Study on the detection efficiency of <sup>18</sup>F-PSMA-1007 PET/CT and mp-MRI in prostate cancer and its correlation with pathological grade

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• Clinical Article •

Study on the detection efficiency of 18F-PSMA-1007 PET/CT and mp-MRI in prostate cancer and its correlation with pathological grade

ZHOU Yunshu CHEN Xiaohua CHEN Zhiqiang ZHANG Ruodi LIU Shili WANG Zhuo ZHANG Shaoru LI Peng LI Yanmei

Cite this article as: ZHOU Y S, CHEN X H, CHEN Z Q, et al. Study on the detection efficiency of 18F-PSMA-1007 PET/CT and mp-MRI in prostate cancer and its correlation with pathological grade[J]. Chin J Magn Reson Imaging, 2024, 15(2): 71-76, 96. DOI:10.12015/issn.1674-8034.2024.02.010.

Abstract

[Abstract] Objective To explore the comparison of the detection efficacy of 18-fluoro-labeled prostate specific membrane antigen (¹⁸F-PSMA-1007) positron emission tomography (PET)/computed tomography (CT) and multi-parameter magnetic resonance imaging (mp-MRI) alone and combined with prostate cancer (PCa) and the correlation between maximum standardized uptake value (SUVmax), apparent diffusion coefficient (ADC), SUVmax/ADC, T1, T2, proton density (PD) value and pathological grade of PCa.Materials and Methods A retrospective analysis was made on 50 patients suspected of PCa who were scheduled to undergo biopsy or surgery in our hospital from April 2020 to September 2022, of which 42 cases were diagnosed with PCa. According to the International Society of Urological Pathology (ISUP), the patients were divided into 5 groups. According to ISUP classification, there were 25 cases in high grade group (≥4 grade) and 17 cases in low grade group (1-3 grade). The differences of SUVmax, ADC and SUVmax/ADC in different grade groups were compared. Spearman correlation analysis was used to analyze the correlation among SUVmax value, ADC value, SUVmax/ADC, T1, T2, PD value and ISUP classification. Taking pathology as the gold standard, the efficacy of ¹⁸F-PSMA-1007 PET/CT and mp-MRI alone or in combination in the detection of benign and malignant prostate was analyzed. The diagnostic efficacy of SUVmax, ADC, SUVmax/ADC and combined parameters was evaluated by drawing receiver operating characteristic (ROC) and calculating the area under the curve (AUC), sensitivity and specificity, and the differences of AUC values were compared by DeLong test.Results There were significant differences in ADC, SUVmax, SUVmax/ADC between high-grade group and low-grade group (all P<0.001). Correlation analysis showed that there was a negative correlation between ADC and SUVmax in 50 cases of prostate diseases (r=-0.516, P<0.05), a negative correlation between ADC and ISUP in 42 cases of diagnosed PCa (r=-0.616, P<0.05), and a positive correlation between SUVmax, SUVmax/ADC and ISUP (r=0.549, r=0.639, all P<0.05). Magnetic resonance image compilation (MAGiC) sequence was completed in 20 cases, in which T1, T2, PD values were not correlated with ISUP (r＝0.045, r=0.202, r=0.028, all P>0.05), T1 and T2 values were positively correlated with ADC (r＝0.616, r=0.756, all P<0.05), while PD values were negatively correlated with ADC (r=-0.506, P<0.05). There was no significant correlation between SUVmax and T1, T2, PD (r＝-0.132, r＝-0.422, r＝0.230, all P>0.05). ROC curve analysis showed that the AUC of SUVmax was 0.940 and the difference was statistically significant (P<0.001). With SUVmax=7.80 as the critical value, the sensitivity and specificity for the diagnosis of PCa were 83.33% and 100.00%, and the AUC of ADC was 0.970 and the difference was statistically significant (P<0.001). When ADC was 1.20×10^-3 mm²/s, the sensitivity and specificity for the diagnosis of PCa were 95.24% and 87.50%, respectively. The AUC of SUVmax/ADC combined diagnosis of PCa was 0.970, and the difference was statistically significant (P<0.001). With SUVmax/ADC=6.43×10³ as the critical value, the sensitivity and specificity of PCa diagnosis were 90.48% and 100.00%, respectively. The AUC of combining the two parameters was 0.976, and the difference was statistically significant (P<0.001). Taking 0.85 as the critical value, the sensitivity of diagnosing PCa was 90.48%, and the specificity was 100.00%.Conclusions The combination of ¹⁸F-PSMA-1007 PET/CT and mp-MRI can improve the diagnostic efficiency of PCa. ADC value, SUVmax and SUVmax/ADC can distinguish between low-risk and medium-high-risk PCa.

[Keywords] prostate cancer；prostate specific membrane antigen；diffusion weighted imaging；maximum standardized uptake value；apparent diffusion coefficient；magnetic resonance imaging；neoplasm grading

Contributor Information

ZHOU Yunshu¹ CHEN Xiaohua¹ CHEN Zhiqiang^{2,
3*} ZHANG Ruodi¹ LIU Shili¹ WANG Zhuo¹ ZHANG Shaoru¹ LI Peng³ LI Yanmei⁴

¹ School of Clinical Medicine, Ningxia Medical University, Yinchuan 750004, China

² Department of Radiology, the First Affiliated Hospital of Hainan Medical University, Haikou 570102, China

³ Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan 750004, China

⁴ Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Yinchuan 750004, China

Corresponding author: CHEN Z Q, E-mail: zhiqiang_chen99@163.com

Conflicts of interest None.

Publication Information

Received 2023-09-15

Accepted 2023-12-26

DOI: 10.12015/issn.1674-8034.2024.02.010

Text

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