The predictive value of 68Ga-PSMA PET/CT to distinguish between benign and malignant prostate disease before repeat prostate biopsy
10.3760/cma.j.cn112330-20210726-00398
- VernacularTitle:68Ga-PSMA PET/CT显像在前列腺重复穿刺前对良恶性病变的预判价值
- Author:
Chen LIU
1
;
Teli LIU
;
Qing XIE
;
Zhongyi ZHANG
;
Kun YAN
;
Yong YANG
;
Yiqiang LIU
;
Zhi YANG
;
Ning ZHANG
Author Information
1. 北京大学肿瘤医院暨北京市肿瘤防治研究所核医学科 恶性肿瘤发病机制及转化研究教育部重点实验室 100142
- Keywords:
Prostatic neoplasms;
Prostate biopsy;
Prostate specific membrane antigen;
Positron emission tomography/computed tomography
- From:
Chinese Journal of Urology
2021;42(9):712-716
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the diagnostic performance of repeat biopsy 68Ga-PSMA PET/CT to distinguish between benign and malignant prostate disease. Methods:The clinical data and medical imaging of thirty-nine patients underwent repeat prostate biopsy were analyzed respectively in this study. The median age of patients was 65 years (range 46-81 years), the median PSA level was 11.0ng/ml (range 5.4-49.8 ng/ml), f/tPSA was 0.15(0.01-16.50)ng/ml, prostate volume was 43.80(7.79-108.63)ml, and PSA density was 0.24(0.09-2.31)ng/ml 2. All patients underwent pre-biopsy 68Ga-PSMA PET/CT and the standard transrectal ultrasound-guided systematic prostate biopsy. Based on the biopsy results, 68Ga-PSMA PET/CT images of all patients were visually and semi-quantitatively analyzed. By visual analysis, 68Ga-PSMA uptake in prostate was defined as focal, multimodal and inhomogeneous, and then the detection rate of prostate cancer in each subgroup was analyzed. The value of the ROC curve in the diagnosis of prostate cancer was analyzed based on the SUV max of prostate cancer(SUV max), tumor-to-normal-prostate background(SUV T/BGp)as semi-quantitative parameters of 68Ga-PSMA PET/CT. Results:Prostate cancer was detected in 18 patients (46.2%) and 12 patients (30.8%) had clinically significant disease. There were 11, 5 and 2 patients with prostate cancer respectively in men with a focal (12 patients), multifocal(7 patients) and inhomogeneous (20 patients) 68Ga-PSMA uptake. The ROC analysis revealed a SUV max 5.3 and SUV T/BGp1.8 as an optimal cut-off level to distinguish between non-prostate cancer and prostate cancer in 68Ga-PSMA PET/CT, the sensitivity and specificity were 100.0% and 85.7% for SUV max (AUC=0.979), 83.3% and 90.5% for SUV T/BGp (AUC=0.915). Conclusions:Pre-biopsy 68Ga-PSMA PET/CT could help to distinguish between benign and malignant prostate disease before repeat prostate biopsy and detect the foci of prostate cancer.
