الملخص
Objective:To evaluate the value of prostate specific membrane antigen (PSMA) PET/CT-based radiomics models in differentiation between prostate cancer and benign prostatic hyperplasia (BPH).Methods:Data from 50 patients with prostate cancer (age: (70.0±8.8) years) and 25 patients with BPH (age: (66.9±9.4) years) who underwent 18F-PSMA-1007 PET/CT imaging and prostate biopsy in the First Affiliated Hospital of Xi′an Jiaotong University from May 2020 to September 2022 were retrospectively collected. Patients were divided into the training set ( n=53) and test set ( n=22) in the ratio of 7∶3 by using random seed number. The ROIs were delineated based on PET and CT images, and radiomics features were extracted respectively. Feature selection was performed using the minimum redundancy and maximum relevance (mRMR) and the least absolute shrinkage and selection operator (LASSO) algorithm. PET and PET/CT radiomics models were generated using logistic regression. ROC curve analysis was employed for model evaluation. In addition, comparisons of the 2 radiomics models with parameters including the ratio of free prostate specific antigen (fPSA)/total prostate specific antigen (tPSA), PET metabolic parameters, as well as prostate cancer molecular imaging standardize evaluation (PROMISE) were conducted (Delong test). Results:A total of 7 features were included in the PET radiomics model, and 3 CT-based features and 4 PET-based features were included in the PET/CT radiomics model. The AUCs of PET and PET/CT radiomics models in the training set and test set were 0.941, 0.914 and 0.965, 0.914, respectively, which were higher than those of fPSA/tPSA (0.719 and 0.710), SUV max(0.748 and 0.800), peak of SUV (SUV peak, 0.722 and 0.771), metabolic tumor volume (MTV, 0.640 and 0.595), total lesion uptake (TLU, 0.525 and 0.476) and PROMISE (0.644 and 0.667)[ z values for the training set: from -6.26 to -3.13, all P<0.01; z values for the test set: from -3.16 to -1.08, P>0.05 (fPSA/tPSA, SUV max, SUV peak) or P<0.05 (MTV, TLU, PROMISE)]. The differential diagnostic accuracy, sensitivity and specificity of PET and PET/CT radiomics models in the test set were 86.36%(19/22), 13/15, 6/7 and 90.91%(20/22), 15/15, 5/7, respectively. Conclusion:Compared with the clinical and PET parameters, PSMA PET/CT-based radiomics model can further improve the efficiency of differential diagnosis between prostate cancer and BPH.
الملخص
【Objective】 To analyze the correlation of whole body tumor burden of 18F-prostate specific membrane antigen positron emission computed tomography （18F-PSMA PET/CT） with prostate specific antigen （PSA） and Gleason score so as to evaluate the value of 18F-PSMA PET/CT whole body tumor burden for predicting serum PSA progression in prostate cancer. 【Methods】 We retrospectively recruited 213 patients with prostate cancer who underwent 18F-PSMA PET/CT scanning from March 2019 to April 2021. The serum PSA and Gleason score were collected. Whole body tumor burden was measured by a semi-automatic method. The correlation of tumor burden with serum PSA and Gleason score was analyzed. After radical prostatectomy， the patients were divided into groups according to negative or positive 18F-PSMA PET/CT. PSA differences between groups were compared， and the receiver operating characteristic curve （ROC） of the subjects was drawn so as to obtain the threshold value of PSA to predict the positive rate of 18F-PSMA PET/CT. The patients were followed up for PSA after radical surgery， divided into groups according to the progress of PSA， and the differences in tumor burden between groups were compared. 【Results】 In Gleason score ≤7， =8， and ≥9 groups， whole body tumor burden was correlated with PSA in each group （P=0.001）， and tumor burden significantly differed between the groups （P<0.001）. In initial diagnosis and treatment group， biochemical recurrence group， and medication group， the correlation between tumor burden and PSA was statistically significant （P=0.001）. The Gleason score of primary prostate lesion was significantly correlated with systemic tumor burden （P<0.001）. The area under ROC curve of PSA predicting the positive rate of 18F-PSMA PET/CT after radical prostatectomy was 0.821； when PSA>0.577 ng/mL， the sensitivity and the specificity were 66.7% and 96.8%， respectively. The mean whole body tumor burden in 18F-PSMA PET/CT positive patients with PSA progression was higher than that in patients without PSA progression. 【Conclusion】 The whole body tumor burden of 18F-PSMA PET/CT is significantly correlated with PSA， which is helpful in predicting the serum PSA progression in prostate cancer. PSA can predict the positive rate of 18F-PSMA PET/CT to a certain extent. At the same time， PSA can also predict positive results of 18F-PSMA PET/CT to a certain extent， and guide clinical rational selection of this examination.
