Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2024; 12(20): 4082-4090
Published online Jul 16, 2024. doi: 10.12998/wjcc.v12.i20.4082
Technetium-99m-methylene diphosphonate single photon emission computed tomography/computed tomography combined with prostate-specific antigen/free prostate-specific antigen ratio for bone metastasis of prostate cancer
Jian He, Yi-Pu Zhong, Shuang Zhang
Jian He, Shuang Zhang, Department of Nuclear Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, Sichuan Province, China
Yi-Pu Zhong, Department of Nuclear Medicine, The People’s Hospital of Jianyang, Jianyang 641400, Sichuan Province, China
Author contributions: He J performed the majority of experiments and wrote the manuscript; Zhong YP designed the study and revised the manuscript; Zhang S was involved in the analytical tools; He J and Zhong YP participated in the collection of the human material; He J and Zhang S served as scientific advisors; Zhong YP was the guarantor.
Institutional review board statement: The research was reviewed and approved by the Review Committee of Hospital of Chengdu University of Traditional Chinese Medicine (Approval No. HCUTCM-23-976).
Informed consent statement: All research participants or their legal guardians provided written informed consent prior to study registration.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No other data available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shuang Zhang, MAMS, Doctor, Department of Nuclear Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shierqiao Road, Chengdu 610072, Sichuan Province, China. shudufeiji7177441@163.com
Received: March 9, 2024
Revised: May 14, 2024
Accepted: June 3, 2024
Published online: July 16, 2024
Processing time: 113 Days and 18.4 Hours
Abstract
BACKGROUND

Prostate cancer (PC) is one of the most common malignant tumors in men, and bone metastasis is one of its common complications, which seriously affects the quality of life and prognosis of patients.

AIM

To investigate the diagnostic value of technetium-99m-methylene diphosphonate (99mTc-MDP) single photon emission computed tomography (SPECT)/CT imaging combined with the serum prostate-specific antigen (PSA)/free PSA ratio for PC bone metastasis (PCBM).

METHODS

One hundred patients with PC who visited the Hospital of Chengdu University of Traditional Chinese Medicine from January 2020 to January 2022 were recruited as the experimental (Exp) group, while 30 patients with benign prostatic lesions (BPLs) were recruited as the control (Ctrl) group. All patients underwent 99mTc-MDP SPECT/CT imaging and serum PSA/fPSA testing. The SPECT/CT imaging results and serum PSA/fPSA ratios of patients were analyzed to evaluate their diagnostic values for PCBM.

RESULTS

The difference in general information of the patients was not obvious, showing comparability. The two methods showed no visible differences in negative predictive value and sensitivity for patients with PCBM, but had great differences in positive predictive value and specificity (P < 0.05). The PSA/fPSA ratio of patients with PC in the Exp group was lower than those with BPLs, and patients with PCBM had a much lower PSA/fPSA ratio than those without PC (P < 0.05). The results confirmed that the combined use of 99mTc-MDP SPECT/CT imaging and serum PSA/fPSA ratio achieved a detection rate of 95% for PCBM.

CONCLUSION

The combination of 99mTc-MDP SPECT/CT and PSA/fPSA ratio is accurate and reliable for the diagnosis of PCBM, which provides an important reference for clinical practice.

Keywords: Matrix metalloproteinase 9; Single photon emission computed tomography; Prostate-specific antigen to free prostate-specific antigen ratio; Prostate cancer; Bone metastasis

Core Tip: This work investigated the diagnostic value of technetium-99m-methylene diphosphonate (99mTc-MDP) single photon emission computed tomography (SPECT)/ CT imaging combined with the serum prostate-specific antigen (PSA)/free PSA ratio for detecting bone metastasis in prostate cancer (PC). Compared to individual methods, the combination of SPECT/CT imaging and PSA/fPSA ratio demonstrated significantly higher positive predictive values and specificity. The PSA/fPSA ratio in PC bone metastasis (PCBM) patients was notably lower than in non-PCBM patients. The integrated approach achieved a 95% detection rate for PCBM, emphasizing its diagnostic efficacy.