[68Ga]镓-PSMA-11与[18F]氟-PSMA-1007 PET/CT在前列腺癌根治术和淋巴结清扫术候选患者淋巴结分期诊断准确性的评估：单机构分析
An Evaluation of the Diagnostic Accuracy of [68Ga]Ga-PSMA-11 vs. [18F]F-PSMA-1007 PET/CT for Lymph Node Staging in Patient Candidates for Radical Prostatectomy and Lymph Node Dissection: A Single Institutional Analysis.
作者信息
Arena Paola, Fasulo Vittorio, Gelardi Fabrizia, Frego Nicola, Jandric Jelena, Maffei Davide, Avolio Pier Paolo, Paciotti Marco, Chiarelli Giuseppe, De Carne Fabio, Dagnino Filippo, Piccolini Andrea, Lopci Egesta, Hurle Rodolfo, Saita Alberto, Chiti Arturo, Lazzeri Massimo, Evangelista Laura, Buffi Nicolò Maria, Casale Paolo, Lughezzani Giovanni
机构信息
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20027 Milan, Italy.
IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy.
出版信息
Diagnostics (Basel). 2025 Jun 12;15(12):1492. doi: 10.3390/diagnostics15121492.
: This study evaluates and compares the diagnostic accuracy of [68Ga]Ga-PSMA-11 and [18F]F-PSMA-1007 for lymph node staging in patients with prostate cancer (PCa) scheduled for robot-assisted radical prostatectomy (RARP) and lymphadenectomy (LND). : We retrospectively reviewed prospectively collected data on patients referred to our hospital from October 2020 to January 2023. We included all patients who underwent [68Ga]Ga-PSMA-11 or [18F]F-PSMA-1007 PET/CT for primary staging and subsequently had RARP with concomitant LND. The maximum standard uptake value (SUVmax) for lymph nodes (LNs) and the SUV node-to-background ratio were reported. Two different cut-off values for the SUV node-to-background ratio (i.e., ≥2 vs. <2 and ≥15.5 vs. <15.5) were used to evaluate the diagnostic performance of both tracers. The first cut-off was empirically chosen, while the second was based on Liu's method. : A total of 156 patients were included (median age: 67 years). Among them, 83 underwent [68Ga]Ga-PSMA-11 and 73 underwent [18F]F-PSMA-1007 PET/CT. Suspicious lymph nodes were identified in 21 patients (13.5%). Pathological nodal involvement (pN1) was confirmed in 25 cases (16%). Of the 21 patients with suspicious pathological lymph nodes on PSMA PET/CT, 9 (42.9%) had positive nodes on the final pathology report. With an SUV node-to-background ratio cut-off of ≥2, [68Ga]Ga-PSMA-11 showed 37.5% sensitivity (SE) and 98.5% specificity(SP), while [18F]F-PSMA-1007 demonstrated 33.3% SE and 100% SP. Using the ≥15.5 cut-off, SE and SP were 31.3% and 100% for [68Ga]Ga-PSMA-11 and 11.1% and 100% for [18F]F-PSMA-1007, respectively. : [18F]F-PSMA-1007 PET/CT showed, even if not statistically significantly, slightly lower SE and higher SP for nodal staging compared to [68Ga]Ga-PSMA-11 PET/CT, irrespective of the SUV ratio used.
本研究评估并比较了[68Ga]镓-PSMA-11和[18F]氟-PSMA-1007对计划接受机器人辅助根治性前列腺切除术（RARP）和淋巴结清扫术（LND）的前列腺癌（PCa）患者进行淋巴结分期的诊断准确性。我们回顾性分析了2020年10月至2023年1月前瞻性收集的转诊至我院患者的数据。我们纳入了所有接受[68Ga]镓-PSMA-11或[18F]氟-PSMA-1007 PET/CT进行初始分期并随后接受RARP及同期LND的患者。报告了淋巴结的最大标准摄取值（SUVmax）和SUV淋巴结与背景比值。使用两种不同的SUV淋巴结与背景比值临界值（即≥2与<2以及≥15.5与<15.5）来评估两种示踪剂的诊断性能。第一个临界值是经验性选择的，而第二个是基于刘的方法。总共纳入了156例患者（中位年龄：67岁）。其中，83例接受了[68Ga]镓-PSMA-11检查，73例接受了[18F]氟-PSMA-1007 PET/CT检查。21例患者（13.5%）发现可疑淋巴结。病理证实有淋巴结转移（pN1）的有25例（16%）。在PSMA PET/CT上有可疑病理淋巴结的21例患者中，9例（42.9%）最终病理报告显示淋巴结阳性。当SUV淋巴结与背景比值临界值≥2时，[68Ga]镓-PSMA-11的敏感性（SE）为37.5%，特异性（SP）为98.5%，而[18F]氟-PSMA-1007的SE为33.3%，SP为100%。使用≥15.5的临界值时，[68Ga]镓-PSMA-11的SE和SP分别为31.3%和100%，[18F]氟-PSMA-1007的SE和SP分别为11.1%和100%。无论使用何种SUV比值，与[68Ga]镓-PSMA-11 PET/CT相比，[18F]氟-PSMA-1007 PET/CT在淋巴结分期方面的SE略低，SP略高，尽管差异无统计学意义。
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