Objective:To evaluate the diagnostic efficacy of 18F-prostate specific membrane antigen (PSMA)-1007 PET/CT in patients with prostate imaging reporting and data system (PI-RADS) 1-3 lesions on multi-parametric MRI (mpMRI) and pathologically confirmed prostate cancer. Methods:Clinical, pathological, and imaging data of 59 patients (age (67.8±7.6) years) with PI-RADS 1-3 lesions on mpMRI in the First Affiliated Hospital of Xi′an Jiaotong University between December 2021 and March 2024 were retrospectively collected. Those patients also underwent 18F-PSMA-1007 PET/CT and prostate biopsy during the same period due to an elevated prostate specific antigen (PSA) level. The diagnostic performances of 18F-PSMA-1007 PET/CT for PI-RADS 1-3 prostate cancer and clinically significant prostate cancer were evaluated by using pathological results as the standard. Mann-Whitney U test was used to compare differences in clinical characteristics and PET parameters between PET-positive and PET-negative groups, and logistic regression analysis was performed to select independent influencing factors for the PET/CT diagnosis of prostate cancer. Results:Of the included 59 patients, 7, 27, and 25 had PI-RADS scores of 1, 2, and 3 respectively. Benign prostate hyperplasia was pathologically confirmed in 8 patients, and prostate cancer was confirmed in 51 patients, of which 37 had clinically significant prostate cancer. The sensitivity of 18F-PSMA-1007 PET/CT in diagnosing prostate cancer was 86.3%(44/51), the specificity was 2/8, the accuracy was 78.0%(46/59), the positive predictive value was 88.0%(44/50), and the negative predictive value was 2/9. For patients with clinically significant prostate cancer, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 91.9%(34/37), 27.3%(6/22), 67.8%(40/59), 68.0%(34/50), and 6/9, respectively. SUV max was significantly higher in the PET-positive group ( n=44) than that in the PET-negative group ( n=7; 12.8(9.1, 23.5) vs 5.1(5.0, 6.2); Z=-4.16, P=0.001). Logistic regression analysis showed that SUV max was an independent influencing factor for the diagnosis of prostate cancer by 18F-PSMA-1007 PET/CT (odds ratio ( OR)=6.01, 95% CI: 1.57-23.00, P=0.009). Conclusions:18F-PSMA-1007 PET/CT has a high sensitivity and positive predictive value in prostate cancer patients with PI-RADS 1-3 on mpMRI. It can be used as a supplementary modality to mpMRI to guide clinical decision for patients with PI-RADS 1-3 and clinically suspected prostate cancer lesions.

Objective The application of 18F-PSMA-1007 PET/CT in the precise diagnosis and treatment of prostate cancer(PCa)is gradually increasing.This study aimed to explore the predictive value of 18F-PSMA-1007 PET/CT for positive surgical margins after radical prostatectomy(RP).Methods A total of 173 PCa patients who were pathologically confirmed and underwent RP in our hospital from July 2020 to August 2023 were retrospectively recruited.All patients underwent 18F-PSMA-1007 PET/CT whole-body imaging before surgery.According to the postoperative pathological results,they were divided into a negative surgical margin group with 83 cases and a positive surgical margin group with 90 cases.The differences in age,SUVmax,SUVmean,preoperative total prostate specific antigen(tPSA),prostate specific antigen density(PSAD),prostate volume,Gleason score,and clinical T staging between the groups were compared,and the risk factors were further analyzed by Logistic regression.Results The preoperative tPSA(Z=-3.252,P=0.001),SUVmax(Z=2.531,P=0.011),and clinical T staging(P=0.018)were all lower in the negative surgical margin group than in the positive surgical margin group.PSAD(OR=3.492,95％CI:1.095-11.133,P=0.035),SUVmax(OR=1.036,95％CI:1.003-1.070,P=0.034),and clinical T staging(OR=3.364,95％CI:1.117-10.133,P=0.045)were independent risk factors for positive surgical margins.Conclusion 18F-PSMA-1007 PET/CT has certain predictive value for positive surgical margins after RP in PCa patients.High PSAD,high SUVmax and high clinical T stage were independent risk factors for predicting positive margin after PR surgery,thus providing some reference for the clinical treatment strategy of PCa patients.

