<sup>68</sup>Ga-PSMA PET-CT与mpMRI显像对前列腺癌淋巴结转移的诊断价值比较

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (587 KB)
输出: BibTeX | EndNote (RIS)

摘要目的系统评价⁶⁸Ga-PSMA PET/CT与mpMRI显像对前列腺癌淋巴结转移的诊断价值。方法通过检索国内外中英文数据库,纳入⁶⁸Ga-PSMA PET/CT与mpMRI显像诊断前列腺癌淋巴结转移的诊断性临床试验,并分别基于患者或病灶提取文献中的原始数据。通过软件将数据合并进行分析,分别合并⁶⁸Ga-PSMA PET/CT与mpMRI显像诊断前列腺癌淋巴结转移的敏感性(sensitivity,SEN)、特异性(specific,SPE)、阳性似然比(positive likelihood ratio,PLR)、阴性似然比(negative likelihood ratio,NLR)、诊断比值比(diagnostic odds ratio,DOR)以及SROC曲线下面积(area under curve,AUC)等。结果共纳入13篇符合条件的文献,系统评价结果显示,基于患者的分析结果中,⁶⁸Ga-PSMA PET/CT与mpMRI对前列腺癌淋巴结转移的SEN、SPE、PLR 、NLR、DOR、AUC分别为0.44、 0.93、5.25、 0.61、 9.6、0.90及0.44、0.95、5.46、0.62、12.06、0.90。基于淋巴结的分析结果中,⁶⁸Ga-PSMA PET/CT与mpMRI对前列腺癌淋巴结转移的SEN、SPE、PLR 、NLR、DOR、AUC分别为0.58、0.99、61.22、0.24、 308.06、0.99及0.61、0.99、27.17、0.36、90.48、0.99。结论 ⁶⁸Ga-PSMA PET/CT与mpMRI显像诊断前列腺癌淋巴结转移的特异性均很高、敏感性欠佳, mpMRI对于PCa淋巴转移的诊断可能更具有临床价值。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	黄世明
	岳建兰
	尹亮
	孙永锋
	林志春

关键词 ：前列腺特异性膜抗原, 多参数磁共振, PET/CT, 前列腺癌, 淋巴结

Abstract：Objective To evaluate the diagnostic value of ⁶⁸Ga-PSMA PET/CT and mpMRI in prostate cancer with lymph node metastasis.Methods The Chinese and English databases at home and abroad were searched for diagnostic clinical trials related to ⁶⁸Ga-PSMA PET/CT and mpMRI imaging used for diagnosis of prostate cancer patients with lymph node metastasis. The original data in the literature was retrieved based on patients or lesions. The data was integrated and analyzed by software, including the sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the area under the SROC curve (AUC) of ⁶⁸Ga-PSMA PET/CT and mpMRI imaging in diagnosing prostate cancer with lymph node metastasis.Results A total of 13 eligible articles were included. The patient-based analysis suggested that the SEN, SPE, PLR, NLR, DOR, and AUC of ⁶⁸Ga-PSMA PET/CT for prostate cancer patients with lymph node metastasis were 0.44, 0.93, 5.25, 0.61, 9.67, and 0.90 respectively, while those of mpMRI imaging were 0.44, 0.95, 5.46, 0.62, 12.06 and 0.90 respectively, compared with 0.58, 0.99, 61.22, 0.24, 308.06 and 0.99 with ⁶⁸Ga-PSMA PET/CT, and 0.61, 0.99, 27.17, 0.36, 90.48 and 0.99 with mpMRI imaging when the analysis was based on lymph nodes.Conclusions Both ⁶⁸Ga-PSMA PET/CT and mpMRI imaging have high specificity but poor sensitivity in diagnosing prostate cancer with lymph node metastasis, and mpMRI may be of higher clinical value for the diagnosis of prostate cancer with lymph node metastasis.

Key words： prostate-specific membrane antigen multiparametric magnetic resonance imaging PET/CT prostate cancer lymph node

收稿日期: 2020-12-03

ZTFLH:

R445

通讯作者: 林志春,E-mail:zhichunlin@126.com

作者简介: 黄世明,硕士研究生,医师。

引用本文:

黄世明, 岳建兰, 尹亮, 孙永锋, 林志春. ⁶⁸Ga-PSMA PET-CT与mpMRI显像对前列腺癌淋巴结转移的诊断价值比较[J]. 武警医学, 2021, 32(4): 320-324. HUANG Shiming, YUE Jianlan, YIN Liang, SUN Yongfeng, LIN Zhichun. A comparison of lymph node staging between ⁶⁸Ga-PSMA PET-CT and mpMRI in patients with prostate cancer. Med. J. Chin. Peop. Armed Poli. Forc., 2021, 32(4): 320-324.

