PDF(Pubmed)
Abstract：
Digital positron emission tomography/computed tomography (PET/CT) has shown enhanced sensitivity and spatial resolution compared with analog PET/CT. The present study compared the diagnostic performance of digital and analog PET/CT with [68Ga]Ga-PSMA-11 in prostate cancer patients who experienced biochemical recurrence (BCR) after prostatectomy. Forty prostate cancer patients who experienced BCR, defined as serum prostate-specific antigen (PSA) concentrations exceeding 0.2 ng/mL after prostatectomy, were prospectively recruited. These patients were stratified into three groups based on their serum PSA levels. [68Ga]Ga-PSMA-11 was injected into each patient, and images were acquired using both analog and digital PET/CT scanners. Analog and digital PET/CT showed comparable lesion detection rate (71.8% vs. 74.4%), sensitivity (85.0% vs. 90.0%), and positive predictive value (PPV, 100.0% vs. 100.0%). However, digital PET/CT detected more lesions (139 vs. 111) and had higher maximum standardized uptake values (SUVmax, 14.3 vs. 10.3) and higher kappa index (0.657 vs. 0.502) than analog PET/CT, regardless of serum PSA levels. On both analog and digital PET/CT, lesion detection rates and interrater agreement increased with increasing serum PSA levels. Compared with analog PET/CT, digital PET/CT detected more lesions with a higher SUVmax and better interrater agreement in prostate cancer patients who experienced BCR after prostatectomy.
摘要：
与模拟PET/CT相比，数字正电子发射断层扫描/计算机断层扫描（PET/CT）显示出增强的灵敏度和空间分辨率。本研究比较了数字和模拟PET/CT与[68Ga]Ga-PSMA-11在前列腺切除术后发生生化复发（BCR）的前列腺癌患者中的诊断性能。40名经历过BCR的前列腺癌患者，定义为前列腺切除术后血清前列腺特异性抗原（PSA）浓度超过0.2ng/mL，被前瞻性招募。根据血清PSA水平将这些患者分为三组。[68Ga]将Ga-PSMA-11注入每位患者，使用模拟和数字PET/CT扫描仪采集图像。模拟和数字PET/CT显示病变检出率相当(71.8%vs.74.4%），灵敏度（85.0%vs.90.0%)，和阳性预测值(PPV，100.0%vs.100.0%）。然而,数字PET/CT检测到更多的病变（139vs.111)，并具有更高的最大标准化摄取值(SUVmax，14.3vs.10.3）和更高的卡帕指数（0.657vs.0.502）比模拟PET/CT，无论血清PSA水平。在模拟和数字PET/CT上，病变检出率和评分者间的一致性随着血清PSA水平的增加而增加。与模拟PET/CT相比，在前列腺切除术后发生BCR的前列腺癌患者中，数字PET/CT检测到更多的病灶，SUVmax更高，评估者之间的一致性更好。
