基于68Ga，PSMA，11 PET/CT和mpMRI構(gòu)建臨床模型預(yù)測前列腺單獨(dú)靶向穿刺的準(zhǔn)確性

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A clinical prediction model based on 68Ga，PSMA，11 PET/CT and mpMRI parameters to determine the diagnostic accuracy of targeted biopsy alone in prostate cancer population

AN Chaoli1，2，QIU Xuefeng1，WANG Feng3，F(xiàn)U Yao4，ZHAO Xiaozhi2，GUO Hongqian1

（1.Department of Urology，2.Department of Andrology，Affiliated Drum Tower Hospital，Medical School of Nanjing University，Nanjing 210000；3.Department of Nuclear Medicine，Nanjing First Hospital，Nanjing Medical University，Nanjing 210000；4.Department of Pathology，Affiliated Drum Tower Hospital，Medical School of Nanjing University，Nanjing 210000，China）

ABSTRACT：ObjectiveTo develop a clinical prediction model based on 68Ga，prostate，specific membrane antigen，11 （68Ga，PSMA，11），positron emission tomography/computed tomography （PET/CT） and multiparametric magnetic resonance imaging （mpMRI） parameters to stratify prostate cancer patients undergoing targeted biopsy，so as to avoid unnecessary systematic biopsy.MethodsA total of 96 clinically significant prostate cancer （csPCa） patients who underwent 68Ga，PSMA，11 PET/CT and mpMRI prior to prostate targeted biopsy with systematic biopsy during Jan.2020 and Feb.2023 in Nanjing Drum Tower Hospital were retrospectively analyzed.By univariate and multivariate logistic regression analyses，maximum standard uptake value （SUVmax） in 68Ga，PSMA，11 PET/CT and minimum apparent diffusion coefficien （ADCmin） in mpMRI，as well as clinical parameters were evaluated to identify the independent predictors correlative with the effective diagnosis of targeted biopsy，and a clinical prediction model was constructed.ResultsMultivariate logistic regression analysis showed that SUVmax （OR=0.878，95%CI：0.804-0.959，P=0.004） and ADCmin （OR=1.005，95%CI：1.001-1.010，P=0.027） were independent predictors of the effective diagnosis of targeted biopsy alone.The sensitivity，specificity，accuracy and area under the receiver operator characteristic curve （AUC） of the model were 0.80，0.80，0.83 and 0.84，respectively.ConclusionThe clinical prediction model based on 68Ga，PSMA，11 PET/CT and mpMRI parameters is helpful to improve the effective diagnosis of targeted biopsy alone，and has practical value to stratify patients with csPCa so as to safely avoid systematic biopsy and effectively balance the benefits and risks.

KEY WORDS： 68Ga，PSMA，11 PET/CT；SUVmax；ADCmin；targeted biopsy alone；clinically significant prostate cancer；mpMRI

摘要：目的基于68Ga，前列腺特異性膜抗原（PSMA），11正電子發(fā)射斷層掃描/計(jì)算機(jī)斷層掃描（PET/CT）和多參數(shù)核磁共振（mpMRI）構(gòu)建臨床預(yù)測模型，幫助臨床實(shí)現(xiàn)對需行前列腺穿刺的可疑臨床顯著性前列腺癌（csPCa）患者進(jìn)行合理分層以避免不必要的系統(tǒng)穿刺。（剩余13477字）