Comparative study in diagnostic value of 68Ga-PSMA-617 PET/CT and multi-parameter MRI for primary prostate cancer / 中华核医学与分子影像杂志

ABSTRACT

Objective To compare the diagnostic efficacy of 68Ga-prostate specific membrane antigen (PSMA)-617 PET/CT and multi-parameter MRI for primary prostate cancer.Methods From June 2017 to November 2017,24 patients (age (67.6±7.0) years) with suspected prostate cancer were prospectively enrolled.All patients underwent 68Ga-PSMA-617 PET/CT and multi-parameter MRI.Pathological diagnosis was considered as the gold standard.The diagnostic efficacy of the two methods was analyzed and the difference was evaluated by receiver operating characteristic (ROC) curve analysis(Z test).Results Based on the puncture biopsy and/or excision biopsy,18 patients were diagnosed as prostate cancer and 6 patients were diagnosed as benign diseases.According to the five-zone analysis for the prostate (24 patients with 120 zones),48 and 56 zones were detected accurately in prostate cancer patients by PET/CT and multi-parameter MRI respectively,which was 54 and 41 for benign patients.The cut-off value of maximum standardized uptake value (SUVmax) in 68Ga-PSMA-617 PET/CT for diagnosing prostate cancer was 4.85,the area under curve (AUC),sensitivity,specificity,positive predictive value,negative predictive value,accuracy and Youden index were 0.890,75.00％ (48/64),96.43％ (54/56),96.00％ (48/50),77.14％ (54/70),85.00％(102/120),71.43％ respectively for prostate cancer by PET/CT,and 0.837,87.50％(56/64),73.21％ (41/56),78.87％ (56/71),83.67％ (41/49),80.83％ (97/120) and 60.71％ respectively by multi-parameter MRI.The difference of AUC was statistically significant (Z=2.82,P＜0.01).Conclusions The diagnostic accuracy of 68Ga-PSMA-617 PET/CT imaging for prostate cancer is higher than that of multi-parameter MRI.Both modalities have high diagnostic efficiency and can be used scientifically as complementary.