⁶⁸Ga-PSMA PET/CT Imaging In Patients With Prostate Cancer

Background:Prostate cancer is a worldwide diagnosed cancer.It is still a difficulty for clinicians to distinguish Prostate cancer from other prostate diseases.PSMA,as a specific antigen of prostate cancer,has already performed an important role in the diagnosis of prostate cancer,and ⁶⁸Ga-PSMA PET imaging is widely used in clinical management of prostate cancer.In this study,we did a research on the maximum standard uptake value of ⁶⁸Ga-PSMA PET/CT imaging,and its relevance with serum PSA level,Gleason score and clinical staging.Then we discussed the clinical significance of PSMA expression in patients with negative biopsy results.Objective:To investigate the maximum standard uptake value of ⁶⁸Ga-PSMA PET/CT imaging in patients with different serum PSA levels,pathologic diagnosis and clinical stagings.To evaluate the value of PSMA expression in patients with negative biopsy results.Materials and Methods:Clinical material of 110 males,with lower urinary tract symptoms and high PSA level,was collected from July 2017 to April 2019.Then we investigate the maximum standard uptake value separately with different serum PSA levels,pathologic diagnosis and clinical stagings in different patient by SPSS 22.0 and GraphPad Prism6.At the same time,12 patients with negative biopsy results were arranged to recive ⁶⁸Ga-PSMA PET/CT imaging and performed prostate biopsy under the guidanc of ⁶⁸Ga-PSMA PET/CT imaging.Then comparison of ⁶⁸Ga-PSMA PET/CT imaging was did in patients with prostate cancer and benign prostatic hyperplasia.Results:The area under summary receiver operating ROC of SUVmax and PSA was 0.858?0.783⁰.933?and 0.674?0.563⁰.785?,respectively.The SUVmax of ⁶⁸Ga-PSMA PET/CT in patients with prostate cancer was significantly higher than that in patients with benign prostatic hyperplasia?P<0.0001?.There was a assosiation between SUVmax and serum PSA levels in prostate cancer patients?r=0.344,P=0.003?,and it presented a difference at the value of 20ng/ml serum PSA level?P=0.005?.But there was no significant difference of SUVmax among different serum PSA levels in patients with benign prostatic hyperplasia?P=0.506?.And it showed a assosiation between SUVmax and Gleason score?r=0.265,P=0.023?,and there was a difference in SUVmax between Gleason score>7 and Gleason score?7?P=0.032?.There was a assosiation between SUVmax and the risk of tumor inwasion?r=0.249,P=0.032?,and there was a difference in SUVmax between T>2c and T?2c?P=0.022?.There was a difference in SUVmax between patient with metastasis and no-metastasis?P=0.049?.⁶⁸Ga-PSMA PET/CT imaging showed differences between patients with prostate cancer and benign prostatic hyperplasia in imaging features and SUVmax.Conclusions:The SUVmax of ⁶⁸Ga-PSMA PET/CT in patient with prostate cancer is higher than patients with benign prostatic hyperplasia.And it is relevant to serum PSA level,Gleason score and clinical stage in patients with prostate cancer.For patients with negative biopsy results and high serum PSA levels,⁶⁸Ga-PSMA PET/CT imaging could modify the biopsy programme and increase the positive rate.