Zeng Yuping, Leng Xiaoming, Liao Hengbin, Jiang Guihua, Chen Ping
The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510317, China.
Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou 510317, China.
Prostate Int. 2022 Jun;10(2):108-116. doi: 10.1016/j.prnil.2022.03.003. Epub 2022 Mar 28.
To assess the diagnostic value of fluorine 18 (F)-labeled prostate-specific membrane antigen (PSMA)-1007 Positron emission tomography/Magnetic resonance imaging (PET/MRI) and compared with that of biparametric MRI (bpMRI) for the detection of prostate cancer (PCa).
The study enrolled 29 patients with suspected PCa preoperatively who underwent F-PSMA-1007 PET/MRI and subsequent targeted biopsy for suspected PCa lesions. Two readers independently assessed the images of each suspected PCa lesion and determined their overall assessment category on bpMRI and F-PSMA-1007 PET/MRI. By using biopsy histopathology as the reference standard, the accuracies of F-PSMA-1007 PET/MRI and bpMRI for the detection of PCa lesion were determined. Furthermore, the receiver-operating characteristic (ROC) curves of their semi-quantitative parameters of the optimal standardized uptake value (SUVmax) and apparent diffusion coefficient (ADC) for detecting PCa lesions were derived, and their correlations with the International Society of Urological Pathology (ISUP) grade were reported.
Of the 48 suspected PCa lesions in 29 patients, 38 were pathologically diagnosed with clinically significant PCa and 10 with nonprostate cancer (non-PCa) lesions. Compared with the pathological results, F-PSMA-1007 PET/MRI demonstrated much greater diagnostic accuracy (area under the curve, AUC), sensitivity, specificity, positive predictive value, and negative predictive value than bpMRI: 0.974 versus 0.711, 94.74% versus 92.11%, 100% versus 50%, 100% versus 87.50%, and 83.33% versus 62.50%, respectively. The semi-quantitative parameters of SUVmax demonstrated a higher AUC of 0.874 than that of ADC with 0.776 for detecting PCa. The ISUP grade was positively associated with SUVmax at spearman's rho correlation coefficient (Rho) = 0.539, p = 0), but not associated with ADC (Rho = -0.105, p = 0.529).
The diagnostic value of F-PSMA-1007 PET/MRI for the detection of PCa is better than that of bpMRI, and a high SUVmax may indicate a lesion with a high ISUP grade.
评估氟18（F）标记的前列腺特异性膜抗原（PSMA）-1007正电子发射断层扫描/磁共振成像（PET/MRI）在前列腺癌（PCa）检测中的诊断价值，并与双参数MRI（bpMRI）进行比较。
本研究纳入29例术前疑似PCa的患者，他们接受了F-PSMA-1007 PET/MRI检查，并对疑似PCa病变进行了后续靶向活检。两名阅片者独立评估每个疑似PCa病变的图像，并确定其在bpMRI和F-PSMA-1007 PET/MRI上的总体评估类别。以活检组织病理学为参考标准，确定F-PSMA-1007 PET/MRI和bpMRI检测PCa病变的准确性。此外，得出其检测PCa病变的最佳标准化摄取值（SUVmax）和表观扩散系数（ADC）的半定量参数的受试者操作特征（ROC）曲线，并报告它们与国际泌尿病理学会（ISUP）分级的相关性。
29例患者的48个疑似PCa病变中，38个经病理诊断为具有临床意义的PCa，10个为非前列腺癌（非PCa）病变。与病理结果相比，F-PSMA-1007 PET/MRI在诊断准确性（曲线下面积，AUC）、敏感性、特异性、阳性预测值和阴性预测值方面均显著高于bpMRI：分别为0.974对0.711、94.74%对92.11%、100%对50%、100%对87.50%、83.33%对62.50%。SUVmax的半定量参数在检测PCa时的AUC为0.874，高于ADC的0.776。ISUP分级与SUVmax呈正相关，斯皮尔曼等级相关系数（Rho）=0.539，p = 0，但与ADC无关（Rho = -0.105，p = 0.529）。
F-PSMA-1007 PET/MRI在PCa检测中的诊断价值优于bpMRI，高SUVmax可能表明病变具有高ISUP分级。
