Hu Xiongjian, Cao Yiming, Ji Bin, Zhao Min, Wen Qiang, Chen Bin
Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun, China.
Front Med (Lausanne). 2023 Jul 31;10:1201977. doi: 10.3389/fmed.2023.1201977. eCollection 2023.
This study aimed to compare the diagnostic efficiency of F-DCFPyL PET/CT imaging and Tc-MDP SPECT/CT bone imaging for the detection of bone metastases in prostate cancer.
A retrospective analysis was conducted on 31 patients with confirmed prostate cancer between September 2020 and September 2022 at China-Japan Union Hospital of Jilin University. All patients underwent F-DCFPyL PET/CT and Tc-MDP SPECT/CT bone imaging. The gold standard was the pathology or Best Valuable Comparator (BVC) result based on clinical follow-up. Diagnostic performance indicators, including sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV), were analyzed at both the patient and lesion levels. The paired sample chi-square test was used to compare the two imaging methods. Receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was calculated for each method. The AUC values were compared using the -test, and a -value < 0.05 was considered statistically significant.
Of the 31 prostate cancer patients, 18 were diagnosed with bone metastases, with a total of 84 bone metastatic lesions. At the patient level, F-DCFPyL PET/CT imaging showed superior diagnostic performance compared to Tc-MDP SPECT/CT bone imaging in all indicators: sensitivity (100% vs. 77.8%, < 0.01), specificity (92.3% vs. 69.2%, < 0.05), accuracy (96.8% vs. 74.2%, < 0.01), PPV (94.7% vs. 77.8%, < 0.01), and NPV (100% vs. 69.2%, < 0.01). The AUC values for F-DCFPyL PET/CT imaging and Tc-MDP SPECT/CT bone imaging were 0.962 and 0.735 ( = 2.168, < 0.05). At the lesion level, F-DCFPyL PET/CT imaging showed superior diagnostic performance compared to Tc-MDP SPECT/CT bone imaging in all indicators: sensitivity (97.6% vs. 72.6%, < 0.01), specificity (95.7% vs. 73.9%, < 0.01), accuracy (97.2% vs. 72.9%, < 0.01), PPV (98.8% vs. 91.0%, < 0.01), and NPV (91.7% vs. 42.5%, < 0.01). The AUC values for F-DCFPyL PET/CT imaging and Tc-MDP SPECT/CT bone imaging were 0.966 and 0.733 ( = 3.541, < 0.001).
Compared with Tc-MDP SPECT/CT bone imaging, F-DCFPyL PET/CT imaging demonstrated higher diagnostic efficiency for bone metastases in prostate cancer, and it can more accurately determine the presence of bone metastases. It is an important supplement to imaging examination for prostate cancer patients and has great potential and broad application prospects.
本研究旨在比较F-DCFPyL PET/CT成像和Tc-MDP SPECT/CT骨显像在检测前列腺癌骨转移方面的诊断效能。
对2020年9月至2022年9月在吉林大学中日联谊医院确诊为前列腺癌的31例患者进行回顾性分析。所有患者均接受F-DCFPyL PET/CT和Tc-MDP SPECT/CT骨显像。金标准为基于临床随访的病理结果或最佳价值对照（BVC）结果。在患者和病灶层面分析诊断性能指标，包括敏感性、特异性、准确性、阳性预测值（PPV）和阴性预测值（NPV）。采用配对样本卡方检验比较两种成像方法。绘制受试者操作特征（ROC）曲线，并计算每种方法的曲线下面积（AUC）。使用t检验比较AUC值，P值<0.05被认为具有统计学意义。
31例前列腺癌患者中，18例被诊断为骨转移，共有84个骨转移病灶。在患者层面，F-DCFPyL PET/CT成像在所有指标上均显示出优于Tc-MDP SPECT/CT骨显像的诊断性能：敏感性（100%对77.8%，P<0.01）、特异性（92.3%对69.2%，P<0.05）、准确性（96.8%对74.2%，P<0.01）、PPV（94.7%对77.8%，P<0.01）和NPV（100%对69.2%，P<0.01）。F-DCFPyL PET/CT成像和Tc-MDP SPECT/CT骨显像的AUC值分别为0.962和0.735（t=2.168，P<0.05）。在病灶层面，F-DCFPyL PET/CT成像在所有指标上均显示出优于Tc-MDP SPECT/CT骨显像的诊断性能：敏感性（97.6%对72.6%，P<0.01）、特异性（95.7%对73.9%，P<0.01）、准确性（97.2%对72.9%，P<0.01）、PPV（98.8%对91.0%，P<0.01）和NPV（91.7%对42.5%，P<0.01）。F-DCFPyL PET/CT成像和Tc-MDP SPECT/CT骨显像的AUC值分别为0.966和0.733（t=3.541，P<0.001）。
与Tc-MDP SPECT/CT骨显像相比，F-DCFPyL PET/CT成像在前列腺癌骨转移的诊断中显示出更高的诊断效能，并且能够更准确地确定骨转移的存在。它是前列腺癌患者影像学检查的重要补充，具有很大的潜力和广阔的应用前景。
