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骨扫描是否在初始分期时超出疾病的阶段,与PSMA PET相比? 一项国际多中心回顾性研究,使用蒙面的独立读者

Thomas A Hope^1,2, Matthias Benz³, Fei Jiang⁴

¹Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California; thomas.hope@ucsf.edu.

Journal of nuclear medicine : official publication, Society of Nuclear Medicine

|August 17, 2023

概括

骨扫描经常在初始阶段误诊转移性前列腺癌,其中57%的错误阳性结果. 这影响了将临床试验数据应用于前列腺特异性膜抗原 (PSMA) PET成像阶段的患者.

科学领域:

在瘤学瘤学.
放射学放射学是一门学科.
核医学就是核医学.

背景情况:

前列腺特异性膜抗原 (PSMA) PET成像为前列腺癌的分期提供了更高的准确性,与CT和骨扫描等传统方法相比.
缺乏了解如何将从传统成像中获得的临床试验数据整合到使用PSMA PET分期的患者管理策略中.

研究的目的:

评估骨扫描在检测前列腺癌患者骨转移的诊断性能.
为了比较骨扫描与PSMA PET的精度,作为参考标准.

主要方法:

一个多中心的回顾性诊断研究包括167名前列腺癌患者,他们在100天内接受了骨扫描和PSMA PET.
三名蒙面读者独立地解释了每个成像研究.
关键的终点包括骨扫描的正预测值 (PPV),负预测值 (NPV),特异性和读者间一致性,PSMA PET作为参考标准.

主要成果:

总体而言,骨扫描显示PPV为0.73,NPV为0.82,特异性为0.82.
在接受初始分期的患者中,骨扫描显示PPV明显较低,为0.43,NPV为0.94,特异性为0.80.
对于骨头扫描 (κ=0.51),读者间的共识是中度的,但对于PSMA PET (κ=0.80) 则很大.

结论:

骨扫描在前列腺癌的初始阶段具有较低的积极预测值,错误阳性率很高 (57%).
这表明,许多通过骨扫描发现的低体积转移性疾病的患者在PSMA PET评估时实际上可能有局部疾病.
这些发现对于准确应用临床试验数据至关重要,例如来自STAMPEDE M1试验的临床试验数据,用于使用先进PSMA PET成像进行分期的患者.

关键词:

在PSMA PET中,骨扫描检查骨扫描检查最初的阶段化初始阶段化.瘤学在瘤学方面.前列腺癌是前列腺癌.放射性药物制品放射性药物制品

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