METHODS: In four different centers, all PCa patients with BS and PSMA-PET/CT within 6 months without any change in therapy or significant disease progression were retrospectively selected. Up to 10 non-confluent clear bone metastases were selected per PSMA-PET/CT and SUVmax, SUVmean, PSMAtot, PSMAvol, density, diameter on CT, and presence of cortical erosion were collected. Clinical variables (age, PSA, Gleason Score) were also considered. Two experienced double-board physicians decided whether a bone metastasis was visible on the BS, with a consensus readout for discordant findings. For predictive performance, a random forest was fit on all available predictors, and its accuracy was assessed using 10-fold cross-validation performed 10 times.
RESULTS: A total of 43 patients were identified with 222 bone lesions on PSMA-PET/CT. A total of 129 (58.1%) lesions were visible on the BS. In the univariate analysis, all PSMA-PET/CT parameters were significantly associated with the visibility on the BS (p < 0.001). The random forest reached a mean accuracy of 77.6% in a 10-fold cross-validation.
CONCLUSIONS: These preliminary results indicate that there might be a way to predict the BS results based on PSMA-PET/CT, potentially improving the comparability between both examinations and supporting decisions for therapy selection.
方法:在四个不同的中心,回顾性选择所有6个月内接受BS和PSMA-PET/CT检查且治疗无任何改变或疾病有显著进展的PCa患者.根据PSMA-PET/CT和SUVmax选择多达10个非汇合的透明骨转移瘤,Suvmean,PSMAtot,PSMAvol,密度,CT上的直径,并收集了皮质侵蚀的存在。临床变量(年龄,PSA,还考虑了格里森评分)。两位经验丰富的双板医生决定在BS上是否可见骨转移,对不一致的发现有共识的读数。对于预测性性能,随机森林适合所有可用的预测因子,其准确性通过进行10次10倍交叉验证进行评估.
结果:共有43例患者在PSMA-PET/CT上发现222个骨病变。在BS上可见总共129个(58.1%)病变。在单变量分析中,所有PSMA-PET/CT参数均与BS上的能见度显著相关(p<0.001).随机森林在10倍交叉验证中达到77.6%的平均准确度。
结论:这些初步结果表明,可能有一种方法可以根据PSMA-PET/CT预测BS结果,可能会改善两种检查之间的可比性,并支持治疗选择的决策。