Nappi Anna Giulia, Ferrari Cristina, Mammucci Paolo, Rubini Dino, Lavelli Valentina, Sardaro Angela, Pisani Antonio Rosario, Rubini Giuseppe
Section of Nuclear Medicine, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy.
Section of Radiology and Radiation Oncology, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy.
Cancers (Basel). 2022 Mar 12;14(6):1461. doi: 10.3390/cancers14061461.
We investigated the [F]Fluciclovine PET/CT reliability in the early detection of recurrent prostate cancer (PCa) and its impact on therapeutic decision making. We retrospectively analyzed 58 [F]Fluciclovine PET/CT scans performed to identify early PCa recurrence. Detection rate (DR) and semiquantitative analysis were evaluated in relation to biochemical and clinical-histological features. Clinical follow-up data were collected and considered as gold standard to evaluate sensitivity, specificity, accuracy, positive and negative predictive value (PPV, NPV). The impact of [F]Fluciclovine PET/CT on clinical management was also assessed. Overall DR resulted as 66%, while DR was 53%, 28%, and 7% in prostate/bed, lymph nodes, and bone, respectively. DR significantly increased with higher PSA values ( = 0.009) and 0.45 ng/mL was identified as the optimal cut-off value. Moreover, SUVmax and SUVmean resulted significant parameters in interpreting malignant from benign findings. [F]Fluciclovine PET/CT reached a sensitivity, specificity, PPV, NPV, and accuracy of 87.10%, 80.00%, 87.10%, 80.00%, and 84.31%, respectively. Therapeutic strategy was changed in 51% of patients. Our results support [F]Fluciclovine PET/CT as a reliable tool for early restaging of PCa patients, especially for local recurrence detection, leading to a significant impact on clinical management. Semiquantitative analysis could improve specificity in interpreting malignant from benign lesions.
我们研究了[F]氟西克洛维PET/CT在复发性前列腺癌（PCa）早期检测中的可靠性及其对治疗决策的影响。我们回顾性分析了58例用于识别早期PCa复发的[F]氟西克洛维PET/CT扫描。根据生化和临床组织学特征评估了检测率（DR）和半定量分析。收集临床随访数据并将其视为评估敏感性、特异性、准确性、阳性和阴性预测值（PPV、NPV）的金标准。还评估了[F]氟西克洛维PET/CT对临床管理的影响。总体DR为66%，而前列腺/床、淋巴结和骨的DR分别为53%、28%和7%。DR随着PSA值升高而显著增加（=0.009），并确定0.45 ng/mL为最佳临界值。此外，SUVmax和SUVmean是区分良恶性结果的重要参数。[F]氟西克洛维PET/CT的敏感性、特异性、PPV、NPV和准确性分别达到87.10%、80.00%、87.10%、80.00%和84.31%。51%的患者治疗策略发生了改变。我们的结果支持[F]氟西克洛维PET/CT作为PCa患者早期再分期的可靠工具，尤其是用于局部复发检测，对临床管理有显著影响。半定量分析可以提高区分良恶性病变的特异性。
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