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Objective:To evaluate the value of 18F-prostate specific membrane antigen (PSMA)-3Q PET/CT imaging in prostate cancer patients with serum prostate specific antigen (PSA) less than 1.00 μg/L after radical prostatectomy. Methods:From May 2021 to August 2022, 18F-PSMA-3Q PET/CT images and clinical data of 58 patients with prostate cancer (age 52-82 years) after radical prostatectomy with PSA less than 1.00 μg/L in Chinese PLA General Hospital were analyzed retrospectively. According to the level of PSA, patients were divided into three groups (0-0.19 μg/L group, 0.20-0.49 μg/L group, and 0.50-0.99 μg/L group). 18F-PSMA-3Q PET/CT images were analyzed according to the standardized evaluation criteria of molecular imaging, and lesions with the scores of molecular imaging PSMA (miPSMA)≥1 were defined as recurrent or metastatic lesions. The detection rates of 18F-PSMA-3Q PET/CT for patients in different PSA level groups were compared ( χ2 test). The PSA levels of patients with positive and negative scans were compared by using independent-sample t test. Results:Of the 58 patients, 36(62.1%, 36/58) patients and 85 lesions were found by 18F-PSMA-3Q PET/CT. There was 91.7%(33/36) with oligofocal lesions (1≤number of foci≤3) and 8.3%(3/36) with multiple lesions (number of foci>3). According to the location, 5.2%(3/58) of the recurrent lesions were found in the prostatic bed, 39.7%(23/58) in the bone lesions, 37.9%(22/58) in the pelvic lymph nodes, 12.0%(7/58) in the retroperitoneal lymph nodes and 5.2%(3/58) in the left clavicular lymph node metastases. There were 15 cases in 0-0.19 μg/L group, 22 cases in 0.20-0.49 μg/L group, and 21 cases in 0.50-0.99 μg/L group. The detection rates of 18F-PSMA-3Q PET/CT in the above groups were 5/15, 59.1%(13/22) and 85.7%(18/21), respectively ( χ2=10.33, P=0.006). There was significant difference in PSA level between patients with positive ( n=36) and negative ( n=22) 18F-PSMA-3Q PET/CT scans ((0.48±0.28) vs (0.28±0.25) μg/L; t=2.67, P=0.010). Conclusions:18F-PSMA-3Q PET/CT can be used to detect the recurrence or metastasis in prostate cancer patients with PSA level lower than 1.00 μg/L after radical prostatectomy. In this kind of patients, the common sites of lesions are bone, pelvic lymph nodes, retroperitoneal lymph nodes, left clavicular lymph nodes and prostatic bed, and oligofocal patients are more common.
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Objective:To investigate the characteristics of 18F-DCFPyL PET/CT imaging in castration-resistant prostate cancer (CRPC) patients with different PSA levels. Methods:The imaging and clinical data of 50 patients with CRPC who underwent 18F-DCFPyL PET/CT examination in Chinese PLA General Hospital from January 2018 to December 2020 were analyzed retrospectively. The average age was 72 (54-95) years old. Serum total PSA was 92.28(0.36-2000.00) ng/ml. According to the total PSA level, the patients were divided into low PSA group(total PSA ≤ 1 ng/ml, n=9), medium PSA group (1 ng/ml<total PSA ≤ 10 ng/ml, n=18) and high PSA group(total PSA>10ng/ml, n=23). According to the standardized evaluation standard of molecular imaging, the suspicious tumor lesions on 18F-DCFPyL PET/CT imaging were scored by molecular imaging PSMA(miPSMA), and the miPSMA score ≥2 was defined as positive lesions. According to the number of lesions displayed by 18F-DCFPyL PET/CT, patients were divided into oligofocal group (the number of lesions ≤3) and multiple lesions group (the number of lesions >3). The imaging characteristics of patients in different groups were summarized. Results:The 18F-DCFPyL PET/CT imaging results of 50 cases in this study were all positive, including oligofocal group (n=27) and multiple lesions group (n=23). Of the 30 patients with unresected prostate, 18 had local recurrence of the prostate, while the other 12 patients with unresected prostate and 20 patients with resected prostate had no signs of local recurrence. The oligofocal group showed local recurrence, regional lymph node metastasis or bone metastasis. Patients with multiple lesions showed multiple lymph nodes and/or bone metastasis with or without local recurrence. There were 9, 18 and 4 patients with oligofoci in low, middle and high PSA groups, respectively.There were 27 patients in the oligonucleogenous group, and 21 of the 22 patients receiving local treatment were effective. All 3 patients treated with systemic treatments were effective. PSA progressed in 2 untreated patients. In the multi-foci group of 23 patients, 6 of 9 patients treated with abiraterone were effective. Two patients treated with enzalumide were ineffective. One of the 4 patients with chemotherapy was effective. One of the two patients treated with 177 Lu-PSMA nuclide was effective. One case did not respond to treatment with 89SrCl 2. Radiotherapy failed in 2 cases. PSA progressed in 3 untreated patients. Conclusions:18F-DCFPyLPET/CT imaging has a high detection rate of lesions in patients with CRPC and has potential guiding significance for follow-up treatment. The number of lesions in CRPC patients with different PSA levels was different, and the patients with low PSA levels were mainly oligofoci.
