PDF(Pubmed)
Abstract：
OBJECTIVE: The increasing use of PSMA-PET/CT for restaging prostate cancer (PCa) leads to a patient shift from a non-metastatic situation based on conventional imaging (CI) to a metastatic situation. Since established therapeutic pathways have been designed according to CI, it is unclear how this should be translated to the PSMA-PET/CT results. This study aimed to investigate whether PSMA-PET/CT and clinical parameters could predict the visibility of PSMA-positive lesions on a bone scan (BS).
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.
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.
摘要：
目的：PSMA-PET/CT在前列腺癌（PCa）中的应用越来越多，导致患者从基于常规成像（CI）的非转移情况转变为转移情况。由于已根据toCI设计了已建立的治疗途径，因此尚不清楚如何将其转化为PSMA-PET/CT结果。这项研究旨在调查PSMA-PET/CT和临床参数是否可以预测骨扫描（BS）上PSMA阳性病变的可见性。
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。
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。
