Abstract：
OBJECTIVE: To improve the diagnostic accuracy of initial detection in patients with suspected primary prostate cancer (PCa).
METHODS: Eighty-four patients who underwent Gallium-68-labeled prostate-specific membrane antigen ([68Ga]Ga-PSMA-11) total-body positron emission tomography/computed tomography (PET/CT) imaging before treatment in our department were enrolled. The maximum standard uptake value (SUVmax) of the prostate (SUVmax-PSMA), liver (SUVmax-PSMA-L), and mediastinal blood pool (SUVmax-PSMA-M) was measured using [68Ga]Ga-PSMA-11 total-body PET/CT imaging. The [68Ga]Ga-PSMA-11 derived metabolic tumor volume (MTV), the total lesion (TLP), and the cross-sectional areas of focal concentration in the prostate (CAP) were also determined. Besides, the prostate-specific antigen (PSA) levels and the above imaging characteristics were analyzed using receiver operating characteristic curves to identify the cutoff value to improve the diagnostic accuracy of suspected PCa. Finally, a multivariate regression analysis was conducted to discover the independent predictor to improve the diagnostic accuracy on [68Ga]Ga-PSMA-11 total-body imaging.
RESULTS: There was no significant difference between the PCa and Non-PCa groups in age, height, weight, injected dose, except for the PSA levels, the SUVmax-PSMA, TLP, MTV, and CAP. Besides, the SUVmax-PSMA-T/L and SUVmax-PSMA-T/M derived from SUVmax-PSMA were both significantly different. In addition, the areas under the curve of PSA levels, SUVmax-PSMA, SUVmax-PSMA-T/L, SUVmax-PSMA-T/M, TLP, MTV, and CAP to predict PCa on [68Ga]Ga-PSMA-11 imaging were 0.620 (95% confidence interval (CI) 0.485-0.755), 0.864 (95% CI 0.757-0.972), 0.819 (95% CI 0.704-0.935), 0.876 (95% CI 0.771-0.980), 0.845 (95% CI 0.741-0.949), 0.820 (95% CI 0.702-0.938), 0.627 (95% CI 0.499-0.754), respectively. However, a multivariate regression analysis showed that SUVmax-PSMA was an independent predictor, with a cutoff value of 11.5 and an odds ratio of 1.221.
CONCLUSIONS: The SUVmax-PSMA with a cutoff value of 11.5 was an independent predictor to improve the diagnostic accuracy of PCa on [68Ga]Ga-PSMA-11 total-body imaging.
METHODS: Eighty-four patients who underwent Gallium-68-labeled prostate-specific membrane antigen ([68Ga]Ga-PSMA-11) total-body positron emission tomography/computed tomography (PET/CT) imaging before treatment in our department were enrolled. The maximum standard uptake value (SUVmax) of the prostate (SUVmax-PSMA), liver (SUVmax-PSMA-L), and mediastinal blood pool (SUVmax-PSMA-M) was measured using [68Ga]Ga-PSMA-11 total-body PET/CT imaging. The [68Ga]Ga-PSMA-11 derived metabolic tumor volume (MTV), the total lesion (TLP), and the cross-sectional areas of focal concentration in the prostate (CAP) were also determined. Besides, the prostate-specific antigen (PSA) levels and the above imaging characteristics were analyzed using receiver operating characteristic curves to identify the cutoff value to improve the diagnostic accuracy of suspected PCa. Finally, a multivariate regression analysis was conducted to discover the independent predictor to improve the diagnostic accuracy on [68Ga]Ga-PSMA-11 total-body imaging.
RESULTS: There was no significant difference between the PCa and Non-PCa groups in age, height, weight, injected dose, except for the PSA levels, the SUVmax-PSMA, TLP, MTV, and CAP. Besides, the SUVmax-PSMA-T/L and SUVmax-PSMA-T/M derived from SUVmax-PSMA were both significantly different. In addition, the areas under the curve of PSA levels, SUVmax-PSMA, SUVmax-PSMA-T/L, SUVmax-PSMA-T/M, TLP, MTV, and CAP to predict PCa on [68Ga]Ga-PSMA-11 imaging were 0.620 (95% confidence interval (CI) 0.485-0.755), 0.864 (95% CI 0.757-0.972), 0.819 (95% CI 0.704-0.935), 0.876 (95% CI 0.771-0.980), 0.845 (95% CI 0.741-0.949), 0.820 (95% CI 0.702-0.938), 0.627 (95% CI 0.499-0.754), respectively. However, a multivariate regression analysis showed that SUVmax-PSMA was an independent predictor, with a cutoff value of 11.5 and an odds ratio of 1.221.
