Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Lund University, Malmö, Sweden.
Department of Urology, Skåne University Hospital, Lund University, Malmö, Sweden.
Clin Physiol Funct Imaging. 2022 Nov;42(6):381-388. doi: 10.1111/cpf.12770. Epub 2022 Aug 8.
Positron emission tomography-computed tomography (PET-CT) with [ F]-fluorocholine (FCH) is used to detect and stage metastatic lymph nodes in patients with prostate cancer. Improvements to hardware and software have recently been made. We compared the capability of detecting regional lymph node metastases using conventional and digital silicon photomultiplier (SiPM)-based PET-CT technology for FCH. Extended pelvic lymph node dissection (ePLND) histopathology was used as a reference method.
The study retrospectively examined 177 patients with intermediate or high-risk prostate cancer who had undergone staging with FCH PET-CT before ePLND. Images were obtained with either the conventional Philips Gemini PET-CT (n = 93) or the digital SiPM-based GE Discovery MI PET-CT (n = 84) and compared.
Images that were obtained using the Philips Gemini PET-CT system showed 19 patients (20%) with suspected lymph node metastases, whereas the GE Discovery MI PET-CT revealed 36 such patients (43%). The sensitivity, specificity, and positive and negative predictive values were 0.3, 0.84, 0.47, and 0.72 for the Philips Gemini, while they were 0.58, 0.62, 0.31, and 0.83 for the GE Discovery MI, respectively. The areas under the curves in a receiver operating characteristic curve analysis were similar between the two PET-CT systems (0.57 for Philips Gemini and 0.58 for GE Discovery MI, p = 0.89).
Marked differences in sensitivity and specificity were found for the different PET-CT systems, although the overall diagnostic performance was similar. These differences are probably due to differences in both hardware and software, including reconstruction algorithms, and should be considered when new technology is introduced.
正电子发射断层扫描计算机断层扫描（PET-CT）联合[F]-氟胆碱（FCH）用于检测和分期前列腺癌患者的转移性淋巴结。近期硬件和软件均有所改进。我们比较了常规和基于数字硅光电倍增管（SiPM）的 FCH PET-CT 技术检测区域淋巴结转移的能力。扩展盆腔淋巴结清扫术（ePLND）的组织病理学为参考方法。
本研究回顾性分析了 177 例接受 FCH PET-CT 分期检查后行 ePLND 的中高危前列腺癌患者。使用常规飞利浦 Gemini PET-CT（n=93）或数字 SiPM 基 GE Discovery MI PET-CT（n=84）获得图像，并进行比较。
飞利浦 Gemini PET-CT 系统获得的图像显示 19 例（20%）患者疑似淋巴结转移，而 GE Discovery MI PET-CT 则显示 36 例（43%）患者疑似淋巴结转移。飞利浦 Gemini 的灵敏度、特异性、阳性预测值和阴性预测值分别为 0.3、0.84、0.47 和 0.72，GE Discovery MI 分别为 0.58、0.62、0.31 和 0.83。受试者工作特征曲线分析中的曲线下面积在两种 PET-CT 系统之间相似（飞利浦 Gemini 为 0.57，GE Discovery MI 为 0.58，p=0.89）。
两种 PET-CT 系统的灵敏度和特异性存在明显差异，尽管总体诊断性能相似。这些差异可能是由于硬件和软件（包括重建算法）的差异所致，在引入新技术时应予以考虑。
