Kitajima Kazuhiro, Yamamoto Shingo, Odawara Soichi, Kobayashi Kaoru, Fujiwara Masayuki, Kamikonya Norihiko, Fukushima Kazuhito, Nakanishi Yukako, Hashimoto Takahiko, Yamada Yusuke, Suzuki Toru, Kanematsu Akihiro, Nojima Michio, Yamakado Koichiro
Division of Nuclear Medicine and PET Center, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Acta Med Okayama. 2018 Jun;72(3):289-296. doi: 10.18926/AMO/56075.
We compared 11C-choline and FDG PET/CT scan findings for the staging and restaging of prostate cancer. Twenty Japanese prostate cancer patients underwent 11C-choline and FDG PET/CT before (n=5) or after (n=15) treatment. Using a five-point scale, we compared these scanning modalities regarding patient- and lesion-based diagnostic performance for local recurrence, untreated primary tumor, and lymph node and bony metastases. Of the 20 patients, documented local lesions, and node and bony metastases were present in 11 (55.0%), 9 (45.0%), and 13 (65.0%), respectively. The patient-based sensitivity/specificity/accuracy/area under the receiver-operating-characteristic curve (AUC) values for 11C-choline-PET/CT for diagnosing local lesions were 90.9% /100%/ 95.0% / 1.0, whereas those for FDG-PET/CT were 45.5% /100%/ 75.0% / 0.773. Those for 11C-choline-PET/CT for node metastasis were 88.9% /100%/ 95.0% / 0.944, and those for FDG-PET/CT were 44.4%/100%/75.0%/0.722. Those for 11C-choline-PET/CT for bone metastasis were 84.6%/100%/90.0%/0.951, and those for FDG-PET/CT were 76.9% /100%/ 85.0% / 0.962. The AUCs for local lesion and node metastasis differed significantly (p=0.0039, p=0.011, respectively). The lesion-based detection rates of 11C-choline compared to FDG PET/CT for local lesion, and node and bone metastases were 91.7% vs. 41.7%, 92.0% vs. 32.0%, and 94.8% vs. 83.0% (p=0.041, p=0.0030, p<0.0001), respectively. 11C-choline-PET/CT is more useful for the staging and restaging of prostate cancer than FDG-PET/CT in Japanese men.
我们比较了11C-胆碱和氟代脱氧葡萄糖（FDG）PET/CT扫描结果在前列腺癌分期及再分期中的应用。20例日本前列腺癌患者在治疗前（n = 5）或治疗后（n = 15）接受了11C-胆碱和FDG PET/CT检查。我们采用五点量表，比较了这两种扫描方式在基于患者和病灶的局部复发、未治疗的原发肿瘤、淋巴结及骨转移诊断性能方面的差异。20例患者中，记录到局部病灶、淋巴结转移和骨转移的分别有11例（55.0%）、9例（45.0%）和13例（65.0%）。基于患者的11C-胆碱PET/CT诊断局部病灶的敏感性/特异性/准确性/受试者操作特征曲线下面积（AUC）值分别为90.9% /100%/ 95.0% / 1.0，而FDG PET/CT的相应值分别为45.5% /100%/ 75.0% / 0.773。11C-胆碱PET/CT诊断淋巴结转移的相应值分别为88.9% /100%/ 95.0% / 0.944，FDG PET/CT的相应值分别为44.4%/100%/75.0%/0.722。11C-胆碱PET/CT诊断骨转移的相应值分别为84.6%/100%/90.0%/0.951，FDG PET/CT的相应值分别为76.9% /100%/ 85.0% / 0.962。局部病灶和淋巴结转移的AUC值差异有统计学意义（分别为p = 0.0039，p = 0.011）。与FDG PET/CT相比，基于病灶的11C-胆碱对局部病灶、淋巴结及骨转移的检出率分别为91.7% 对 41.7%、92.0% 对 32.0%、94.8% 对 83.0%（p = 0.041，p = 0.0030，p<0.0001）。在日本男性中，11C-胆碱PET/CT在前列腺癌分期及再分期方面比FDG PET/CT更有用。
