^(18)F-PSMA-1007 PET/CT与^(18)F-FDG PET/CT在脑胶质瘤分级评估中的对比研究  

Comparative study of^(18)F-PSMA-1007 PET/CT and^(18)F-FDG PET/CT in the grading assessment of gliomas

作　　者：尚宇 刘军[1] 李瑞春[1] 梁华[1] 高俊刚[1] 刘翔[1] 周明静 齐思言 牛晨[1] Shang Yu;Liu Jun;Li Ruichun;Liang Hua;Gao Jungang;Liu Xiang;Zhou Mingjing;Qi Siyan;Niu Chen(Department of PET/CT Center,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院PET/CT室,西安710061

出　　处：《中华解剖与临床杂志》2024年第1期9-14,共6页Chinese Journal of Anatomy and Clinics

基　　金：国家自然科学基金(82102014);陕西省自然科学基础研究计划(2022JQ-792);西安市创新能力强基计划(21YXYJ0110);西安交通大学第一附属医院临床研究中心课题(XJTU1AF-CRF-2017-019)

摘　　要：目的对比^(18)F-前列腺特异性膜抗原(^(18)F-PSMA)-1007正电子发射体层摄影(PET)/CT与^(18)F-脱氧葡萄糖(^(18)F-FDG)PET/CT在脑胶质瘤分级诊断中的应用价值。方法回顾性队列研究。纳入2022年8月—2023年3月西安交通大学第一附属医院脑胶质瘤患者32例,其中男16例、女16例,年龄19~79(50.3±13.2)岁。患者术前均行头颅^(18)F-PSMA-1007 PET/CT和^(18)F-FDG PET/CT检查,2次扫描间隔时间均<1周;均接受颅内占位切除术治疗,术后病理WHO分级Ⅱ级14例、Ⅲ6例、Ⅳ级12例。根据WHO分级将患者分为2组:Ⅲ~Ⅳ级18例为高级别胶质瘤(HGG)组,Ⅱ级14例为低级别胶质瘤(LGG)组。观察指标:(1)比较HGG组和LGG组在^(18)F-PSMA-1007 PET/CT和^(18)F-FDG PET/CT图像中病灶最大标准摄取值(SUVmax)、肿瘤/背景比值(TBR)的差异,统计2种不同示踪剂PET/CT显像在诊断HGG和LGG时的灵敏度、特异度和准确度。绘制受试者操作特征曲线并计算曲线下面积(AUC),评估2种示踪剂在胶质瘤分级中的诊断效能。(2)统计HGG组和LGG组中^(18)F-PSMA-1007 PET/CT和^(18)F-FDG PET/CT能够清晰显示病灶边界的病例数,比较2种显像方法在显示病灶边界清晰度上的差异。结果LGG组^(18)F-PSMA-1007 PET/CT和^(18)F-FDG PET/CT的SUVmax分别为0.69±0.32、8.87±3.20,TBR分别为1.05±0.45、0.89±0.30;HGG组^(18)F-PSMA-1007 PET/CT和^(18)F-FDG PET/CT的SUVmax分别为5.39±3.88、11.85±3.54,TBR分别为12.99±10.60、1.25±0.54。LGG组^(18)F-PSMA-1007 PET/CT和^(18)F-FDG PET/CT的SUVmax、TBR均小于HGG组,差异均有统计学意义(P值均<0.05)。^(18)F-PSMA-1007 PET/CT的SUVmax和TBR对HGG和LGG分级诊断的灵敏度、特异度、准确度和AUC均高于^(18)F-FDG PET/CT。^(18)F-PSMA-1007 PET/CT中TBR的AUC最高,为0.988(95%可信区间0.960~1.000),相应的阈值为2.15;^(18)F-FDG PET/CT TBR的AUC最低,为0.694(95%可信区间0.512~0.877),相应的阈值为0.97。^(18)F-PSMA-1007 PET/CT图像上HGG组和LGG组清晰显示病灶边界的�Objective This work aims to compare the application value of^(18)F-prostate specific membrane antigen(PSMA)-1007 positron emission tomography/computed tomography(PET/CT)and^(18)F-fluorodeoxyglucose(FDG)PET/CT in the grading of gliomas.Methods A retrospective cohort study was conducted on the data of 32 patients with gliomas who underwent head^(18)F-PSMA-1007 PET/CT and^(18)F-FDG PET/CT examinations at the PET Center of the First Affiliated Hospital of Xi'an Jiaotong University from August 2022 to March 2023.The data included 16 males and 16 females,with an age range of 19-79 years(50.3±13.2).All patients underwent intracranial mass resection surgery,and postoperative pathological grading were as follows:14 patients were classified as WHO gradeⅡ,6 patients were classified as gradeⅢ,and 12 patients were classified as gradeⅣ.According to the WHO grading,the patients were divided into two groups:18 patients with gradesⅢtoⅣwere categorized as the high-grade glioma(HGG)group,and 14 patients with gradeⅡwere categorized as the low-grade glioma(LGG)group.The observation indicators were as follows:(1)Observe the differences in the maximum standardized uptake value(SUVmax)and tumor-to-background ratio(TBR)of lesions in^(18)F-PSMA-1007 PET/CT and^(18)F-FDG PET/CT images between the HGG group and the LGG group;statistically analyze the sensitivity,specificity,and accuracy of the two different tracer PET/CT imaging methods in differentiating between HGG and LGG;and utilize the receiver operating characteristic curve and calculate the area under the curve(AUC)to assess the diagnostic performance of two tracers in the grading of gliomas.(2)Count the number of cases in which the lesion boundaries were clearly delineated by^(18)F-PSMA-1007 PET/CT and^(18)F-FDG PET/CT in the HGG group and the LGG group,and compare the differences in the clarity of lesion boundary delineation between the two imaging methods.Results In the LGG group,the SUVmax values for^(18)F-PSMA-1007 PET/CT and^(18)F-FDG PET/CT were 0.69±0.32 and 8.8

关 键 词：神经胶质瘤 正电子发射体层摄影/计算机体层成像 ^(18)F‐脱氧葡萄糖 前列腺特异性膜抗原 

分 类 号：R739.4[医药卫生—肿瘤] R730.44[医药卫生—临床医学]