基于68Ga，PSMA，11 PET/CT和mpMRI构建临床模型预测前列腺单独靶向穿刺的准确性

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A clinical prediction model based on 68Ga，PSMA，11 PET/CT and mpMRI parameters to determine the diagnostic accuracy of targeted biopsy alone in prostate cancer population

AN Chaoli1，2，QIU Xuefeng1，WANG Feng3，FU Yao4，ZHAO Xiaozhi2，GUO Hongqian1

（1.Department of Urology，2.Department of Andrology，Affiliated Drum Tower Hospital，Medical School of Nanjing University，Nanjing 210000；3.Department of Nuclear Medicine，Nanjing First Hospital，Nanjing Medical University，Nanjing 210000；4.Department of Pathology，Affiliated Drum Tower Hospital，Medical School of Nanjing University，Nanjing 210000，China）

ABSTRACT：ObjectiveTo develop a clinical prediction model based on 68Ga，prostate，specific membrane antigen，11 （68Ga，PSMA，11），positron emission tomography/computed tomography （PET/CT） and multiparametric magnetic resonance imaging （mpMRI） parameters to stratify prostate cancer patients undergoing targeted biopsy，so as to avoid unnecessary systematic biopsy.MethodsA total of 96 clinically significant prostate cancer （csPCa） patients who underwent 68Ga，PSMA，11 PET/CT and mpMRI prior to prostate targeted biopsy with systematic biopsy during Jan.2020 and Feb.2023 in Nanjing Drum Tower Hospital were retrospectively analyzed.By univariate and multivariate logistic regression analyses，maximum standard uptake value （SUVmax） in 68Ga，PSMA，11 PET/CT and minimum apparent diffusion coefficien （ADCmin） in mpMRI，as well as clinical parameters were evaluated to identify the independent predictors correlative with the effective diagnosis of targeted biopsy，and a clinical prediction model was constructed.ResultsMultivariate logistic regression analysis showed that SUVmax （OR=0.878，95%CI：0.804-0.959，P=0.004） and ADCmin （OR=1.005，95%CI：1.001-1.010，P=0.027） were independent predictors of the effective diagnosis of targeted biopsy alone.The sensitivity，specificity，accuracy and area under the receiver operator characteristic curve （AUC） of the model were 0.80，0.80，0.83 and 0.84，respectively.ConclusionThe clinical prediction model based on 68Ga，PSMA，11 PET/CT and mpMRI parameters is helpful to improve the effective diagnosis of targeted biopsy alone，and has practical value to stratify patients with csPCa so as to safely avoid systematic biopsy and effectively balance the benefits and risks.

KEY WORDS： 68Ga，PSMA，11 PET/CT；SUVmax；ADCmin；targeted biopsy alone；clinically significant prostate cancer；mpMRI

摘要：目的基于68Ga，前列腺特异性膜抗原（PSMA），11正电子发射断层扫描/计算机断层扫描（PET/CT）和多参数核磁共振（mpMRI）构建临床预测模型，帮助临床实现对需行前列腺穿刺的可疑临床显著性前列腺癌（csPCa）患者进行合理分层以避免不必要的系统穿刺。（剩余13477字）