الملخص
【Objective】 To investigate the value of prostate-specific antigen （PSA） level， Gleason score， and PSMA PET/CT maximum standardized uptake value （SUVmax） in predicting prostate cancer （PCa） metastasis and the treatment option of oligometastatic PCa. 【Methods】 We retrospectively recruited 170 patients with PCa confirmed by pathology， 97 of whom were untreated， and divided them into nonmetastatic group， oligometastatic group （metastasis≤5）， and polymetastatic group. In addition， 28 patients with oligometastatic PCa underwent radical prostatectomy and 45 patients underwent androgen-deprivation therapy. We compared the differences in SUVmax， PSA， and Gleason scores between the three sub-groups of untreated patients， and also analyzed the correlation between SUVmax of local cancer lesions， Gleason score and PSA level. We further compared the differences in SUVmax and PSA levels between radical prostatectomy and androgen-deprivation therapy of oligometastatic PCa patients. According to Gleason score， patients with oligometastatic PCa were divided into two groups （low-intermediate risk group with Gleason score ≤7 and high-risk group with Gleason score ≥8）， and the levels of SUVmax and PSA between the groups were compared. 【Results】 With the increasing number of metastases， SUVmax， PSA levels and Gleason scores all showed an upward trend， and there were significant differences among the three groups （P=0.029， P=0.001， P=0.046）. The post-hoc test found significant difference in Gleason score between the oligometastatic group and the other two groups （P=0.043， P=0.002） as well as correlation of SUVmax level of the primary tumor with Gleason score and PSA （P=0.002， r=0.315； P<0.001， r=0.430）. There was significant difference in PSA level between the two groups after radical prostatectomy and androgen-deprivation therapy （P=0.017）. The difference in PSA between the two treatments persisted in the low-intermediate risk groups （P=0.021）. 【Conclusion】 PSA level， Gleason score and SUVmax have some value in predicting PCa metastasis. Radical prostatectomy is an effective treatment strategy for patients with oligometastatic PCa， especially those with low-intermediate Gleason score.
الملخص
【Objective】 To investigate the diagnostic efficiency of 18F-PSMA-1007 PET/CT in assessing the metastasis of newly diagnosed prostate cancer （PC）， and evaluate its relationship with clinical risk classification. 【Methods】 The clinical data of 257 newly diagnosed PC patients who underwent 18F-PSMA-1007 PET/CT between March 2019 and April 2021 were retrospectively reviewed in this study. All images were interpreted by two senior PET/CT diagnostic specialists. According to the D’Amico risk classification， the patients were divided into low-， intermediate- and high-risk groups. According to Gleason score （GS）， the patients were divided into GS≤6， GS=7， and GS≥8 groups. According to the level of serum total prostate-specific antigen （tPSA）， the patients were divided into <10 ng/mL， 10-20 ng/mL， and >20 ng/mL groups. Finally， in the groups with D’Amico risk classification， the subgroups were divided according to tPSA level and GS， and the differences of 18F-PSMA-1007 PET/CT in the detection of metastasis were compared among the subgroups. 【Results】 A total of 257 patients were enrolled with a median tPSA 16.34 （3.38-783.12） ng/mL and median Gleason score （GS） 8 （range： 6-10）. There were 10 （3.89%）， 36 （15.01%）， and 211（80.10%） PC patients in the low-， intermediate-， and high-risk groups， respectively. The rate of metastasis in high-risk group， GS ≥ 8 group， and tPSA >20 ng/mL group was 45.02%， 46.50%， and 47.02%， respectively. The rate of metastasis in low-risk group， GS ≤6 group and tPSA <10 ng/mL group was 0， 8.82%， and 15.63%， respectively. When tPSA <10 ng/mL， the rate of metastasis in low-risk group （0） was lower than that in high-risk group （33.33%）. When tPSA was 10-20 ng/mL， the rate of metastasis in intermediate-risk group （7.69%） was lower than that in high-risk group （38.71%）. When GS ≤6， the rate of metastasis in low-risk group （0） was lower than that in high-risk group （38.71%）. 【Conclusion】 The detection rate of metastasis in patients with newly diagnosed prostate cancer by 18F-PSMA-1007 PET/CT is positively correlated with GS， preoperative tPSA level， and D’Amico risk grade.