Objective To construct a radiomics model to improve the discriminatory ability of 18 F-PSMA-1007 PET/CT for focal prostate cancer.Methods We retrospectively collected data from 74 patients diagnosed with prostate cancer by biopsy at The First Affiliated Hospital of Xi'an Jiaotong University between July 2020 and April 2024.These patients had focal radionuclide accumulation observed on 18F-PSMA-1007 PET/CT,with the median age of 71 years.Among them,42 patients had a Gleason score＜8 and 32 patients had a Gleason score ≥8.An external validation set was randomly selected based on the timing of examination,while the remaining patients were randomly divided into training and test sets at a 7∶3 ratio.Region of interest(ROI)were semi-automatically drawn on registered images,manually adjusted,and symmetrically shifted to contralateral non-tumor tissue.We made variance and correlation analyses to choose features,and built models with Logistic regression and compared the results with those of visual evaluation.Receiver operating characteristics(ROC)curves were drawn to compare model performance,and subgroup analysis was performed to identify optimal features for distinguishing tumor tissue,based on Gleason score,serum total prostate specific antigen(tPSA)levels,and lesion location.Results A total of eight features were selected.The area under the curve(AUC)for visual evaluation,testing set,and external validation set were 0.858,0.933,and 0.891,respectively.The sensitivity was 0.757,0.800 and 0.917;the specificity was 0.960,0.800 and 0.792,respectively.Subgroup analysis showed that the radiomic features 10percentile and skewness had a high value in tumor differentiation.In tumor tissues,the 10percentile values were higher than in non-tumor tissues across all groups(P-values were 0.012,0.002,＜0.001,＜0.001,＜0.001,and＜0.001).When tPSA≤10 ng/mL and Gleason score ≥8,there was no statistically significant difference in skewness between tumor and non-tumor tissues(P=0.08).When tPSA ≥20 ng/mL,the skewness of non-tumor tissue was slightly higher than that of tumor tissue,but the difference was not statistically significant(P-values were 0.285 and 0.791).When the tumor was located in the posterior part of the prostate(left posterior and right posterior),the skewness was significantly higher in tumor tissue than in non-tumor tissue(P-values＜0.001 for both).Conclusion The radiomics model had better sensitivity and accuracy than visual evaluation in distinguishing focal prostate cancer tumors from non-tumor tissues,but visual evaluation had higher specificity.Skewness and 10percentile had a high value in differential diagnosis.

Objective To include patients with clinical data matched by propensity scores and to explore the value of 18F-fluorode-oxyglucose(18F-FDG)PET/CT metabolic parameters and radiomics in differentiating benign and malignant solitary pulmonary nod-ule(SPN).Methods A total of 54 patients with SPN(27 benign and 27 malignant)were retrospectively selected,all of them under-went 18F-FDG PET/CT scans.Then the metabolic parameters were analyzed,and the metabolic parameters model was established.After delineating the lesion,imaging features were selected through variance and correlation analysis.The logistic regression was used to build the model,and balance accuracy(bACC)was used to compare the performance of the models.The correlation between meta-bolic parameters and radiomics features was analyzed.Results The maximum standardized uptake value(SUVmax),total lesion uptake(TLU),and coefficient of variation(COV)of malignant were higher than those of benign(P＜0.05).SUVmax and COV had positive predictive value for malignant lesions[odds ratio(OR)＞1,P＜0.05].There was no statistical difference between the performance of the metabolic parameters model and the radiomics model(P＞0.05).There was a strong correlation between radiomics features and metabolic parameters.Conclusion After propensity score matching,metabolic parameters and radiomics show no statistical difference in differentiating benign from malignant SPN.

Objective The application of 18F-PSMA-1007 PET/CT in the precise diagnosis and treatment of prostate cancer(PCa)is gradually increasing.This study aimed to explore the predictive value of 18F-PSMA-1007 PET/CT for positive surgical margins after radical prostatectomy(RP).Methods A total of 173 PCa patients who were pathologically confirmed and underwent RP in our hospital from July 2020 to August 2023 were retrospectively recruited.All patients underwent 18F-PSMA-1007 PET/CT whole-body imaging before surgery.According to the postoperative pathological results,they were divided into a negative surgical margin group with 83 cases and a positive surgical margin group with 90 cases.The differences in age,SUVmax,SUVmean,preoperative total prostate specific antigen(tPSA),prostate specific antigen density(PSAD),prostate volume,Gleason score,and clinical T staging between the groups were compared,and the risk factors were further analyzed by Logistic regression.Results The preoperative tPSA(Z=-3.252,P=0.001),SUVmax(Z=2.531,P=0.011),and clinical T staging(P=0.018)were all lower in the negative surgical margin group than in the positive surgical margin group.PSAD(OR=3.492,95％CI:1.095-11.133,P=0.035),SUVmax(OR=1.036,95％CI:1.003-1.070,P=0.034),and clinical T staging(OR=3.364,95％CI:1.117-10.133,P=0.045)were independent risk factors for positive surgical margins.Conclusion 18F-PSMA-1007 PET/CT has certain predictive value for positive surgical margins after RP in PCa patients.High PSAD,high SUVmax and high clinical T stage were independent risk factors for predicting positive margin after PR surgery,thus providing some reference for the clinical treatment strategy of PCa patients.

