Correlation of Intraprostatic Tumor Extent with 68Ga-PSMA Distribution in Patients with Prostate Cancer
Correlation of Intraprostatic Tumor Extent with 68Ga-PSMA Distribution in Patients with Prostate Cancer
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DOI：
10.2967/jnumed.115.169243
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发表时间：
2016-04-01
影响因子：
9.3
通讯作者：
Boegemann, Martin
中科院分区：
文献类型：
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作者：
Rahbar, Kambiz;Weckesser, Matthias;Boegemann, Martin
我们评估前列腺特异性膜抗原（PSMA） PET在前列腺切除术前前列腺癌的诊断价值和准确性。方法：我们确定了6例活检证实的高危前列腺癌患者，他们在根治性前列腺切除术前接受了Ga-68-PSMA PET/CT检查，以排除转移。前列腺切除术后，重建前列腺的组织学图。将前列腺各节段的组织学范围和Gleason评分与切片至组织轴的Ga-68-PSMA PET图像进行比较。计算敏感性、特异性、阳性和阴性预测值、阳性和阴性似然比。测量各细分市场的SUV，并比较中位数。结果：132个片段中，有112个符合分析条件。组织学结果与Ga-68-PSMA PET图像的相关性显示特异性和敏感性为92%。Ga-68-PSMA PET检测前列腺癌的阳性、阴性似然比和阳性、阴性预测值分别为11.5、0.09、96%和85%。前列腺真阳性节段的中位SUVmax显著高于真阴性节段（11.0 +/- 7.8 vs. 2.7 +/- 0.9, P < 0.001），截断值为4，敏感性和特异性为86.5%，准确性为87.5%。结论：这些初步结果表明Ga-68-PSMA PET可以预测前列腺癌的前列腺内定位和范围。这种成像方法可能有助于在前列腺活检前识别目标病变，并可能支持局灶性或根治性治疗前的决策。
We evaluated the diagnostic value and accuracy of prostate-specific membrane antigen (PSMA) PET for the intraprostatic delineation of prostate cancer before prostatectomy. Methods: We identified 6 patients with biopsy-proven high-risk prostate cancer who were referred for Ga-68-PSMA PET/CT before radical prostatectomy to rule out metastasis. After prostatectomy, a histologic map of the prostate was reconstructed. The histologic extent and Gleason score of each segment of the prostate were compared with Ga-68-PSMA PET images resliced to the histologic axis. Sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratios were calculated. The SUV of each segment was measured, and median values were compared. Results: Of the 132 segments, 112 were eligible for analysis. The correlation of histologic results with Ga-68-PSMA PET images showed a specificity and sensitivity of 92%. The positive and negative likelihood ratio and the positive and negative predictive value for detection of prostate cancer on Ga-68-PSMA PET were 11.5, 0.09, 96%, and 85%, respectively. The median SUVmax of true-positive prostate segments was significantly higher than that of true-negative segments (11.0 +/- 7.8 vs. 2.7 +/- 0.9, P < 0.001), and a cutoff of 4 revealed a sensitivity and specificity of 86.5% and an accuracy of 87.5%. Conclusion: These preliminary results show that the intraprostatic localization and extent of prostate cancer may be estimated by Ga-68-PSMA PET. This imaging method may be helpful for identifying target lesions before prostate biopsy and may support decision making before focal or radical therapy.