现代泌尿外科杂志2024,Vol.29Issue(3) :212-218.DOI:10.3969/j.issn.1009-8291.2024.03.004

基于68Ga-PSMA-11 PET/CT和mpMRI构建临床模型预测前列腺单独靶向穿刺的准确性

A clinical prediction model based on 68Ga-PSMA-11 PET/CT and mpMRI parameters to determine the diagnostic accuracy of targeted biopsy alone in prostate cancer population

安超力 邱雪峰 王峰 付尧 赵晓智 郭宏骞
现代泌尿外科杂志2024,Vol.29Issue(3) :212-218.DOI:10.3969/j.issn.1009-8291.2024.03.004

基于68Ga-PSMA-11 PET/CT和mpMRI构建临床模型预测前列腺单独靶向穿刺的准确性

A clinical prediction model based on 68Ga-PSMA-11 PET/CT and mpMRI parameters to determine the diagnostic accuracy of targeted biopsy alone in prostate cancer population

安超力 1邱雪峰 2王峰 3付尧 4赵晓智 5郭宏骞2
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作者信息

  • 1. 南京大学医学院附属鼓楼医院泌尿外科,江苏南京 210000;南京大学医学院附属鼓楼医院男科,江苏南京 210000
  • 2. 南京大学医学院附属鼓楼医院泌尿外科,江苏南京 210000
  • 3. 南京市第一医院核医学科,江苏南京 210000
  • 4. 南京大学医学院附属鼓楼医院病理科,江苏南京 210000
  • 5. 南京大学医学院附属鼓楼医院男科,江苏南京 210000
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摘要

目的 基于68Ga-前列腺特异性膜抗原(PSMA)-11正电子发射断层扫描/计算机断层扫描(PET/CT)和多参数核磁共振(mpMRI)构建临床预测模型,帮助临床实现对需行前列腺穿刺的可疑临床显著性前列腺癌(csPCa)患者进行合理分层以避免不必要的系统穿刺.方法 回顾性收集南京大学医学院附属鼓楼医院2020年1月-2023年2月在前列腺靶向穿刺联合系统穿刺前接受了68Ga-PSMA-11 PET/CT和mpMRI扫描的96例可疑csPCa患者,纳入68 Ga-PSMA-11 PET/CT中的最大标准摄取值(SUVmax)和mpMRI中的最小表观扩散系数(ADCmin)以及其他临床参数,通过单因素和多因素logistic回归分析,确定单独靶向穿刺有效诊断的独立预测因子,并根据这些参数构建临床预测模型.结果 多因素logistic回归分析显示SUVmax(OR=0.878,95%CI:0.804~0.959,P=0.004)和 ADCmin(OR=1.005,95%CI:1.001~1.010,P=0.027)是单独靶向穿刺有效诊断的独立预测因子.以SUVmax和ADCmin构建的临床预测模型的灵敏度、特异度、准确性及受试者工作特征曲线下面积(AUC)值分别为0.80、0.80、0.83、0.84.结论 基于68Ga-PSMA-11 PET/CT和mpMRI参数构建的临床预测模型有助于提高单独靶向穿刺的有效诊断,根据该模型对可疑csPCa患者进行合理分层,安全避免系统穿刺,有效平衡获益和风险.

Abstract

Objective To develop a clinical prediction model based on 68 Ga-prostate-specific membrane antigen-11(68Ga-PSMA-11),positron emission tomography/computed tomography(PET/CT)and multiparametric magnetic resonance imaging(mpMRI)parameters to stratify prostate cancer patients undergoing targeted biopsy,so as to avoid unnecessary systematic biopsy.Methods A total of 96 clinically significant prostate cancer(csPCa)patients who underwent 68Ga-PSMA-11 PET/CT and mpMRI prior to prostate targeted biopsy with systematic biopsy during Jan.2020 and Feb.2023 in Nanjing Drum Tower Hospital were retrospectively analyzed.By univariate and multivariate logistic regression analyses,maximum standard uptake value(SUVmax)in 68 Ga-PSMA-11 PET/CT and minimum apparent diffusion coefficien(ADCmin)in mpMRI,as well as clinical parameters were evaluated to identify the independent predictors correlative with the effective diagnosis of targeted biopsy,and a clinical prediction model was constructed.Results Multivariate logistic regression analysis showed that SUVmax(OR=0.878,95%CI:0.804-0.959,P=0.004)and ADCmin(OR=1.005,95%CI:1.001-1.010,P=0.027)were independent predictors of the effective diagnosis of targeted biopsy alone.The sensitivity,specificity,accuracy and area under the receiver operator characteristic curve(AUC)of the model were 0.80,0.80,0.83 and 0.84,respectively.Conclusion The clinical prediction model based on 68Ga-PSMA-11 PET/CT and mpMRI parameters is helpful to improve the effective diagnosis of targeted biopsy alone,and has practical value to stratify patients with csPCa so as to safely avoid systematic biopsy and effectively balance the benefits and risks.

关键词

68Ga-PSMA-11/PET/CT/最大标准摄取值/最小表观扩散系数/单独靶向穿刺/临床显著性前列腺癌/多参数核磁共振

Key words

68Ga-PSMA-11 PET/CT/SUVmax/ADCmin/targeted biopsy alone/clinically significant prostate cancer/mpMRI

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出版年

2024
现代泌尿外科杂志
西安交通大学

现代泌尿外科杂志

CSTPCD
影响因子:1.106
ISSN:1009-8291
参考文献量29
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