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Objective: To explore the value of 18F-DCFPyL PET/CT in pre-operative diagnosis of regional lymph node metastasis in patients with prostate cancer. Methods: Preoperative 18F-DCFPyL PET/CT images and clinical data of 49 patients with prostate cancer who underwent radical prostatectomy and pelvic lymph node dissection simultaneously were retrospectively analyzed. The total number of dissected lymph nodes and metastatic lymph nodes were counted, and the diagnostic efficacy of 18F-DCFPyL PET/CT for regional metastatic lymph nodes was calculated. The differences of the long diameter, middle diameter and short diameter of metastatic lymph nodes and non-metastatic lymph nodes were compared after resection. Results: A total of 511 lymph nodes were dissected in 49 patients. Fourteen lymph node metastases were found in 10 patients, 9 of which were correctly diagnosed by 18F-DCFPyL PET/CT. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 18F-DCFPyL PET/CT in diagnosis of lymph node metastasis of prostate cancer was 90.00%, 100%, 97.96%,100% and 97.50%, respectively. The mean long diameter, medium diameter and short diameter of metastatic lymph nodes and non-metastatic lymph nodes were (1.64±0.33)cm and (1.12±0.79)cm, (1.05±0.23)cm and (0.59±0.51)cm, (0.61±0.14)cm and (0.36±0.24)cm after resection (all P>0.05). Conclusion: Regional lymph node metastasis of prostate cancer is independent of its size. 18F-DCFPyL PET/CT has high diagnostic value for pre-operative diagnosis of regional lymph node metastasis in patients with prostate cancer.
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Objective To evaluate the value of 18F-FDG PET/CT in preoperative diagnosis and staging of suspected extrahepatic cholangiocarcinoma (EHCC).Methods The clinical data of 116 patients (72 males,44 females;age range 26-89 years) with suspected EHCC from January 2013 to October 2014 were retrospectively analyzed.All patients received preoperative whole body 18F-FDG PET/CT scan.The imaging results were compared with final clinical diagnosis.The diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy of 18F-FDG PET/CT were calculated.Two-sample t test was applied to compare lesion SUVmax of malignant and benign diseases.One-way analysis of variance was applied to compare SUVmax of highly,moderately and poorly differentiated tumors.x2 test was used to compare the difference of diagnostic sensitivities for hilar cholangiocarcinomas and common bile duct tumors.Results All patients were confirmed by exploratory laparotomy and subsequent histologic examination.A total of 94 cases (93 adenocarcinomas and 1 squamous carcinoma) were confirmed malignant and 22 cases (11 biliary calculi,9 cholangitis,1 choledochal cyst,1 tuberculosis) were confirmed benign.The diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy of 18F-FDG PET/CT for primary tumor were 61.7％ (58/94),77.3％ (17/22),92.1％ (58/63),32.1％ (17/53),64.7％ (75/116),respectively.The diagnostic sensitivity and specificity for regional lymph node metastasis were 45.5％(15/33),91.4％(53/58),and those for distant metastasis were 3/4,94.3％(82/87).The SUVmax of malignant tumors were higher than that of benign lesions (4.57± 3.75,2.72± 2.48;t =2.83,P＜ 0.05),while the differences of SUVmax among highly,moderately and poorly differentiated tumors were not significant (4.89±4.75,4.23±2.49,4.47±2.73;F=0.269,P＞0.05).18F-FDG PET/CT showed a lower sensitivity in hilar cholangiocarcinomas than that in common bile duct tumors,while no statistical significance was observed:48.6％ (17/35) vs 69.0％ (40/58),x2=3.827,P＞0.05.Conclusions The value of 18F-FDG PET/CT in preoperative diagnosis and staging of EHCC is limited.It can distinguish some benign diseases from malignant tumors,but with higher false positive for cholangitis.It can help to adjust treatment strategies by detecting distant metastasis.