الملخص
【Objective】 To analyze the correlation between metabolic parameters of 18F-deoxyglucose-labeledpositron emission tomography/computed tomography（18F-FDG PET/CT） scan and the immunohistochemistry （IHC） expression in patients with primary breast cancer so as to explore the predictive value of the metabolic parameters for molecular subtypes. 【Methods】 We retrospectively recruited 97 patients who underwent 18F-FDG PET/CT scan from November 2016 to June 2020 with breast cancer. The clinical stages （Ⅰ,Ⅱ,Ⅲ and Ⅳ） and menstrual status （pre-menopause or menopause） were collected. Metabolic parameters， including the maximum standardized uptake value （SUVmax）， mean standardized uptake value （SUVmean）， metabolic tumor volume （MTV） and total lesion glycolysis （TLG） of the primary tumor， were calculated by physician according to the 40% SUVmax principle. The IHC expressions （positive or negative） of the estrogen receptor （ER）， progesterone receptor （PR）， human epidermal growth factor receptor 2 （HER2）， proliferating cell nuclear antigen （Ki-67） and p53； the ipsilateral axillary lymph node metastasis （with or without）， and the molecular subtypes （Luminal A， Luminal B， HER2 overexpression， and triple negative） were determined by an experienced pathologist. The correlations between the metabolic parameters and IHC expression were analyzed by Pearson test or Spearman test， and were further stratified by different menstrual status and ipsilateral axillary lymph node metastasis. Finally， we analyzed metabolic parameters among different molecular subtypes. 【Results】 For all the patients， SUVmax and SUVmean had significantly negative correlation with ER and PR expressions （P<0.05）； SUVmax， SUVmean， and TLG were significantly positively correlated with Ki-67 expression （P<0.05）. SUVmax， SUVmean， and TLG of premenopausal patients （n=57） were negatively correlated with ER and PR expressions （P<0.05）， but positively correlated with Ki-67 expression （P<0.05）. MTV， TLG and PR expressions in postmenopausal patients （n=40） were positively correlated （P<0.05）. In patients with （n=27） or without （n=57） ipsilateral axillary lymph node metastasis， Ki-67 was negatively correlated with SUVmax and SUVmean （P<0.05）； in patients without ipsilateral axillary lymph node metastasis， SUVmax， SUVmean， and TLG were negatively correlated with PR （P<0.05）. Among different molecular types， SUVmax of HER2 overexpression was significantly higher than that of Luminal A （P<0.05）. 【Conclusion】 The 18F-FDG PET/CT metabolic parameters of breast cancer patients have a good correlation with the expression of immunohistochemistry， and SUVmax has predictive value for the expression of hetergeneous molecular types.
الملخص
Objective To explore the characteristics and significance signification of changes of cerebral glucose metabolism in patients with Alzheimer's disease (AD).Methods Seventeen patients diagnosed with AD based on standard clinical diagnostic criteria (AD group),and 15 healthy volunteers as normal control group (HC group)were enrolled in this study.Positron emission tomography (PET)were performed in both groups and three-dimensional reconstruction images were obtained.The visual evaluation,regions of interesting (ROI)technology and brain function analysis software were used to analyze PET results data in of each group.Results ①In AD group,glucose metabolisam was decreased and mainly distributed in the parietal lobe,temporal lobe,frontal cortex,posterior cingultate and hippocampus,but not in occipital lobe,basal ganglia,thalamus and cerebellum nuclei basales,thalamus and opisthencephalon.Ssomatic sensation and motor functionand were not affected.②Compared with mild AD patients,glucose metabolism inof moderate and severe AD patients was decreased more significantly in parietal lobe,temporal lobe,frontal cortex,posterior cingultate and hippocampus,with a wider range of lesionsthe range also expanded,and visual area and speech centerpartly followed by the disorder of visual center and speech center may bewere involved in some patients.③The built-in brain function analysis software of PET system software carried by PET system was more objectiveprecise and accurate than visual evaluation or and ROI technology,can accurately reflected the changes in brain glucose metabolism which and iwas suitable for popularization and application.Conclusion Because the distribution of impaired glucose metabolism in cerebral cortex hads certain characteristics and regularity laws in AD patients.18 F-FDG PET imaging can maybe meaningful valuable in diagnosis,differential diagnosis and therapeutic evaluation in AD.
