改良的^(18)F-PSMA-1007 PET-CT评分与mpMRI PI-RADS评分诊断前列腺癌的效果比较  

Effect comparison between improved ^(18)F-PSMA-1007 PET-CT score and mpMRI PI-RADS score for diagnosis of prostate cancer

作　　者：保兰兰 赵铭[1] 田蓉蓉[1] 张茜[1] 赵彤 史凤琴 Bao Lanlan;Zhao Ming;Tian Rongrong;Zhang Xi;Zhao Tong;Shi Fengqin(Nuclear Medicine PET/CT Center,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院,中国医学科学院肿瘤医院山西医院,山西医科大学附属肿瘤医院核医学PET/CT中心,太原030013

出　　处：《肿瘤研究与临床》2024年第9期670-677,共8页Cancer Research and Clinic

基　　金：山西省重点研发计划(201903D321187);国家肿瘤区域医疗中心科教培育基金(SD2023023);山西省科技合作交流专项(202304041101006)。

摘　　要：目的探讨改良的^(18)F-前列腺特异性膜抗原(PSMA)-1007 PET-CT评分(简称:PSMA评分)和多参数磁共振成像(mpMRI)的前列腺影像报告和数据系统(PI-RADS)2.1评分(简称:PI-RADS评分)对原发性前列腺癌(PCa)的诊断价值。方法回顾性病例系列研究。收集2018年7月至2023年5月山西省肿瘤医院134例可疑PCa的接受^(18)F-PSMA-1007 PET-CT检查和盆腔mpMRI检查患者影像图像及临床资料。病理诊断PCa 92例,前列腺良性病变42例,比较两组临床和影像学参数及两评分患者分布。分别依据改良的PSMA评分(将1分分为1a分和1b分,1b、2、3分诊断为PCa)、PI-RADS评分(3、4、5分诊断为PCa)、两者联合(符合PSMA评分≥1b分、PI-RADS评分≥4分中任意一项时诊断为PCa)盲法诊断前列腺病变良恶性。计算PSMA评分、PI-RADS评分和两者联合对PCa诊断效能的指标。以病理结果为金标准,分别绘制依据PSMA评分、PI-RADS评分及两者联合诊断PCa的受试者工作特征(ROC)曲线,分析三种方法诊断效能。结果PCa组患者年龄、血清前列腺特异抗原、PET-CT最大标准摄取值均高于前列腺良性病变组,差异均有统计学意义(均P<0.05)。PSMA评分诊断PCa的灵敏度、特异度、准确度、假阴性率、假阳性率、阳性预测值、阴性预测值分别为91.30%(84/92)、80.95%(34/42)、88.06%(118/134)、8.70%(8/92)、19.05%(8/42)、91.30%(84/92)、80.95%(34/42),PI-RADS评分分别为93.48%(86/92)、61.90%(26/42)、83.58%(112/134)、61.90%(26/42)、38.10%(16/42)、84.31%(86/102)、81.25%(26/32),两者联合分别为97.83%(90/92)、88.10%(37/42)、94.78%(127/134)、2.17%(2/92)、11.90%(5/42)、94.74%(90/95)、94.87%(37/39),三种方法间特异度、准确度、假阴性率、假阳性率差异均有统计学意义(均P<0.05)。ROC曲线分析显示,PSMA评分、PI-RADS评分、两者联合诊断PCa的曲线下面积分别为0.930(95%CI:0.872~0.967)、0.935(95%CI:0.826~0.939)、0.959(95%CI:0.910~0.986),两两比较差异均有统计�ObjectiveTo explore the diagnostic value of improved ^(18)F-prostate specific membrane antigen(PSMA)-1007 PET-CT score(referred to as PSMA score)and multi parameter magnetic resonance imaging(mpMRI)prostate imaging reporting and data system(PI-RADS)score(referred to as PI-RADS score)for primary prostate cancer(PCa).MethodsA retrospective case series study was conducted.The imaging and clinical data of 134 suspected PCa patients underwent ^(18)F-PSMA-1007 PET-CT and mpMRI examinations at Shanxi Province Cancer Hospital from July 2018 to May 2023 were collected.Pathological diagnosis showed 92 cases of PCa and 42 cases of benign prostatic lesions.The clinical and imaging parameters,as well as the distribution of patients with two scores,were compared between the two groups.The blind diagnosis of benign and malignant lesions was made based on the improved PSMA score(dividing 1 point into 1a and 1b points,1b,2 and 3 points were diagnosed as PCa),PI-RADS score(3,4 and 5 points were diagnosed as PCa)and the combination of the two(diagnosed as PCa when either PSMA score≥1b point or PI-RADS score≥4 points was met).The indicators of the diagnostic efficiency of PSMA score,PI-RADS score and the combination of the two for PCa were calculated.Using pathological results as the gold standard,the receiver operating characteristic(ROC)curve of PSMA score,PI-RADS score and the combination of the two for diagnosing PCa was drawn,and the diagnostic efficiency of the 3 methods was analyzed.ResultsThe age,serum prostate-specific antigen,and maximum standard uptake value of PET-CT in the PCa group were higher than those in the benign prostatic lesion group,and the differences were statistically significant(all P<0.05).The sensitivity,specificity,accuracy,false negative rate,false positive rate,positive predictive value,and negative predictive value of PSMA score for diagnosing PCa were 91.30%(84/92),80.95%(34/42),88.06%(118/134),8.70%(8/92),19.05%(8/42),91.30%(84/92),and 80.95%(34/42),respectively;those of PI-RADS score were 93.48

关 键 词：前列腺肿瘤 前列腺特异抗原 正电子发射断层显像术 体层摄影术 X线计算机 磁共振成像 诊断 

分 类 号：R737.25[医药卫生—肿瘤]