The Comparative Study Of ¹⁸F-PSMA-1007PET/CT Imaging And ^99mTc-MDPSPECT/CT Spect/ct Bone Fusion Imaging In The Diagnosis Of Prostate Cancer Bone Metastasis

Objective:Explore the application value of ¹⁸F-PSMA-1007 PET/CT imaging and^99mTc-MDP SPECT/CT bone fusion imaging in prostate cancer bone metastasis,and analyze the factors that may affect the detection rate of ¹⁸F-PSMA-1007 PET/CT imaging.Methods:A retrospective study of 45 male prostate cancer patients who underwent^99mTc-MDP SPECT/CT bone fusion imaging and ¹⁸F-PSMA-1007 PET/CT imaging in our hospital from September 2018 to October 2020,age 55～88（75.50±10.11）years old,the patient’s serum total prostate specific antigen（t PSA）value is 0.23～1367.00ng/ml,the median is 20.75ng/ml.Combined with pathology and BVC,the final diagnosis of bone metastasis was made.The patients were divided into no bone metastasis group and bone metastasis group.The statistics of ^99mTc-MDP SPECT/CT bone fusion imaging and 18F-PSMA-1007 PET/CT respectively The detection rate and number of bone metastases detected by imaging are calculated based on the sensitivity,specificity,and accuracy of the two imaging methods for each patient and each lesion,and draw the receiver operating characteristic curve,and calculate The areas under the respective curves were evaluated and compared for the diagnostic differences of the two imaging methods.At the same time,patients were divided into different subgroups according to the serum t PSA value,Gleason score,serum AKP value,and T staging.The number of positive and negative cases of ¹⁸F-PSMA-1007 PET/CT imaging in each subgroup was counted,and the number of cases was calculated.For the detection ratio of imaging,useχ2 test or Fisher’s exact probability method to compare the difference of detection ratio between different subgroups.Spearman rank correlation analysis was used to analyze the relationship between detection ratio and each subgroup.P<0.05 was considered statisticaly significant.Results:Bone metastasis occurred in 24 of 45 cases（24/45）,including 21 cases of oligometastasis and 3 cases of multiple bone metastases.Based on patient analysis:¹⁸F-PSMA-1007 PET/CT imaging and ^99mTc-MDP SPECT/CT bone fusion The sensitivity,specificity,accuracy and AUC value of imaging in the diagnosis of bone metastases were100.00%（24/24）,95.24%（20/21）,97.78%（44/45）,0.976;83.33%（20/24）),71.42%（15/21）,77.78%（35/45）,0.774,the AUC difference between the two is 0.202（95%confidence interval 0.064-0.341）,and the difference in area under the curve is statistically significant（z=2.871,P=0.004<0.05）;based on lesion analysis:the sensitivity,specificity,accuracy and AUC value of ¹⁸F-PSMA-1007 PET/CT imaging and ^99mTc-MDP SPECT/CT bone fusion imaging in the diagnosis of bone metastases were 100.00%（57/57）,95.24%（20/21）,98.72%（77/78）,0.976;57.89%（33/57）,71.42%（15/21）,61.53%（48/78）,0.690,The AUC difference between the two was 0.286（95%confidence interval0.049-0.522）,and the difference in the area under the curve was statistically significant（z=2.367,P=0.0179<0.05）.Under different Gleason grades,serum t PSA grades,serum AKP grades,and T staging grades,¹⁸F-PSMA-1007 PET/CT imaging has different detection rates for prostate cancer bone metastases,and the differences are statistically significant（χ2 values are 10.266、7.650、6.000、4.664;P values are 0.006、0.022、0.014、0.031）.Spearman rank correlation analysis showed that the detection rate of bone metastasis of prostate cancer by ¹⁸F-PSMA-1007 PET/CT imaging was positively correlated with Gleason classification,serum t PSA classification,serum AKP classification and T staging classification（r values are 0.446、0.412、0.365、0.322;P values are 0.002、0.005、0.014、0.031）.Conclusions:Compared with ^99mTc-MDP SPECT/CT bone fusion imaging,¹⁸F-PSMA-1007 PET/CT imaging is more effective in diagnosing prostate cancer bone metastasis,and can more accurately determine whether there is bone metastasis.It is an image of prostate cancer patients.It is an important supplement to academic inspection,with great potential and broad application prospects.And the detection rate of ¹⁸F- PSMA-1007 PET/CT imaging for bone metastasis of prostate cancer increased with the increase of serum AKP grade,serum t PSA grade,Gleason score grade and T stage grade.