| Part 1 Comparative study of whole body high-resolution similar PET-MRI and SPECT-CT in evaluating bone metastasis of prostate cancerObjective: Comparison the diagnostic performance of whole body high-resolution similar PET-MRI(WB-HRMRI)and SPECT-CT in the diagnosis of bone metastases in newly diagnosed patients with intermediate to high risk prostate cancerMethods : This was a prospective study.We enrolled patients with newly diagnosed prostate cancer from January 2016 to December 2017.WB-HRMRI and SPECT-CT were performed separately in two weeks.Six senior radiologists and nuclear medicine doctors read the images and obtained preliminary results according to the principle of consistency.All patients had at least 6 months of imaging and clinical follow-up.The best valuable comparison(BVC)was used to get the final results,the sensitivity,specificity,and area under the curve(AUC)values of the two examination methods based on each patient and each lesion level were derived.Results:Analysis of 203 patients,36 of which had bone metastases.Based on each patient analysis: sensitivity,specificity,and AUC values for WB-HRMRI were: 97.2%,98.8%,0.980(95% confidence interval 0.950-0.995);sensitivity,specificity,and AUC values for SPECT-CT were: 61.1%,94.0%,and 0.776(95% confidence interval 0.712-0.831);the difference between the two AUCs was 0.205(95% confidence interval 0.114-0.295),and the P <0.001.Based on each lesion analysis: sensitivity,specificity,and AUC values for WB-HRMRI were: 85.6%,98.8%,0.923(95% confidence interval 0.879-0.954);sensitivity,specificity and AUC value of SPECT-CT were: 44.6%,91.7%,0.682(95% confidence interval 0.616-0.742);the difference between the two AUCs was 0.241(95% confidence interval 0.114-0.295),P < 0.001.Conclusions:Compared with SPECT-CT,WB-HRMRI has better detection efficiency and can avoid radiation damage,which is worthy of clinical application.Part 2 Predictive nomogram of bone metastasis in patients with prostate cancer diagnosed by whole body high-resolution similar PET magnetic resonance imagingObjective: Using the whole body high-resolution similar PET-MRI(WB-HRMRI)as an examination tool to establish a nomogram to predict the risk of bone metastasis in newly diagnosed prostate cancer.Methods: A prospective recruitment of prostate cancer patients with pathological diagnosis in our hospital from January 2016 to December 2017.All patients were not treated for prostate cancer before enrollment.WB-HRMRI was performed within two weeks after enrollment.Three experienced radiologists read the pictures and based on the principle of consistency to obtain preliminary results(no metastasis,suspicion,metastasis),at least half a year of follow-up of suspicious patients,using the best valuable comparison(BVC)to finally result.After dividing the patients into the metastatic group and non-metastatic group,age,prostate specific antigen(PSA),Gleason score,clinical T stage,alkaline phosphatase(ALP)were performed in univariate analysis and multivariate logistic analysis,and the nomogram was used to graphically display the logistic regression results.Results: A total of 277 patients were enrolled in the study,19 of whom were excluded for various reasons.258 patients were analysed in the study.Among them,47 patients were diagnosed with bone metastases according to the BVC criteria.Based on univariate analysis,age was not a predictor of bone metastasis.PSA,Gleason score grading,T stage,and ALP were predictors of bone metastasis.Based on multivariate logistic regression results,the PSA,Gleason score grading,T staging,and ALP were used to establish a nomogram of patients with newly diagnosed prostate cancer with bone metastases.Conclusions: A nomogram model for predicting the risk of bone metastasis in newly diagnosed prostate cancer patients using WB-HRMRI as an examination tool has been established,and helping clinicians determine whether patients need to undergo WB-HRMRI. |
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