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Abstract：
OBJECTIVE: To evaluate the diagnostic value of 68Ga-prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) for intracapsular prostate cancer with a poor prognosis (PPC) and no extracapsular invasion or distant metastasis.
METHODS: The PET/CT images and clinical data of 221 patients were retrospectively analyzed. These patients all had clear pathological results. The maximum standard uptake value (SUVmax) of the main lesions was measured at the postprocessing workstation and was tested for correlation with the pathological score. The diagnostic accuracy was calculated using the receiver operating characteristic (ROC) curve, and the best diagnostic threshold was calculated. The correlation between SUVmax and the International Society of Urological Pathology Grade Group (GG) was also analyzed.
RESULTS: The pathological results of the 221 patients were 48 benign lesions and 173 malignant lesions, including 81 PPC. Low-, intermediate-, and high-risk prostate cancers made up 21.97% (38/173), 54.33% (94/173), and 23.70% (41/173) of the malignant lesions, respectively. SUVmax and GG were positively correlated (r = 0.54, P < 0.01). The best SUVmax thresholds for 68Ga-PSMA PET/CT for the diagnosis of intracapsular PC and PPC were 7.95 and 13.94, respectively; the specificities were 0.83 and 0.85, the negative predictive values were 0.55 and 0.87, and the areas under the ROC curves were 0.88 and 0.88, respectively.
CONCLUSIONS: 68Ga-PSMA PET/CT has high specificity and NPV in the diagnosis of intracapsular PPC, but the sensitivity for the diagnosis of intracapsular low-risk PC is low, which may cause some cases to be undetected.
METHODS: The PET/CT images and clinical data of 221 patients were retrospectively analyzed. These patients all had clear pathological results. The maximum standard uptake value (SUVmax) of the main lesions was measured at the postprocessing workstation and was tested for correlation with the pathological score. The diagnostic accuracy was calculated using the receiver operating characteristic (ROC) curve, and the best diagnostic threshold was calculated. The correlation between SUVmax and the International Society of Urological Pathology Grade Group (GG) was also analyzed.
RESULTS: The pathological results of the 221 patients were 48 benign lesions and 173 malignant lesions, including 81 PPC. Low-, intermediate-, and high-risk prostate cancers made up 21.97% (38/173), 54.33% (94/173), and 23.70% (41/173) of the malignant lesions, respectively. SUVmax and GG were positively correlated (r = 0.54, P < 0.01). The best SUVmax thresholds for 68Ga-PSMA PET/CT for the diagnosis of intracapsular PC and PPC were 7.95 and 13.94, respectively; the specificities were 0.83 and 0.85, the negative predictive values were 0.55 and 0.87, and the areas under the ROC curves were 0.88 and 0.88, respectively.
CONCLUSIONS: 68Ga-PSMA PET/CT has high specificity and NPV in the diagnosis of intracapsular PPC, but the sensitivity for the diagnosis of intracapsular low-risk PC is low, which may cause some cases to be undetected.
摘要：
目的：评价68Ga-前列腺特异性膜抗原（PSMA）正电子发射断层扫描/计算机断层扫描（PET/CT）对预后不良（PPC）且无囊外浸润或远处转移的囊内前列腺癌的诊断价值。
方法：对221例患者的PET/CT图像及临床资料进行回顾性分析。这些患者均有明确的病理结果。在后处理工作站测量主要病变的最大标准摄取值（SUVmax），并测试其与病理评分的相关性。使用受试者工作特性（ROC）曲线计算诊断准确性，并计算出最佳诊断阈值。还分析了SUVmax与国际泌尿外科病理学会分级组（GG）之间的相关性。
结果:221例患者病理结果为良性病变48例,恶性病变173例,包括81PPC。低-,中介-，高危前列腺癌占21.97%(38/173)，54.33%（94/173），23.70%(41/173)的恶性病变，分别。SUVmax与GG呈正相关(r=0.54,P<0.01)。68Ga-PSMAPET/CT诊断囊内PC和PPC的最佳SUVmax阈值分别为7.95和13.94；特异性分别为0.83和0.85，阴性预测值分别为0.55和0.87，ROC曲线下面积分别为0.88和0.88。
结论：68Ga-PSMAPET/CT对囊内PPC的诊断具有较高的特异性和NPV,但诊断囊内低风险PC的敏感性较低，这可能会导致某些病例未被发现。
方法：对221例患者的PET/CT图像及临床资料进行回顾性分析。这些患者均有明确的病理结果。在后处理工作站测量主要病变的最大标准摄取值（SUVmax），并测试其与病理评分的相关性。使用受试者工作特性（ROC）曲线计算诊断准确性，并计算出最佳诊断阈值。还分析了SUVmax与国际泌尿外科病理学会分级组（GG）之间的相关性。
结果:221例患者病理结果为良性病变48例,恶性病变173例,包括81PPC。低-,中介-，高危前列腺癌占21.97%(38/173)，54.33%（94/173），23.70%(41/173)的恶性病变，分别。SUVmax与GG呈正相关(r=0.54,P<0.01)。68Ga-PSMAPET/CT诊断囊内PC和PPC的最佳SUVmax阈值分别为7.95和13.94；特异性分别为0.83和0.85，阴性预测值分别为0.55和0.87，ROC曲线下面积分别为0.88和0.88。
结论：68Ga-PSMAPET/CT对囊内PPC的诊断具有较高的特异性和NPV,但诊断囊内低风险PC的敏感性较低，这可能会导致某些病例未被发现。
