Value of 18F-PSMA-1007PET/CT and MRI-DWI in identifying pelvic lymph node metastasis of prostate cancer patient
He Hongjin
Li Qiong
Sun Bin
Yu Mingru
Abstract：Objective:To investigate the diagnostic value of 18F-prostate specific membrane antigen(PSMA)-1007 PET/CT and magnetic resonance diffusion-weighted imaging(MRI-DWI)for the pelvic lymph node metasta-sis of prostate cancer(PCa).Methods:The clinic and pathological datas of 45 patients with PCa admitted in our hos-pital from March 2020 to February 2023 were retrospectively analyzed.All received 18F-PSMA-1007 PET/CT and MRI-DWI preoperative scans to obtain the maximum standardized uptake value(SUVmax)and apparent diffusion co-efficient(ADC).According to post-operative pathological findings to differential diagnosis metastatic and non-meta-static lymph nodes.The levels of SUVmax and ADC were compared between metastatic and non-metastatic lymph nodes to analyze the value of differential diagnosis pelvic lymph node metastasis.Results:A total of 45 patients with PCa were included in this study,all were prostate alveolar adenocarcinoma by postoperative pathological diagno-sised.522 pelvic lymph nodes were cleared,with an average of(11.6±4.5)lymph nodes cleared per patient.10.92%(57/522)of the pelvic lymph nodes were confirmed positive by postoperative pathological diagnosised.29 cases(64.44%)were detected pelvic lymph node metastasis by 18F-PSMA-1007 PET/CT,the counts of pelvic lymph nodes was 79,17 cases(37.78%)were detected by MRI-DWI,the counts of pelvic lymph nodes was 77.24 and 16 cases were respectively diagnosed positive after postoperative pathological diagnosis.The SUVmax of metastatic lymph nodes was higher than that of non-metastatic lymph nodes,and the ADC was lower than that of non-metastatic lymph nodes(P<0.05).The sensitivity,specificity and accuracy of 18F-PSMA-1007 PET/CT for differential diag-nosis of pelvic lymph node metastasis were 96.49%,94.84%and 95.02%,and MRI-DWI were 68.42%,91.83%,89.27%.The Kappa value with pathological diagnosis was 0.781,0.522 respectively(P<0.05).The LogP model was used to fit SUVmax to ADC,and the results showed that the AUC of the combined diagnostic model to identify pelvic lymph node metastasis was 0.973(95%CI:0.955-0.985),which was higher than that of SUVmax[0.901(95%CI:0.872-0.925)and ADC[0.896(95%CI:0.868-0.920)](P<0.05).Conclusion:The diagnostic value of 18F-PSMA-1007 PET/CT for pelvic lymph node metastasis was superior to that of MRI-DWI.The quantitative pa-rameters of SUVmax and ADC from both diagnostic techniques demonstrate good diagnostic performance,and the combined efficacy of the two parameters was higher than single.
Keywords：positron emission tomography computed tomographymagnetic resonance imagingprostatic neoplasmslymphatic metastasis
Publication Date：2023-10-05
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 316-321 )