Wang Qingyun, Wu Lingmei, Gao Fengxiao
Department of CTMRI Inspection, Xingtai People's Hospital, 054031 Xingtai, Hebei, China.
Department of Nuclear Medicine, Xingtai People's Hospital, 054031 Xingtai, Hebei, China.
Arch Esp Urol. 2025 Jun;78(5):572-578. doi: 10.56434/j.arch.esp.urol.20257805.77.
The early and accurate diagnosis of prostate cancer (PCa) bone metastases is of great importance for formulating the best treatment plan and improving the prognosis of patients. This work aimed to compare and analyse the application value of F-fludeoxyglucose (FDG) and F-prostate-specific membrane antigen-1007 (F-PSMA-1007) positron emission tomography/computed tomography (PET/CT) in the diagnosis of PCa bone metastases.
Data from the pathological specimens from patients diagnosed with PCa admitted to the Xingtai People's Hospital from October 2021 to October 2024 were retrospectively collected. These patients underwent F-FDG PET/CT and F-PSMA-1007 PET/CT scans, with an interval not exceeding 3 days between the two examinations. The sensitivity, specificity, negative and positive predictive values and diagnostic coincidence rate of the two imaging methods were evaluated by comparing the lesion count and anatomical distribution of prostatic bone metastases after the two examinations. The pathological diagnosis results of prostate lesion needle biopsy or radical PCa resection specimens were taken as the gold standard.
Seventy-eight patients with PCa were admitted during the study. A total of 418 positive lesions, 78 primary prostatic lesions, 340 bone metastases and 12 negative lesions were detected by prostate lesion biopsy as the gold standard. A total of 410 positive foci were found in F-PSMA-1007, including 78 primary prostatic foci and 332 bone metastases. A total of 376 positive lesions, 76 prostate lesions and 300 bone metastases were found in F-FDG. F-PSMA-1007 detected more PCa bone metastases in different bone regions than F-FDG, but the difference was not statistically significant ( > 0.05). The sensitivity, specificity, positive and negative predictive values and diagnostic coincidence rate of F-PSMA-1007 were significantly higher than those of F-FDG ( < 0.01).
F-PSMA-1007 PET/CT has high sensitivity and diagnostic coincidence rate and is expected to become a new standard for the diagnosis of PCa bone metastases.
前列腺癌（PCa）骨转移的早期准确诊断对于制定最佳治疗方案和改善患者预后至关重要。本研究旨在比较和分析¹⁸F-氟脱氧葡萄糖（FDG）和¹⁸F-前列腺特异性膜抗原1007（F-PSMA-1007）正电子发射断层扫描/计算机断层扫描（PET/CT）在PCa骨转移诊断中的应用价值。
回顾性收集2021年10月至2024年10月在邢台市人民医院确诊为PCa的患者病理标本数据。这些患者接受了¹⁸F-FDG PET/CT和¹⁸F-PSMA-1007 PET/CT扫描，两次检查间隔不超过3天。通过比较两次检查后前列腺骨转移的病灶数量和解剖分布，评估两种成像方法的敏感性、特异性、阴性和阳性预测值以及诊断符合率。以前列腺病变穿刺活检或PCa根治性切除标本的病理诊断结果作为金标准。
研究期间共收治78例PCa患者。以前列腺病变活检为金标准，共检测到418个阳性病灶，7�个原发性前列腺病灶，340个骨转移病灶和12个阴性病灶。¹⁸F-PSMA-1007共发现410个阳性灶，其中包括78个原发性前列腺灶和332个骨转移灶。¹⁸F-FDG共发现376个阳性病灶，76个前列腺病灶和300个骨转移病灶。¹⁸F-PSMA-1007在不同骨区域检测到的PCa骨转移灶比¹⁸F-FDG多，但差异无统计学意义（P>0.05）。¹⁸F-PSMA-1007的敏感性、特异性、阳性和阴性预测值以及诊断符合率均显著高于¹⁸F-FDG（P<0.01）。
¹⁸F-PSMA-1007 PET/CT具有较高的敏感性和诊断符合率，有望成为PCa骨转移诊断的新标准。
