Yoon James, Ballas Leslie, Desai Bhushan, Jadvar Hossein
Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Department of Radiation Oncology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
World J Nucl Med. 2017 Jul-Sep;16(3):229-236. doi: 10.4103/1450-1147.207286.
We evaluated the association between serum prostate specific antigen (PSA) level and kinetics to predict F-sodium fluoride positron emission tomography-computed tomography (F-NaF PET-CT) positivity for first bone metastases in men with biochemical recurrence after radical prostatectomy. All F-NaF PET-CT scans that were performed at our institution during 2010-2014 were queried to find patients who demonstrated biochemical recurrence after radical prostatectomy. Records were reviewed to obtain data on PSA levels and kinetics at the time of F-NaF PET-CT and pathologic features of the prostatectomy specimen, which were then used for receiver operating characteristic (ROC) analysis to determine predictability for F-NaF PET positivity. Thirty-six patients met our inclusion criteria. Of these, 8 (22.2%) had positive F-NaF PET-CT scans. Mean values for PSA, PSA doubling time (PSADT), and PSA velocity (PSAV) were 2.02 ng/ml (range: 0.06-11.7 ng/ml), 13.2 months (range: 1.11-60.84), and 1.28 ng/ml/year (range: 0.1-5.28) for F-NaF PET-CT negative scans, and 4.11 ng/ml (range: 0.04-14.38 ng/ml), 8.9 months (range; 0.7-27.8), and 9.06 ng/ml/year (range: 0.04-50.2) for F-NaF PET-CT positive scans, respectively ( = 0.07, 0.47, and 0.02, respectively, for PSA, PSADT, and PSAV). ROC analysis for F-NaF PET-CT positivity resulted in area under the curve (AUC) values of 0.634 for PSA, 0.598 for PSADT, and 0.688 for PSAV. ROC analysis with combined models gave AUC values of 0.723 for a combination of PSA and PSADT, 0.689 for a combination of PSA and PSAV, and 0.718 for grouping of PSA, PSADT, and PSAV. There was no significant association between F-NaF PET-CT positivity and primary tumor Gleason score, TN staging, and status of surgical margins. F-NaF PET-CT detected first-time osseous metastases in 22.2% of our patients with biochemical recurrence after prostatectomy with the PSA level range ≤11.7 ng/ml. PSAV was statistically significant in predicting F-NaF PET-CT positivity. ROC analysis demonstrated higher AUCs when PSA was combined with PSA kinetics parameters.
我们评估了血清前列腺特异性抗原（PSA）水平与动力学之间的关联，以预测前列腺癌根治术后生化复发男性首次骨转移的氟代氟化钠正电子发射断层扫描-计算机断层扫描（F-NaF PET-CT）阳性情况。查询了2010年至2014年在我们机构进行的所有F-NaF PET-CT扫描，以找出前列腺癌根治术后出现生化复发的患者。回顾记录以获取F-NaF PET-CT检查时的PSA水平和动力学数据以及前列腺切除标本的病理特征，然后将其用于受试者操作特征（ROC）分析，以确定F-NaF PET阳性的预测能力。36例患者符合我们的纳入标准。其中，8例（22.2%）F-NaF PET-CT扫描呈阳性。F-NaF PET-CT阴性扫描的PSA、PSA倍增时间（PSADT）和PSA速度（PSAV）的平均值分别为2.02 ng/ml（范围：0.06 - 11.7 ng/ml）、13.2个月（范围：1.11 - 60.84）和1.28 ng/ml/年（范围：0.1 - 5.28），F-NaF PET-CT阳性扫描分别为4.11 ng/ml（范围：0.04 - 14.38 ng/ml）、8.9个月（范围：0.7 - 27.8）和9.06 ng/ml/年（范围：0.04 - 50.2）（PSA、PSADT和PSAV的P值分别为0.07、0.47和0.02）。F-NaF PET-CT阳性的ROC分析得出曲线下面积（AUC）值，PSA为0.634，PSADT为0.598，PSAV为0.688。联合模型的ROC分析得出，PSA和PSADT组合的AUC值为0.723，PSA和PSAV组合的AUC值为0.689，PSA、PSADT和PSAV分组的AUC值为0.718。F-NaF PET-CT阳性与原发肿瘤Gleason评分、TN分期及手术切缘状态之间无显著关联。F-NaF PET-CT在我们前列腺切除术后生化复发且PSA水平范围≤11.7 ng/ml的患者中检测到22.2%的首次骨转移。PSAV在预测F-NaF PET-CT阳性方面具有统计学意义。ROC分析表明，当PSA与PSA动力学参数联合时，AUC值更高。