Objective To construct a radiomics model to improve the discriminatory ability of 18 F-PSMA-1007 PET/CT for focal prostate cancer.Methods We retrospectively collected data from 74 patients diagnosed with prostate cancer by biopsy at The First Affiliated Hospital of Xi'an Jiaotong University between July 2020 and April 2024.These patients had focal radionuclide accumulation observed on 18F-PSMA-1007 PET/CT,with the median age of 71 years.Among them,42 patients had a Gleason score＜8 and 32 patients had a Gleason score ≥8.An external validation set was randomly selected based on the timing of examination,while the remaining patients were randomly divided into training and test sets at a 7∶3 ratio.Region of interest(ROI)were semi-automatically drawn on registered images,manually adjusted,and symmetrically shifted to contralateral non-tumor tissue.We made variance and correlation analyses to choose features,and built models with Logistic regression and compared the results with those of visual evaluation.Receiver operating characteristics(ROC)curves were drawn to compare model performance,and subgroup analysis was performed to identify optimal features for distinguishing tumor tissue,based on Gleason score,serum total prostate specific antigen(tPSA)levels,and lesion location.Results A total of eight features were selected.The area under the curve(AUC)for visual evaluation,testing set,and external validation set were 0.858,0.933,and 0.891,respectively.The sensitivity was 0.757,0.800 and 0.917;the specificity was 0.960,0.800 and 0.792,respectively.Subgroup analysis showed that the radiomic features 10percentile and skewness had a high value in tumor differentiation.In tumor tissues,the 10percentile values were higher than in non-tumor tissues across all groups(P-values were 0.012,0.002,＜0.001,＜0.001,＜0.001,and＜0.001).When tPSA≤10 ng/mL and Gleason score ≥8,there was no statistically significant difference in skewness between tumor and non-tumor tissues(P=0.08).When tPSA ≥20 ng/mL,the skewness of non-tumor tissue was slightly higher than that of tumor tissue,but the difference was not statistically significant(P-values were 0.285 and 0.791).When the tumor was located in the posterior part of the prostate(left posterior and right posterior),the skewness was significantly higher in tumor tissue than in non-tumor tissue(P-values＜0.001 for both).Conclusion The radiomics model had better sensitivity and accuracy than visual evaluation in distinguishing focal prostate cancer tumors from non-tumor tissues,but visual evaluation had higher specificity.Skewness and 10percentile had a high value in differential diagnosis.

Objective To include patients with clinical data matched by propensity scores and to explore the value of 18F-fluorode-oxyglucose(18F-FDG)PET/CT metabolic parameters and radiomics in differentiating benign and malignant solitary pulmonary nod-ule(SPN).Methods A total of 54 patients with SPN(27 benign and 27 malignant)were retrospectively selected,all of them under-went 18F-FDG PET/CT scans.Then the metabolic parameters were analyzed,and the metabolic parameters model was established.After delineating the lesion,imaging features were selected through variance and correlation analysis.The logistic regression was used to build the model,and balance accuracy(bACC)was used to compare the performance of the models.The correlation between meta-bolic parameters and radiomics features was analyzed.Results The maximum standardized uptake value(SUVmax),total lesion uptake(TLU),and coefficient of variation(COV)of malignant were higher than those of benign(P＜0.05).SUVmax and COV had positive predictive value for malignant lesions[odds ratio(OR)＞1,P＜0.05].There was no statistical difference between the performance of the metabolic parameters model and the radiomics model(P＞0.05).There was a strong correlation between radiomics features and metabolic parameters.Conclusion After propensity score matching,metabolic parameters and radiomics show no statistical difference in differentiating benign from malignant SPN.

