磁共振PI-RADS评分联合^(18)F-PSMA PET/CT对前列腺癌的诊断效能研究  

Performance of PI-RADS of MRI combined with^(18)F-PSMA PET/CT in diagnosis of prostate cancer

作　　者：胡兴和[1] 李晶[1] 刘新球[1] 王新江[1] 陈穗惠[1] 刘家金[2] 徐贤[1] HU Xinghe;LI Jing;LIU Xinqiu;WANG Xinjiang;CHEN Suihui;LIU Jiajin;XU Xian(Department of Radiology,the Second Medical Center&National Clinical Research Center for Geriatric Diseases,Chinese PLA General Hospital,Beijing 100853,China;Department of Nuclear Medicine,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第二医学中心放射诊断科,国家老年疾病临床医学研究中心,北京100853 [2]解放军总医院第一医学中心核医学科,北京100853

出　　处：《解放军医学院学报》2024年第11期1120-1125,共6页Academic Journal of Chinese PLA Medical School

摘　　要：背景老年男性恶性肿瘤中,前列腺癌的发病率已位居第2位,其早期筛查有重要临床意义。目的探索前列腺影像报告和数据系统(Prostate Imaging Reporting and Data System,PI-RADS)评分联合^(18)F-PSMA PET/CT评分对前列腺癌的诊断价值。方法回顾性分析2019年1月—2022年11月在解放军总医院行前列腺穿刺活检或手术的124例患者的前列腺磁共振检查(magnetic resonance imaging,MRI)及^(18)F-PSMA PET/CT影像资料,2名影像医师和2名核医学科医师分别对MRI图像和PET/CT图像进行PI-RADS评分和分子成像前列腺特异性膜抗原(molecular imaging prostate specific membrane antigen,miPSMA)评分。以病理结果为金标准,分别以PI-RADS≥3分、miPSMA≥2分以及PI-RADS≥3分联合miPSMA≥2分作为前列腺癌的不同诊断模型,评估各模型的诊断效能。结果124例受试者平均年龄(77.74±10.30)岁,100例被确诊为前列腺癌。以PI-RADS≥3分、miPSMA≥2分以及PI-RADS≥3分联合miPSMA≥2分为标准诊断前列腺癌的敏感度分别为99.0%、96.0%和95.0%;特异度分别为33.3%、83.3%和83.3%;准确度分别为86.3%、93.5%和92.7%;AUC分别为0.662(0.523~0.800)、0.897(0.806~0.987)和0.892(0.801~0.983)。结论前列腺PI-RADS评分≥3分联合miPSMA≥2分有着较高的诊断效能,可作为前列腺癌的精准诊断方案应用于临床。Background Prostate cancer has become the second most common malignant tumor in older men,and its early screening is particularly important.Objective To explore the value of prostate imaging reporting and data system(PI-RADS)score based on magnetic resonance imaging(MRI)combined with molecular prostate specific membrane antigen(miPSMA)score based on 18-fluoro-labeled prostate specific membrane antigen PET/CT imaging(^(18)F-PSMA PET/CT)in the diagnosis of prostate cancer.Methods The MRI of the prostate and^(18)F-PSMA PET/CT in 124 cases who underwent prostate puncture biopsy or surgery in Chinese PLA General Hospital from January 2019 to November 2022 were retrospective analyzed by two radiologists and two nuclear medicine physicians independently for PI-RADS score and miPSMA score.According to the pathological results,the efficacy of three different diagnostic models including PI-RADS≥3,miPSMA≥2,and PI-RADS≥3 combined with miPSMA≥2 were evaluated,respectively.Results The mean age of the 124 subjects was(77.74±10.30)years and 100 subjects were diagnosed with prostate cancer.The sensitivity of diagnosing prostate cancer using PI-RADS≥3,miPSMA≥2,and PI-RADS≥3 combined with miPSMA≥2 as criteria was 99.0%,96.0%,and 95.0%,the specificity was 33.3%,83.3%and 83.3%,the accuracy was 86.3%,93.5%and 92.7%,and area under the curve(AUC)was 0.662(0.523-0.800),0.897(0.806-0.987)and 0.892(0.801-0.983),respectively.Conclusion PI-RADS≥3 combined with miPSMA≥2 has a high diagnostic efficacy and can be used as imaging diagnostic model for prostate cancer in clinical practice.

关 键 词：磁共振成像 前列腺影像报告和数据系统 ^(18)F-PSMA PET/CT 前列腺癌 

分 类 号：R71[医药卫生—妇产科学]