使用抗3-[(18)F]FACBC PET/CT检测复发性前列腺癌：与CT的比较。
Recurrent prostate cancer detection with anti-3-[(18)F]FACBC PET/CT: comparison with CT.
作者信息
Odewole Oluwaseun A, Tade Funmilayo I, Nieh Peter T, Savir-Baruch Bital, Jani Ashesh B, Master Viraj A, Rossi Peter J, Halkar Raghuveer K, Osunkoya Adeboye O, Akin-Akintayo Oladunni, Zhang Chao, Chen Zhengjia, Goodman Mark M, Schuster David M
机构信息
Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA.
Urology, Emory University, Atlanta, GA, USA.
出版信息
Eur J Nucl Med Mol Imaging. 2016 Sep;43(10):1773-83. doi: 10.1007/s00259-016-3383-8. Epub 2016 Apr 18.
PURPOSE
To compare the diagnostic performance of the synthetic amino acid analogue PET radiotracer anti-3-[(18)F]FACBC (fluciclovine) with that of CT in the detection of recurrent prostate carcinoma.
METHODS
This was a retrospective analysis of 53 bone scan-negative patients with suspected recurrent prostate carcinoma who underwent fluciclovine PET/CT and routine clinical CT within 90 days of each other. The correlation between imaging findings and histology and clinical follow-up was evaluated. Positivity rates and diagnostic performance were calculated for fluciclovine PET/CT and CT.
RESULTS
Of 53 fluciclovine PET/CT and 53 CT examinations, 41 (77.4 %) and 10 (18.9 %), respectively, had positive findings for recurrent disease. Positivity rates were higher with fluciclovine PET/CT than with CT at all prostate-specific antigen (PSA) levels, PSA doubling times and original Gleason scores. In the prostate/bed, fluciclovine PET/CT was true-positive in 31 and CT was true-positive in 4 of 51 patients who met the reference standard. In extraprostatic regions, fluciclovine PET/CT was true-positive in 12 and CT was true-positive in 3 of 41 patients who met the reference standard. Of the 43 index lesions used to prove positivity, 42 (97.7 %) had histological proof. In 51 patients with sufficient follow-up to calculate diagnostic performance in the prostate/bed, fluciclovine PET/CT demonstrated a sensitivity of 88.6 %, a specificity of 56.3 %, an accuracy of 78.4 %, a positive predictive value (PPV) of 81.6 %, and a negative predictive value (NPV) of 69.2 %; the respective values for CT were 11.4 %, 87.5 %, 35.3 %, 66.7 % and 31.1 %. In 41 patients with sufficient follow-up to calculate diagnostic performance in extraprostatic regions, fluciclovine PET/CT demonstrated a sensitivity of 46.2 %, a specificity of 100 %, an accuracy of 65.9 %, a PPV of 100 %, and an NPV of 51.7 %; the respective values for CT were 11.5 %, 100 %, 43.9 %, 100 % and 39.5 %.
CONCLUSION
The diagnostic performance of fluciclovine PET/CT in recurrent prostate cancer is superior to that of CT and fluciclovine PET/CT provides better delineation of prostatic from extraprostatic recurrence.
目的
比较合成氨基酸类似物PET放射性示踪剂抗-3-[(18)F]FACBC（氟西克洛维）与CT在检测复发性前列腺癌中的诊断性能。
方法
对53例骨扫描阴性且疑似复发性前列腺癌的患者进行回顾性分析，这些患者在彼此90天内接受了氟西克洛维PET/CT和常规临床CT检查。评估影像学表现与组织学及临床随访之间的相关性。计算氟西克洛维PET/CT和CT的阳性率及诊断性能。
结果
在53例氟西克洛维PET/CT检查和53例CT检查中，分别有41例（77.4%）和10例（18.9%）发现复发性疾病阳性结果。在所有前列腺特异性抗原（PSA）水平、PSA倍增时间和初始Gleason评分中，氟西克洛维PET/CT的阳性率均高于CT。在前列腺/前列腺床，符合参考标准的51例患者中，氟西克洛维PET/CT真阳性31例，CT真阳性4例。在前列腺外区域，符合参考标准的41例患者中，氟西克洛维PET/CT真阳性12例，CT真阳性3例。用于证实阳性的43个索引病变中，42个（97.7%）有组织学证据。在51例有足够随访时间以计算前列腺/前列腺床诊断性能的患者中，氟西克洛维PET/CT的敏感性为88.6%，特异性为56.3%，准确性为78.4%，阳性预测值（PPV）为81.6%，阴性预测值（NPV）为69.2%；CT的相应值分别为11.4%、87.5%、35.3%、66.7%和31.（此处原文有误，推测应为31.1%）。在41例有足够随访时间以计算前列腺外区域诊断性能的患者中，氟西克洛维PET/CT的敏感性为46.2%，特异性为100%，准确性为65.9%，PPV为100%，NPV为51.7%；CT的相应值分别为11.5%、100%、43.9%、100%和39.5%。
结论
氟西克洛维PET/CT在复发性前列腺癌中的诊断性能优于CT，且氟西克洛维PET/CT能更好地区分前列腺内复发与前列腺外复发。
Zotero 插件