Objective:To evaluate the diagnostic efficacy of 18F-prostate specific membrane antigen (PSMA)-1007 PET/CT in patients with prostate imaging reporting and data system (PI-RADS) 1-3 lesions on multi-parametric MRI (mpMRI) and pathologically confirmed prostate cancer. Methods:Clinical, pathological, and imaging data of 59 patients (age (67.8±7.6) years) with PI-RADS 1-3 lesions on mpMRI in the First Affiliated Hospital of Xi′an Jiaotong University between December 2021 and March 2024 were retrospectively collected. Those patients also underwent 18F-PSMA-1007 PET/CT and prostate biopsy during the same period due to an elevated prostate specific antigen (PSA) level. The diagnostic performances of 18F-PSMA-1007 PET/CT for PI-RADS 1-3 prostate cancer and clinically significant prostate cancer were evaluated by using pathological results as the standard. Mann-Whitney U test was used to compare differences in clinical characteristics and PET parameters between PET-positive and PET-negative groups, and logistic regression analysis was performed to select independent influencing factors for the PET/CT diagnosis of prostate cancer. Results:Of the included 59 patients, 7, 27, and 25 had PI-RADS scores of 1, 2, and 3 respectively. Benign prostate hyperplasia was pathologically confirmed in 8 patients, and prostate cancer was confirmed in 51 patients, of which 37 had clinically significant prostate cancer. The sensitivity of 18F-PSMA-1007 PET/CT in diagnosing prostate cancer was 86.3%(44/51), the specificity was 2/8, the accuracy was 78.0%(46/59), the positive predictive value was 88.0%(44/50), and the negative predictive value was 2/9. For patients with clinically significant prostate cancer, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 91.9%(34/37), 27.3%(6/22), 67.8%(40/59), 68.0%(34/50), and 6/9, respectively. SUV max was significantly higher in the PET-positive group ( n=44) than that in the PET-negative group ( n=7; 12.8(9.1, 23.5) vs 5.1(5.0, 6.2); Z=-4.16, P=0.001). Logistic regression analysis showed that SUV max was an independent influencing factor for the diagnosis of prostate cancer by 18F-PSMA-1007 PET/CT (odds ratio ( OR)=6.01, 95% CI: 1.57-23.00, P=0.009). Conclusions:18F-PSMA-1007 PET/CT has a high sensitivity and positive predictive value in prostate cancer patients with PI-RADS 1-3 on mpMRI. It can be used as a supplementary modality to mpMRI to guide clinical decision for patients with PI-RADS 1-3 and clinically suspected prostate cancer lesions.

ObjectiveTo compare the effect of three kinds of intrinsic foot muscle exercise on flatfoot. MethodsFrom September to November, 2022, 45 subjects with flatfoot from Capital University of Physical Education and Sports were randomly divided into short foot exercise (SFE) group (n = 15), toe-spread-out exercise (TSOE) group (n = 15) and short foot & toe-spread-out exercise (SF+TSOE) group (n = 15), who received SFE, TSOE and SF+TSOE, respectively, for eight weeks. The cross-sectional area of abductor hallucis muscle, navicular drop test (NDT) and Chippaux-Smirak index (CSI) were measured before treatment, four weeks after treatment and eight weeks after treatment. ResultsThree subjects dropped out in each group. The main effect of time was significant for left and right cross-sectional area of abductor hallucis muscle, NDT and CSI (F > 13.906, P < 0.001). The main effect of group was not significant for left and right cross-sectional area of abductor hallucis muscle, NDT and CSI (F < 1.934, P > 0.05). The interaction effect of group and time was significant for left and right NDT (F > 3.044，P < 0.05), and it was better in SF+TSOE group than in SFE group and TSOE group (P < 0.05). ConclusionSF and TSOE can improve the cross-sectional area of abductor hallucis muscle and foot morphology in subjects with flatfoot, and the combination of them may be more effective.

ObjectiveTo systematically review the effects of short-foot exercise on adult flatfoot. MethodsArticles related to short-foot exercise for flatfoot were searched from PubMed, Web of Science, Cochrane, Embase, Scopus, CNKI, Wanfang Data and CBM, from January, 2010 to December, 2022. The methodological quality was evaluated with the Physiotherapy Evidence Database (PEDro) scale, and the relevant data were extracted. ResultsTen randomized controlled trials were included, involved 335 individuals. The mean score of the PEDro scale was 7.1. Short-foot exercise improved the navicular drop, posture index score, balance and cross-sectional area of abductor hallucis muscle for patients with flatfoot, but plantar pressure. ConclusionShort-foot exercise can improve the foot structure, balance and adductor hallucis muscle in adult flatfoot, but plantar pressure.