Study On Bone Imaging Semi-quantitative Method And Clinical Related Factors In The Diagnosis Of Bone Metastasis Of Prostate Cancer

Objective:1)To study the diagnostic value of factors such as Gleason score of primary lesion of prostate cancer and serum PSA index in patients with systemic bone metastasis of prostate cancer,and to elucidate the correlation between them and Soloway grade of Nuclide whole-body bone imaging of prostate cancer;2)To explore the value of semi-quantitative analysis of SPECT planar bone imaging in the differential diagnosis of single skeletal focus on whole body bone imaging of prostate cancer.Methods:1)Retrospective analysis was performed on 174 patients diagnosed with prostate cancerwho underwent radionuclide whole-body bone imaging in our department from January 2018 to December 2019.According to the clinical diagnostic criteria of bone metastases,the patients were divided into bone metastasis groups(56 cases)and non-bone metastasis group(118 cases).Intergroup test was used to analyze the correlation between age,primary lesion Gleason score,serum PSA index and bone metastasis,and binary Logistic regression analysis was used to determine the value of each parameter in the diagnosis of prostate cancer bone metastasis.At the same time,Soloway grade was performed according to the number of bone metastases identified by the radionuclide whole-body bone imaging,and the correlation between the parameters and Soloway grade on whole-body bone imaging was analyzed.2)Semi-quantitative analysis of 584 bone imaging agent abnormal concentration foci on 174 patients with SPECT whole body planar bone imaging,obtained(T-NT)/NT,and the relationship between(T-NT)/ NT and benign or malignant foci was explored.At the same time,ROC curve was used to determine the diagnostic efficiency of single foci.Results:1)Among 174 PCa patients,56 patients were diagnosed with bone metastases,while 118 patients were diagnosed without bone metastases.Univariate analysis showed that there were significant differences in Gleason score,t PSA and f PSA between PCa bone metastasis group and non-bone metastasis group.Multivariate Logistic regression analysis showed that only Gleason score and f PSA were the main independent risk factors for the diagnosis of PCa bone metastasis.ROC curve analysis showed that the combination of Gleason score,t PSA and f PSA(AUC=0.85)and a single f PSA(AUC=0.82)showed no statistically significant difference in the diagnostic efficiency of PCa bone metastases(P=0.29),and they were significantly better than single factor Gleason Score and t PSA(AUC were 0.73 and 0.78,respectively;P<0.05).There are significant differences in the Gleason score,t PSA and f PSA levels of different Soloway grades in radionuclide bone imaging(P<0.01),and their levels are significantly positively correlated with Soloway grades(r=0.38,0.46,0.53;P <0.01).2)According to the clinical diagnostic criteria,584 imaging agent abnormally concentrated foci were divided into bone metastases(334)and non-bone metastases(250).The(T-NT)/NT level of bone imaging agent concentration foci was significantly different between bone metastatic foci(6.83±3.92)and non-bone metastatic foci(3.25±2.11)(P< 0.01).When(T-NT)/ NT is 4.56,the diagnostic value of abnormal concentration of single imaging agent in PCa radionuclide bone imaging is the best,and the sensitivity and specificity are 69.46% and 79.20%,respectively.Conclusion:1)Gleason score,t PSA and f PSA are important factors in the diagnosis of PCa bone metastasis,among which Gleason score and f PSA are the main independent risk factors.There is no significant difference between the combination of the three and single f PSA in the diagnosis of PCa bone metastasis,and they are significantly better than single Gleason score,t PSA;and Gleason score,t PSA and f PSA and Soloway grade of radionuclide bone imaging.And Gleason score,t PSA and f PSA were significantly correlated with Soloway grade of radionuclide bone imaging.2)The semi-quantitative method of radionuclide bone imaging,namely(T-NT)/NT index,has certain value in differentiating the benign and malignant of the abnormal concentration foci of PCA single imaging agent;and the diagnostic value is the best when(T-NT)/ NT is 4.56.