链接本文:

http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2021/V32/I4/320

[1]	Culp M B, Soerjomataram I, Efstathiou J A, et al. Recent global patterns in prostate cancer incidence and mortality rates[J]. Eur Urol, 2020,77(1):38-52.
[2]	Ali A, Hoyle A, Mistry H, et al. Importance of non-regional lymph nodes in assigning risk in primary metastatic prostate cancer[J]. BJU Int, 2019, 123(1): 65-73.
[3]	Chen M, Qiu X, Zhang Q, et al. PSMA uptake on 68Ga-PSMA-11-PET/CT positively corrects with prostate cancer aggressiveness[J]. Q J Nucl Med Mol Imaging, 2019.
[4]	Porpiglia F, Manfredi M, Mele F, et al. Indication to pelvic lymph nodes dissection for prostate cancer: the role of multiparametric magnetic resonance imaging when the risk of lymph nodes invasion according to Briganti updated nomogram is <5[J]. Prostate Cancer Prostatic Dis, 2018, 21(1): 85-91.
[5]	Israel B, Leest M V, Sedelaar M, et al. Multiparametric magnetic resonance imaging for the detection of clinically significant prostate cancer: what urologists need to know. Part 2: interpretation[J]. Cancer Imaging, 2020, 77(4): 469-480.
[6]	Calais J, Ceci F, Eiber M, et al. 18F-fluciclovine PET-CT and 68Ga-PSMA-11 PET-CT in patients with early biochemical recurrence after prostatectomy: a prospective, single-centre, single-arm, comparative imaging trial[J]. Lancet Oncol, 2019, 20(9): 1286-1294.
[7]	Schwenck J, Rempp H, Reischl G, et al. Comparison of 68Ga-labelled PSMA-11 and 11C-choline in the detection of prostate cancer metastases by PET/CT[J]. Eur J Nucl Med Mol Imaging, 2017, 44(1): 92-101.
[8]	Freitag M T, Radtke J P, Hadaschik B A, et al. Comparison of hybrid 68Ga-PSMA PET/MRI and 68Ga-PSMA PET/CT in the evaluation of lymph node and bone metastases of prostate cancer[J]. Eur J Nucl Med Mol Imaging, 2016, 43(1): 70-83.
[9]	Jilg C A, Drendel V, Rischke H C, et al. Detection rate of 18F-choline PET/CT and 68Ga-PSMA-HBED-CC PET/CT for prostate cancer lymph node metastases with direct link from PET to histopathology: dependence on the size of tumor deposits in lymph nodes[J]. J Nucl Med, 2019, 60(7): 971-977.
[10]	Franklin A, Yaxley W J, Raveenthiran S, et al. Histological comparison between predictive value of preoperative 3-T multiparametric MRI and 68 Ga-PSMA PET/CT scan for pathological outcomes at radical prostatectomy and pelvic lymph node dissection for prostate cancer[J]. BJU Int,2020,127(1):71-79.
[11]	Yilmaz B, Turkay R, Colakoglu Y, et al. Comparison of preoperative locoregional Ga-68 PSMA-11 PET-CT and mp-MRI results with postoperative histopathology of prostate cancer[J]. Prostate, 2019, 79(9): 1007-1017.
[12]	van Leeuwen P J, Donswijk M, Nandurkar R, et al. Gallium-68-prostate-specific membrane antigen (68 Ga-PSMA) positron emission tomography (PET)/computed tomography (CT) predicts complete biochemical response from radical prostatectomy and lymph node dissection in intermediate- and high-risk prostate cancer[J]. BJU Int,2019, 124(1): 62-68.
[13]	Zhang Q, Zang S, Zhang C, et al. Comparison of 68Ga-PSMA-11 PET-CT with mpMRI for preoperative lymph node staging in patients with intermediate to high-risk prostate cancer[J]. J Transl Med, 2017, 15(1): 230.
[14]	Gupta M, Choudhury P S, Hazarika D, et al. A comparative study of 68gallium-prostate specific membrane antigen positron emission tomography-computed tomography and magnetic resonance imaging for lymph node staging in high risk prostate cancer patients: an initial experience[J]. World J Nucl Med, 2017, 16(3): 186-191.
