据2019年1月国家癌症中心发布的数据，前列腺癌的发病率居我国男性癌症发病率的第6位^[2]。前列腺癌患者中，约有30%～40%在初始治疗后发生复发或转移^[3]。尽早进行准确的再分期、根据肿瘤累及部位和范围选择不同的补救治疗方案至关重要。PET/CT在前列腺癌根治术术后生化复发患者的诊疗过程中的价值已逐渐得到认可，目前应用较为广泛的是¹⁸F－脱氧葡萄糖(fluorodeoxyglucose, FDG)PET/CT显像。但当血清总前列腺特异抗原(total prostate specific antigen, tPSA)水平较低，尤其tPSA水平≤2 μg/L时，¹⁸F－FDG PET/CT检测前列腺癌复发转移的灵敏度和特异性均较低^[4]。⁶⁸Ga－前列腺特异膜抗原(prostate specific membrane antigen, PSMA)是前列腺癌放射性标志物之一，已成为近年来的研究热点。目前，我国尚未广泛开展⁶⁸Ga－PSMA－11 PET/CT检查，大多数医疗机构仍以¹⁸F－FDG PET/CT检查为主。本研究比较了⁶⁸Ga－PSMA－11 PET/CT与¹⁸F－FDG PET/CT对前列腺癌根治术术后生化复发患者的诊断价值。

贡献者信息

王一宁

上海交通大学医学院附属仁济医院核医学科　200127

陈若华

上海交通大学医学院附属仁济医院核医学科　200127

陈虞梅

上海交通大学医学院附属仁济医院核医学科　200127

刘建军

上海交通大学医学院附属仁济医院核医学科　200127

通信作者

刘建军

上海交通大学医学院附属仁济医院核医学科　200127

Email：nuclearj@163.com

关键词

前列腺肿瘤; 复发; 前列腺特异膜抗原; 镓放射性同位素; 正电子发射断层显像术; 体层摄影术，X线计算机; 脱氧葡萄糖;

利益冲突

所有作者均声明不存在利益冲突

历史

出版日期：2020-08-25

收稿日期：2020-02-01

Clinical Investigation

Comparison of ⁶⁸Ga-PSMA PET/CT and ¹⁸F-FDG PET/CT in the diagnosis of biochemical recurrence of prostate cancer

Wang Yining, Chen Ruohua, Chen Yumei, Liu Jianjun

Published 2020-08-25

Cite as Chin J Nucl Med Mol Imaging, 2020, 40(8): 470-474. DOI: 10.3760/cma.j.cn321828-20200201-00032

Abstract

Objective

To compare the diagnostic efficacy of ⁶⁸Ga-prostate specific membrane antigen (PSMA)-11 PET/CT and ¹⁸F-flurodeoxyglucose (FDG) PET/CT in patients with prostate cancer biochemical recurrence after radical prostatectomy.

Methods

A total of 82 patients ((76.7±7.1) years) with clinical diagnosis of biochemical recurrence after radical prostatectomy from June 2018 to August 2019 in Renji Hospital, School of Medicine, Shanghai Jiao Tong University were included. All patients underwent ⁶⁸Ga-PSMA-11 PET/CT and ¹⁸F-FDG PET/CT within 2 weeks. The diagnostic efficacy of 2 methods were compared, and the detection rates were also compared among patients with different total prostate specific antigen (tPSA) levels (tPSA≤0.5 μg/L, 0.5 μg/L<tPSA≤1.0 μg/L, 1.0 μg/L<tPSA≤2.0 μg/L, 2.0 μg/L<tPSA≤4.0 μg/L, 4.0 μg/L<tPSA≤10.0 μg/L, tPSA>10.0 μg/L). Logistic regression analysis was applied to analyze the factors affecting the detection rate of ⁶⁸Ga-PSMA-11 PET/CT.

Results

A total of 57 patients (98 regional lesions) were detected by ⁶⁸Ga-PSMA-11 PET/CT and/or ¹⁸F-FDG PET/CT. Patients were followed up for 2-12 months, and 50 patients (81 lesions) were found to have recurrence or metastasis of prostate cancer. The patient-related detection rate, sensitivity and positive predictive value of ⁶⁸Ga-PSMA-11 PET/CT and ¹⁸F-FDG PET/CT were 68.29%(56/82) vs 36.59%(30/82), 96.00%(48/50) vs 52.00%(26/50), 85.71%(48/56) vs 86.67%(26/30); the detection rates were significantly different (χ²=19.756, P<0.05). The patient-related detection rates of⁶⁸Ga-PSMA PET/CT were higher than those of ¹⁸F-FDG PET/CT under different tPSA levels, especially when 0.5 μg/L<tPSA≤1.0 μg/L (10/18 vs 2/18). The detection rate of ⁶⁸Ga-PSMA PET/CT was significantly correlated with tPSA level (odds ratio(OR)=1.319, 95% CI: 1.088-1.598), age (OR=1.141, 95% CI: 1.051-1.238), preoperative staging (OR=1.357, 95% CI: 1.052-2.439), and postoperative treatment (OR=1.134, 95% CI: 1.020-1.917) (all P<0.05).

Conclusion

⁶⁸Ga-PSMA PET/CT has better detection advantages than ¹⁸F-FDG PET/CT in diagnosing biochemical recurrence after radical prostatectomy.

Key words:

Prostatic neoplasms; Recurrence; Prostate-specific membrane antigen; Gallium radioisotopes; Positron-emission tomography; Tomography, X-ray computed; Deoxyglucose

Contributor Information

Wang Yining

Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China

Chen Ruohua

Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China

Chen Yumei

Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China

Liu Jianjun

Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China

共有条评论

验证码

本文被引情况 CSCD: 0次万方数据： 0次 Scopus: 0次

施引文献(最多仅列5条文献，进入CSCD官网发现更多)

未获取施引文献信息...

暂无相关资源