CONCLUSIONS: The SUVmax-PSMA with a cutoff value of 11.5 was an independent predictor to improve the diagnostic accuracy of PCa on [68Ga]Ga-PSMA-11 total-body imaging.
摘要：
目的：提高疑似原发性前列腺癌（PCa）患者初始检测的诊断准确性。
方法：纳入84例患者治疗前接受了68镓标记的前列腺特异性膜抗原（[68Ga]Ga-PSMA-11）全身正电子发射断层扫描/计算机断层扫描（PET/CT）成像。前列腺的最大标准摄取值(SUVmax)(SUVmax-PSMA),肝脏（SUVmax-PSMA-L），使用[68Ga]Ga-PSMA-11全身PET/CT成像测量纵隔血池(SUVmax-PSMA-M)。[68Ga]Ga-PSMA-11来源的代谢性肿瘤体积(MTV),总病变（TLP），还确定了前列腺局灶性浓度（CAP）的横截面面积。此外,使用受试者工作特征曲线分析前列腺特异性抗原(PSA)水平和上述影像学特征,以确定临界值,从而提高疑似PCa的诊断准确性.最后,进行了多元回归分析,以发现提高[68Ga]Ga-PSMA-11全身成像诊断准确性的独立预测因子.
结果：PCa组和非PCa组的年龄没有显着差异，高度,体重,注射剂量,除了PSA水平,SUVmax-PSMA,TLP,MTV,和CAP。此外,来自SUVmax-PSMA的SUVmax-PSMA-T/L和SUVmax-PSMA-T/M均存在显着差异。此外,PSA水平曲线下的面积,SUVmax-PSMA,SUVmax-PSMA-T/L,SUVmax-PSMA-T/M,TLP,MTV,在[68Ga]Ga-PSMA-11成像上预测PCa的CAP为0.620（95％置信区间（CI）0.485-0.755），0.864（95%CI0.757-0.972），0.819（95%CI0.704-0.935），0.876（95%CI0.771-0.980），0.845（95%CI0.741-0.949），0.820（95%CI0.702-0.938），0.627（95%CI0.499-0.754），分别。然而,多元回归分析显示SUVmax-PSMA是独立预测因子,截止值为11.5，比值比为1.221。
结论：截止值为11.5的SUVmax-PSMA是提高PCa对[68Ga]Ga-PSMA-11全身成像诊断准确性的独立预测因子。
方法：纳入84例患者治疗前接受了68镓标记的前列腺特异性膜抗原（[68Ga]Ga-PSMA-11）全身正电子发射断层扫描/计算机断层扫描（PET/CT）成像。前列腺的最大标准摄取值(SUVmax)(SUVmax-PSMA),肝脏（SUVmax-PSMA-L），使用[68Ga]Ga-PSMA-11全身PET/CT成像测量纵隔血池(SUVmax-PSMA-M)。[68Ga]Ga-PSMA-11来源的代谢性肿瘤体积(MTV),总病变（TLP），还确定了前列腺局灶性浓度（CAP）的横截面面积。此外,使用受试者工作特征曲线分析前列腺特异性抗原(PSA)水平和上述影像学特征,以确定临界值,从而提高疑似PCa的诊断准确性.最后,进行了多元回归分析,以发现提高[68Ga]Ga-PSMA-11全身成像诊断准确性的独立预测因子.
结果：PCa组和非PCa组的年龄没有显着差异，高度,体重,注射剂量,除了PSA水平,SUVmax-PSMA,TLP,MTV,和CAP。此外,来自SUVmax-PSMA的SUVmax-PSMA-T/L和SUVmax-PSMA-T/M均存在显着差异。此外,PSA水平曲线下的面积,SUVmax-PSMA,SUVmax-PSMA-T/L,SUVmax-PSMA-T/M,TLP,MTV,在[68Ga]Ga-PSMA-11成像上预测PCa的CAP为0.620（95％置信区间（CI）0.485-0.755），0.864（95%CI0.757-0.972），0.819（95%CI0.704-0.935），0.876（95%CI0.771-0.980），0.845（95%CI0.741-0.949），0.820（95%CI0.702-0.938），0.627（95%CI0.499-0.754），分别。然而,多元回归分析显示SUVmax-PSMA是独立预测因子,截止值为11.5，比值比为1.221。
结论：截止值为11.5的SUVmax-PSMA是提高PCa对[68Ga]Ga-PSMA-11全身成像诊断准确性的独立预测因子。
