Abstract
PURPOSE: To evaluate the difference in the diagnostic efficacy of (18)F-PSMA-1007 PET/CT and pelvic MRI in primary prostate cancer, as well as the correlation between the two methods and histopathological parameters and serum PSA levels. METHODS: A total of 41 patients with suspected prostate cancer who underwent (18)F-PSMA-1007 PET/CT imaging in our department from 2018 to 2023 were retrospectively collected. All patients underwent (18)F-PSMA-1007 PET/CT and MRI scans. The sensitivity, PPV and diagnostic accuracy of MRI and (18)F-PSMA-1007 PET/CT in the diagnosis of prostate cancer were calculated after comparing the results of MRI and (18)F-PSMA-1007 PET/CT with biopsy. The Spearman test was used to calculate the correlation between (18)F-PSMA-1007 PET/CT, MRI parameters, histopathological indicators, and serum PSA levels. RESULTS: Compared with histopathological results, the sensitivity, PPV and diagnostic accuracy of (18)F-PSMA-1007 PET/CT in the diagnosis of prostate cancer were 95.1%, 100.0% and 95.1%, respectively. The sensitivity, PPV and diagnostic accuracy of MRI in the diagnosis of prostate cancer were 82.9%, 100.0% and 82.9%, respectively. There was a mild to moderately positive correlation between Gleason (Gs) score, Ki-67 index, serum PSA level and (18)F-PSMA-1007 PET/CT parameters (p < 0.05). There was a moderately negative correlation between the expression of AMACR (P504S) and (18)F-PSMA-1007 PET/CT parameters (p < 0.05). The serum PSA level and the Gs score were moderately positively correlated with the MRI parameters (p < 0.05). There was no correlation between histopathological parameters and MRI parameters (p > 0.05). CONCLUSION: Compared with MRI, (18)F-PSMA-1007 PET/CT has higher sensitivity and diagnostic accuracy in the detection of malignant prostate tumors. In addition, the Ki-67 index and AMACR (P504S) expression were only correlated with (18)F-PSMA-1007 PET/CT parameters. Gs score and serum PSA level were correlated with (18)F-PSMA-1007 PET/CT and MRI parameters. (18)F-PSMA-1007 PET/CT examination can provide certain reference values for the clinical diagnosis, evaluation, and treatment of malignant prostate tumors.