Japanese journal of radiology · 2026
Diagnostic accuracy of 18F-PSMA-1007 PET/CT and bone scintigraphy for detecting bone metastases in prostate cancer.
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Kitajima Kazuhiro, Naka Sadahiro, Hatano Koji, Uemura Motohide, Sasaki Hidetaka, Kamiya Takashi, Kurimoto Kenta, Katayama Daisuke, Kato Hiroki, Liu Yuwei, Cardinale Jens, Giesel Frederik L, Nonomura Norio, Watabe Tadashi
Аннотация
OBJECTIVE: The performance of 18F-labeled prostate-specific membrane antigen (18F-PSMA-1007) positron emission tomography/computed tomography (PET/CT) and bone scintigraphy (BS) for detecting bone metastases in prostate cancer patients was compared.
MATERIALS AND METHODS: One hundred prostate cancer patients (initial staging, n = 9; biochemical recurrence, n = 63; metastatic castration-resistant prostate cancer (mCRPC), n = 15; m0CRPC, n = 13) underwent 18F-PSMA-1007 PET/CT and BS. The patient-, region-, and lesion-based performances of 18F-PSMA-1007 PET/CT and BS for detecting bone metastases were evaluated by experienced readers using a five-point scale.
RESULTS: Bone metastases were identified in 46 (46.0%) patients, 99 (24.8%) of the 400 regions, and 528 lesions. In the analysis, the area under the receiver-operating-characteristic curve (AUC), sensitivity, specificity, and accuracy values for 18F-PSMA-1007 PET/CT were 0.9985, 100%, 94.4%, and 97.0%, respectively, whereas those for BS were 0.8507, 71.7%, 88.9%, and 81.0%, respectively. AUC, sensitivity, and accuracy were significantly higher for 18F-PSMA-1007 PET/CT than for BS (p = 0.00021, p = 0.00087, and p = 0.00018, respectively; McNemar test). 18F-PSMA-1007 PET/CT detected 527 of the 528 metastatic lesions (99.8%), whereas BS detected 253 (47.9%) (p < 0.0001). The numbers of patients with (a) no bone metastases, (b) oligometastatic disease (1-3 lesions), (c) 4-5 lesions, (d) 6-20 lesions, and (e) > 20 lesions for BS were 13, 21, 0, 8, and 4, respectively, compared with 0, 27, 3, 9, and 7, respectively, on 18F-PSMA-1007 PET/CT. In addition, 18F-PSMA-1007 PET/CT detected local recurrence (n = 51), nodal metastases (n = 37), and visceral metastases (n = 4).
CONCLUSIONS: 18F-PSMA-1007 PET/CT demonstrated higher sensitivity and accuracy than BS for detecting bone metastases in prostate cancer patients.
MATERIALS AND METHODS: One hundred prostate cancer patients (initial staging, n = 9; biochemical recurrence, n = 63; metastatic castration-resistant prostate cancer (mCRPC), n = 15; m0CRPC, n = 13) underwent 18F-PSMA-1007 PET/CT and BS. The patient-, region-, and lesion-based performances of 18F-PSMA-1007 PET/CT and BS for detecting bone metastases were evaluated by experienced readers using a five-point scale.
RESULTS: Bone metastases were identified in 46 (46.0%) patients, 99 (24.8%) of the 400 regions, and 528 lesions. In the analysis, the area under the receiver-operating-characteristic curve (AUC), sensitivity, specificity, and accuracy values for 18F-PSMA-1007 PET/CT were 0.9985, 100%, 94.4%, and 97.0%, respectively, whereas those for BS were 0.8507, 71.7%, 88.9%, and 81.0%, respectively. AUC, sensitivity, and accuracy were significantly higher for 18F-PSMA-1007 PET/CT than for BS (p = 0.00021, p = 0.00087, and p = 0.00018, respectively; McNemar test). 18F-PSMA-1007 PET/CT detected 527 of the 528 metastatic lesions (99.8%), whereas BS detected 253 (47.9%) (p < 0.0001). The numbers of patients with (a) no bone metastases, (b) oligometastatic disease (1-3 lesions), (c) 4-5 lesions, (d) 6-20 lesions, and (e) > 20 lesions for BS were 13, 21, 0, 8, and 4, respectively, compared with 0, 27, 3, 9, and 7, respectively, on 18F-PSMA-1007 PET/CT. In addition, 18F-PSMA-1007 PET/CT detected local recurrence (n = 51), nodal metastases (n = 37), and visceral metastases (n = 4).
CONCLUSIONS: 18F-PSMA-1007 PET/CT demonstrated higher sensitivity and accuracy than BS for detecting bone metastases in prostate cancer patients.