الملخص
Objective To explore the characteristics and significance signification of changes of cerebral glucose metabolism in patients with Alzheimer's disease (AD).Methods Seventeen patients diagnosed with AD based on standard clinical diagnostic criteria (AD group),and 15 healthy volunteers as normal control group (HC group)were enrolled in this study.Positron emission tomography (PET)were performed in both groups and three-dimensional reconstruction images were obtained.The visual evaluation,regions of interesting (ROI)technology and brain function analysis software were used to analyze PET results data in of each group.Results ①In AD group,glucose metabolisam was decreased and mainly distributed in the parietal lobe,temporal lobe,frontal cortex,posterior cingultate and hippocampus,but not in occipital lobe,basal ganglia,thalamus and cerebellum nuclei basales,thalamus and opisthencephalon.Ssomatic sensation and motor functionand were not affected.②Compared with mild AD patients,glucose metabolism inof moderate and severe AD patients was decreased more significantly in parietal lobe,temporal lobe,frontal cortex,posterior cingultate and hippocampus,with a wider range of lesionsthe range also expanded,and visual area and speech centerpartly followed by the disorder of visual center and speech center may bewere involved in some patients.③The built-in brain function analysis software of PET system software carried by PET system was more objectiveprecise and accurate than visual evaluation or and ROI technology,can accurately reflected the changes in brain glucose metabolism which and iwas suitable for popularization and application.Conclusion Because the distribution of impaired glucose metabolism in cerebral cortex hads certain characteristics and regularity laws in AD patients.18 F-FDG PET imaging can maybe meaningful valuable in diagnosis,differential diagnosis and therapeutic evaluation in AD.
الملخص
Objective To build an advanced clinical case collection and teaching system for the department of radiology, and thus to facilitate the scientific research and teaching.Methods By combining several free software, we built a network version of the case collection system with simple web pages, to achieve centralized storage of case text and image data, thus to facilitate the research and teaching work.Results This case collection system quickly saved text data and image data through simple operation, supported parallel work without the need for complex configuration on the client, and had good support for wide area network.This system had stable system operation and could be customized to meet the clinical needs well.Conclusion Using free software to establish the network version of the case collection and teaching system is low cost and has no legal risk.This system is a simple but powerful tool, and can meet the needs of hospitals with different sizes, which is a more perfect case collection system.
الملخص
Objective To observe the application value of PET glucose metabolic imaging and MR structural imaging in diagnosis of Alzheimer disease (AD) and mild cognitive impairment (MCI).Methods Totally 18 patients with AD (AD group),6 patients with MCI (MCI group) and 10 healthy volunteers (HC group) were enrolled.There were 11 cases of moderate or severe AD and 7 cases of mild AD in AD group.PET and structural MR imaging of the brain were performed.The radioactivity distribution in the brain and the hippocampal atrophy were observed through visually evaluation and quantitative analysis.Results The glucose metabolism reduced in certain regions of the brain in all AD patients (18/18,100％).Among them,11 patients with moderate or severe AD accompanied hippocampal atrophy,while 3 of 7 patients with mild AD showed hippocampal atrophy.No hippocampal atrophy was found in 5 patients with MCI (5/6,83.33 ％),but 2 of them showed decreased radioactivity in the brain.The symmetric mild diminution of radioactivity distribution without hippocampal atrophy was found in all subjects in HC group (10/10,100％).Two cases in HC group showed mild encephalanalosis.Conclusion Both of PET glucose metabolic imaging and MR structural imaging can be used to diagnose AD or MCI with different focus.Combination of these two techniques is helpful to improving diagnostic accuracy.