~(18)F-FDG和~(11)C-Choline PET/CT显像及PSA值对前列腺癌诊断的临床价值

目的探讨~(18)F-脱氧葡萄糖(~(18)FFDG)和~(11)C-胆碱(~(11)C-Choline)正电子发射计算机断层显像CT检查(PET/CT)在前列腺癌诊断效能的差异。方法 63例前列腺病变患者,平均年龄(69.19±9.07)。行~(18)F-FDG和~(11)C-Choline PET/CT检查,对前列腺良性病变和前列腺癌部位分别计算标准摄取值(SUV)最大值(SUVmax)。将PET/CT诊断结果与病理检查结果对比,并分析SUVmax与血清前列腺特异抗原(PSA)的相关性。统计学处理采用SPSS 17.0软件。结果 (1)比较前列腺癌和前列腺良性病变患者~(11)C-Choline SUVmax差异有统计学意义(P0.01),两组~(18)F-FDG SUVmax值差异无统计学意义(P0.05);比较前列腺癌和前列腺良性病变患者fPSA(ng/mL)差异有统计学意义(P0.05)。(2)前列腺癌患者~(18)F-FDG SUVmax与血清f/T比值呈正相关(r=0.474,P0.05),而在前列腺良性病变患者两者之间则呈负相关(r=-0.540,P0.05)。~(11)C-Choline SUVmax与TPSA、fPSA、f/T值之间无相关性(P0.05)。结论~(11)C-Choline对前列腺癌诊断效能高于~(18)F-FDG PET/CT,但两者互相补充,fPSA和血清f/T可以协助诊断。

The Value of 18F-FDG Versus 11C-choline PET/CT and PSA in the Diagnosis of Prostate Cancer

Objective To compare the accuracy of 18F-FDG and 11C-choline PET/CT in diagnosis of prostate cancer. Methods This prospective study enrolled 63 consecutive patients with prostate diseases and presenting with rising PSA. All had 11C-choline and 18F-FDG PET/CT performed, maximum standardized uptake value SUV was used for image evaluation. The result of 11C-choline and 18F-FDG PET/CT were compared with pathologic findings, sensitivity, specificity, positive predictive value, negative predictive value were calculated for both the tracers. Possible correlation between serum prostate specific antigen(PSA)and SUVmax were investigated with linear correlation. Results (1)11C-Choline SUVmax difference was statistically significant between the patients with prostate cancer and benign lesions (P<0.01),but there were no statistically significant differences of 18F- FDG SUVmax among two groups (P>0.05). Two groups, fPSA (ng/mL) were statistically significant difference (P<0.05). (2)18F-FDG SUVmax were positively correlated with f/T ratio in prostate cancer patients (r=0.474, P<0.05),but were negatively correlated with serum f/T ratio in patients with prostatic benign lesions (r=0.540, P<0.05). Conclusion In our experimental conditions, 11C-choline provided a statistically better performance in terms of lesion detection rate as compared with 18F-FDG, but 18F-FDG and 11C-choline PET/CT play a complementary role in the diagnosis of prostate cancer patients, fPSA and serum f/T also can assist in making the diagnosis.