^(68)Ga-PSMA-11 PET/CT显像应用miPSMA评分诊断前列腺癌的价值  

^(68)Ga-PSMA-11 PET/CT Imaging in the Diagnosis of Prostate Cancer with miPSMA Score

作　　者：刘亚超[1] 程诺 李云钢[1] 袁露露 高江平[2] 徐白萱[1] LIU Yachao;CHENG Nuo;LI Yungang;YUAN Lulu;GAO Jiangping;XU Baixuan(Department of Nuclear Medicine,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;不详)

机构地区：[1]解放军总医院第一医学中心核医学科,北京100853 [2]解放军总医院第一医学中心泌尿外科,北京100853

出　　处：《中国医学影像学杂志》2021年第1期47-50,55,共5页Chinese Journal of Medical Imaging

基　　金：国家自然科学基金(81571715);解放军总医院转化医学项目(2018TM-07);解放军总医院科技创新苗圃基金(17KMM36)。

摘　　要：目的探讨分子成像前列腺特异性膜抗原(miPSMA)评分对前列腺癌的诊断效能,以及前列腺癌灶的最大标准摄取值(SUVmax)是否可预测D'Amico危险度等级。资料与方法回顾性分析38例可疑前列腺癌患者的68Ga-PSMA-11 PET/CT影像及临床资料,将miPSMA≥2分诊断为前列腺癌,最终以穿刺活检病理诊断为“金标准”,计算miPSMA评分对前列腺癌的诊断效能。根据D'Amico风险组分层将前列腺癌患者分为高危组和中低危组,比较两组前列腺癌灶的SUVmax差异。结果38例患者中,前列腺癌32例,良性前列腺增生6例;miPSMA评分诊断前列腺癌的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为90.63%(29/32)、66.67%(4/6)、86.84%(33/38)、93.55%(29/31)和57.14%(4/7)。高危组21例和中低危组11例前列腺癌患者的SUVmax分别为24.99±28.18和11.29±10.66,差异无统计学意义(P=0.133)。结论miPSMA评分诊断前列腺癌具有较高的敏感度、准确度及阳性预测值,但特异度及阴性预测值较差;单独依据SUVmax无法预测前列腺癌的D'Amico危险度等级。Purpose To investigate the diagnostic efficacy of molecular imaging prostate-specific membrane antigen(miPSMA)score in prostate cancer,and to analyze whether maximum standard uptake value(SUVmax)of prostate cancer lesion can predict D'Amico risk grade.Materials and Methods 68Ga-PSMA-11 PET/CT images and clinical data of 38 patients with suspected prostate cancer were analyzed retrospectively.Prostate cancer was diagnosed with miPSMA≥2.Finally,the diagnostic efficacy of miPSMA score in prostate cancer was evaluated according to the pathological diagnosis of prostate biopsy.All patients were divided into high-risk group and middleand low-risk group according to D'Amico risk,and the difference in SUVmax of two groups of prostate cancer lesions was compared.Results For 38 patients,32 cases were prostate cancer and 6 cases were benign prostatic hyperplasia.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of miPSMA in the diagnosis of prostate cancer were 90.63%(29/32),66.67%(4/6),86.84%(33/38),93.55%(29/31)and 57.14%(4/7),respectively.The average SUVmax of prostate cancer patients in D'Amico high-risk group and middle-and low-risk group were 24.99±28.18 and 11.29±10.66,respectively;no significant difference was observed between the two groups(P=0.133).Conclusion miPSMA score has a high sensitivity,accuracy and positive predictive value in the diagnosis of prostate cancer,but the specificity and negative predictive value are poor.SUVmax alone can not predict the D'Amico risk grade of prostate cancer.

关 键 词：前列腺肿瘤 正电子发射断层显像术 体层摄影术 X线计算机 镓放射性同位素 肿瘤标记 生物学 miPSMA评分 D'Amico危险度 诊断 鉴别 病理学 外科 

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