^11C-胆碱PET／MRSUVmax／ADCmin比值诊断前列腺癌的价值  

Diagnostic value of SUVmax/ADCmin obtained by u C-choline PET/MR in patients with prostate cancer

作　　者：刘亚超[1] 许勇[2] 刘爱军[3] 刘家金[1] 李灿[1] 李云钢[1] 高江平[2] 张旭[2] 田嘉禾[1] 徐白萱[1] 

机构地区：[1]解放军总医院核医学科,北京100853 [2]解放军总医院泌尿外科,北京100853 [3]解放军总医院病理科,北京100853

出　　处：《中华核医学与分子影像杂志》2016年第1期30-33,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的探讨^11C-胆碱PET／MR一体机SUVmax／ADCmin比值在前列腺良恶性病变鉴别诊断中的作用。方法收集分析2014年4月至2015年1月于解放军总医院接受经会阴前列腺系统性穿刺活组织病理检查（简称活检）前行PET／MR显像的可疑前列腺癌患者资料。将前列腺分为5区，测量各区组织SUVmax及ADCmin，并计算其比值（SUVmax／ADCmin）；以各区穿刺活检诊断为“金标准”，将病变区分为前列腺癌（恶性病变）区和非前列腺癌（良性病变）区。采用Pearson相关分析和两样本t检验分析数据。结果经穿刺活检证实，纳入的15例患者（75区）中，前列腺癌9例（恶性病变区25个，良性病变区20个），前列腺良性病变6例（良性病变区30个）。前列腺良恶性病变区SUVmax与ADCmin呈负相关（r=-0．521，P〈0．05）。前列腺良性与恶性病变区SUVmax／ADCmin。分别为5．67±3．03与13．76±7．13，差异有统计学意义（t=6．9，P〈0．01）。ADCmain、SUVmax及SUVmax／ADCmin的ROCAUC分别为0．880、0．809和0．898。以SUVmax／ADCmin〉7．78为标准，^11C-胆碱PET／MR显像诊断前列腺恶性病变区的灵敏度为84．0％（21／25），特异性为86．0％（43／50），准确性为85．3％（64／75）。结论^11C-胆碱PET／MR可用于前列腺检查；SUVmax／ADCmin可作为有效的PET／MR融合后诊断指标鉴别前列腺良恶性病变。Objective To evaluate the value of SUVmax/ADCmin obtained by ^11C-choline PET/MR imaging in the differential diagnosis of benign and malignant prostate disease. Methods Suspicious prostate cancer patients who underwent PET/MR before transperineal prostate biopsy in People＇s Liberation Army General Hospital from April 2014 to January 2015 were observed. Prostate gland was divided into five dis- tricts. A ROI with the diameter of 1 cm was drawn at the highest radioactivity concentration and/or lowest ADC signal area in each district, and SUVmax, ADCmin and SUVmax/ADCmin were then calculated. Taking the pathological results as the gold standard, malignant and benign prostate disease districts were separated. Pearson correlation analysis and two-sample t test were used for statistical analysis. Results Biopsy pathology showed 9 cases were malignant （25 prostate cancer districts, and 20 benign prostate disease districts）, and 6 cases were benign （30 benign prostate disease districts）. The SUVm= had a negative correlation with ADCmin（r=-0.521, P〈0. 05）. The SUVmax/ADCmin of benign and malignant districts was significantly dif- ferent（5.67±3.03 and 13.76±7.13; t=6.9, P〈0.01）. The ROC AUC for ADCmin, SUVmax and SUVmax/ ADCmin were 0. 880, 0. 809 and 0.898. Using SUVmax/ADCmin of 7.78 as a cutoff, the sensitivity, specificity and accuracy of n C-choline PET/MR imaging for differentiating the benign and malignant prostate lesions were 84.0%（21/25）, 86.0%（43/50） and 85.3%（64/75）, respectively. Conclusions Simultaneous HC- choline PET/MR could be used for detecting prostate cancer. SUWmax/mDCmin may serve as an effective diagnostic indicator for differentiating benign and malignant prostate lesions.

关 键 词：前列腺肿瘤 体层摄影术 发射型计算机 磁共振成像 胆碱 碳放射性同位素 

分 类 号：R737.25[医药卫生—肿瘤] R730.44[医药卫生—临床医学] R445.2