目的：探讨11C-胆碱PET/CT显像在前列腺癌诊断中对18F-FDG的补充价值。方法：前瞻性对2011年10月—2016年1月我院核医学科进行PET/CT检查的前列腺疾病患者分别进行18F-FDG和11C-胆碱显像，共有63例男性患者纳入研究，以病理或≥6月的随访为标准确诊，其中前列腺癌患者38例，平均年龄71.0（48~91）岁，良性前列腺增生患者25例，平均年龄66.5（47~81）岁。比较18F-FDG和11C-胆碱PET/CT的诊断效能，分析11C-胆碱PET/CT显像在前列腺癌诊断中对18F-FDG的补充价值。结果：11C-胆碱PET/CT显像前列腺癌组SUVmax（3.91±3.29）高于前列腺增生组（1.01±1.10），差异有统计学意义（t=4.252，P<0.05）；18F-FDG PET/CT显像前列腺癌组SUVmax（3.98±4.17）与良性前列腺增生组（2.17±3.33）无明显差异（t=1.824，P>0.05）。11C-胆碱、18F-FDG PET/CT诊断前列腺癌的灵敏度分别为89.5%、81.6%，特异性分别为88.0%、60.0%，准确性分别为88.9%、73.0%；阳性预测值分别为91.9%、75.6%，阴性预测值分别为84.6%、68.2%；两者联合应用的灵敏度89.5%、特异性96.0%、准确性92.1%、阳性预测值97.1%、阴性预测值85.7%。PET/CT发现有17例骨转移，8例淋巴结转移，1例肺转移。11C-胆碱PET/CT检出骨转移病灶（584个）较18F-FDG PET/CT（497个）多，差异有统计学意义（t=2.151，P<0.05）。11C-胆碱PET/CT显像对淋巴结转移病灶的标准摄取值及转移个数与18F-FDG PET/CT显像比较无统计学差异（P>0.05）。结论：11C-胆碱可弥补18F-FDG的不足，18F-FDG联合11C-胆碱PET/CT显像可提高PET/CT对前列腺癌的诊断效能。
Abstract
Objective: To analyse the added value of 11C-choline PET/CT imaging to 18F-FDG PET/CT in primary prostate cancer. Methods: A prospective study of 18F-FDG PET/CT and 11C-choline PET/CT imaging in prostate patients encountered in our hospital from Oct 2011 to Jan 2016, a total of 63 male patients were included in the study. Including 38 cases of prostate cancer(mean age: 71 years old), 25 cases of benign prostatic hyperplasia(mean age: 66.5 years old), all cases were diagnosed by histopathology or follow-up or more for the standard diagnosis. Comparing 11C-choline with 18F-FDG PET/CT imaging for further analysis of the added value of 11C-choline PET/CT imaging to a 18F-FDG PET/CT in primary prostate cancer patients. Results: The 11C-choline PET/CT imaging showed that the SUVmax of the prostate cancer group(3.91±3.29) higher than the benign prostatic hyperplasia(1.01±1.10). The SUVmax of 18F-FDG was no stastistical difference with the prostate cancer(3.98±4.17) and the benign prostatic hyperplasia(2.17±3.33). The sensitivity, the specificity, the accuracy, the positive predictive value and the negative predictive value of 11C-choline PET/CT and 18F-FDG PET/CT are 89.5%, 81.6%, 88.0%, 60.0%, 88.9%, 73.0%, 91.9%, 75.6%, 84.6%, 68.2%, respectively. The sensitivity, the specificity, the accuracy, the positive predictive value and the negative predictive value of combined two radioactive tracers scan is 89.5%, 96%, 92.1%, 97.1%, 85.7%, respectively. Seventeen cases of bone metastases, 8 cases of lymph node metastasis, 1 case of pulmonary metastasis were recognized by PET/CT. The SUVmax of bone metastasis of 11C-choline PET/CT has no obviously variance compared with 18F-FDG PET/CT. 11C-choline PET/CT imaging showed that bone metastases lesions(584) were more than 18F-FDG PET/CT(497), that difference was statistically significant(t=2.151, P<0.05). The SUVmax of lymph node metastasis and total number is no statistical difference between 11C-choline PET/CT imaging and 18F-FDG PET/CT(P>0.05). Conclusions: 11C-choline PET/CT imaging combined with 18F-FDG PET/CT imaging has better diagnostic value in the prostate cancer. 11C-choline PET/CT can make up for the inadequacy of 18F-FDG PET/CT.
关键词
前列腺肿瘤 /
氟脱氧葡萄糖F18 /
正电子发射断层显像术
Key words
Prostatic neoplasms /
Fluorodeoxyglucose F18 /
Positron-emission tomography
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基金
新疆维吾尔自治区自然科学基金（2013211A104）