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Objective To evaluate the value of SUVmax/ADCmin obtained by 11 C?choline PET/MR imaging in the differential diagnosis of benign and malignant prostate disease. Methods Suspicious prostate cancer patients who underwent PET/MR before transperineal prostate biopsy in People′s Liberation Army General Hospital from April 2014 to January 2015 were observed. Prostate gland was divided into five dis?tricts. A ROI with the diameter of 1 cm was drawn at the highest radioactivity concentration and/or lowest ADC signal area in each district, and SUVmax , ADCmin and SUVmax/ADCmin were then calculated. Taking the pathological results as the gold standard, malignant and benign prostate disease districts were separated. Pearson correlation analysis and two?sample t test were used for statistical analysis. Results Biopsy pathol?ogy showed 9 cases were malignant ( 25 prostate cancer districts, and 20 benign prostate disease districts) , and 6 cases were benign (30 benign prostate disease districts). The SUVmax had a negative correlation with ADCmin( r=-0.521, P<0?05) . The SUVmax/ADCmin of benign and malignant districts was significantly dif?ferent(5.67±3.03 and 13?76±7.13; t=6.9, P<0.01). The ROC AUC for ADCmin, SUVmax and SUVmax/ADCmin were 0?880, 0?809 and 0.898. Using SUVmax/ADCmin of 7.78 as a cutoff, the sensitivity, specificity and accuracy of 11 C?choline PET/MR imaging for differentiating the benign and malignant prostate lesions were 84.0%(21/25), 86.0%(43/50) and 85.3%(64/75), respectively. Conclusions Simultaneous 11C?choline PET/MR could be used for detecting prostate cancer. SUVmax/ADCmin may serve as an effective diag?nostic indicator for differentiating benign and malignant prostate lesions.
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OBJECTIVE@#Investigate the effect of oxidative stress on the occurrence and development of laryngeal squamous cell carcinoma associated with smoking, and the clinical diagnostic value of catalase on smoking related laryngeal squamous cell carcinoma.@*METHOD@#Collecting 119 smokers(including the smoking related laryngeal cancer group 68 cases, the control group 51 cases), the indexes of catalase (CAT), malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione (GSH), nitric oxide (NO) in blood plasma and cancerous tissue in two groups were compared. The association between these oxidative stress indicators and the occurrence and severity of smoking related laryngeal squamous cell carcinoma was analysised by SPSS 17.0.@*RESULT@#(1) Compared with control group, the smoke frequency and amount, CAT, MDA, GSH increased significantly in the smoking related laryngeal cancer group (P = 0.000; 0.000; 0.000; 0.000; 0.000); whereas SOD, NO decreased (P = 0.000; 0.000). (2) The lower the differentiation degree, the higher the serum CAT (P = 0.000) and the higher CAT, MDA, GSH of larynx tissue (P = 0.000; 0.000; 0.000), but the lower the serum NO (P = 0.000) and the lower SOD, NO of larynx tissue (P = 0.000; 0.000); The higher the clinical stage, the higher CAT of serum and larynx tissue and the higher GSH of larynx tissue (P = 0.000; 0.001), the lower NO of larynx tissue (P = 0.009). (3) The serum CAT, MDA were independent risk factors of smoking related laryngeal squamous cell carcinoma (OR = 1.060, 2.475; P < 0.01, P < 0.05).@*CONCLUSION@#Oxidative stress is the key factor of the occurrence of smoking related laryngeal squamous cell carcinoma, and the CAT can be used as the indicator of clinical diagnosis of smoking related laryngeal squamous cell carcinoma.