[15]	Yaxley J W, Raveenthiran S, Nouhaud F X, et al. Outcomes of primary lymph node staging of intermediate and high risk prostate cancer with 68Ga-PSMA positron emission tomography/computerized tomography compared to histological correlation of pelvic lymph node pathology[J]. J Urol, 2019, 201(4): 815-820.
[16]	Öbek C, Doganca T, Demirci E, et al. The accuracy of 68Ga-PSMA PET/CT in primary lymph node staging in high-risk prostate cancer[J]. Eur J Nucl Med Mol Imaging, 2017, 44(11): 1806-1812.
[17]	Jilg C A, Drendel V, Rischke H C, et al. Diagnostic accuracy of Ga-68-HBED-CC-PSMA-Ligand-PET/CT before salvage lymph node dissection for recurrent prostate cancer[J]. Theranostics, 2017, 7(6): 1770-1780.
[18]	Pfister D, Porres D, Heidenreich A, et al. Detection of recurrent prostate cancer lesions before salvage lymphadenectomy is more accurate with 68Ga-PSMA-HBED-CC than with 18F-Fluoroethylcholine PET/CT[J]. Eur J Nucl Med Mol Imaging, 2016, 43(8): 1410-1417.
[19]	Budäus L, Leyh-Bannurah S R, Salomon G, et al. Initial experience of 68Ga-PSMA PET/CT imaging in high-risk prostate cancer patients prior to radical prostatectomy[J]. Eur Urol, 2016, 69(3): 393-396.
[20]	van Leeuwen P J, Emmett L, Ho B, et al. Prospective evaluation of 68Gallium-prostate-specific membrane antigen positron emission tomography/computed tomography for preoperative lymph node staging in prostate cancer[J]. BJU Int,2017, 119(2): 209-215.
[21]	Piccardo A, Paparo F, Piccazzo R, et al. Value of fused 18F-Choline-PET/MRI to evaluate prostate cancer relapse in patients showing biochemical recurrence after EBRT: preliminary results[J]. Biomed Res Int, 2014, 2014: 103718.
[22]	Kitajima K, Murphy R C, Nathan M A, et al. Detection of recurrent prostate cancer after radical prostatectomy: comparison of 11C-choline PET/CT with pelvic multiparametric MR imaging with endorectal coil[J]. J Nucl Med, 2014, 55(2): 223-232.
[23]	Parker C C, James N D, Brawley C D, et al. Radiotherapy to the primary tumour for newly diagnosed, metastatic prostate cancer (STAMPEDE): a randomised controlled phase 3 trial[J]. Lancet, 2018, 392(10162): 2353-2366.
[24]	Gillessen S, Attard G, Beer T M, et al. Management of patients with advanced prostate cancer: the report of the advanced prostate cancer consensus conference APCCC 2017[J]. Eur Urol, 2018, 73(2): 178-211.
[25]	Sun Y, Reynolds H M, Parameswaran B, et al. Multiparametric MRI and radiomics in prostate cancer: a review[J]. Australas Phys Eng Sci Med, 2019, 42(1): 3-25.
[26]	Pereira M R,Treglia G,Ferrari M,et al.Correlation between PSA kinetics and PSMA-PET in prostate cancer restaging: a meta-analysis[J].Eur J Clin Invest,2019, 49(3): e13063.
[27]	Hirmas N, Al-Ibraheem A, Herrmann K, et al.[68Ga]PSMA PET/CT improves initial staging and management plan of patients with high-risk prostate cancer[J]. Mol Imaging Biol, 2019, 21(3): 574-581.
[28]	Roggero E, Giovacchini G, Giovannini E, et al. PET/CT with 68Ga-PSMA in prostate cancer: radiopharmaceutical background and clinical implications[J]. Eur J Clin Invest, 2018, 11(1): 4-13.
[29]	Sheng K, Le K, Bui C, et al. Incidental detection of splenic hemangioma on 68Ga-PSMA PET/CT[J]. Clin Nucl Med, 2019, 44(10): 821-823.
[30]	Raveenthiran S, Esler R, Yaxley J, et al. The use of 68Ga-PET/CT PSMA in the staging of primary and suspected recurrent renal cell carcinoma[J]. Eur J Nucl Med Mol Imaging, 2019, 46(11): 2280-2288.