确定与单独 PSMA-PET/CT 相比，同步对比增强诊断 CT (DxCT) 是否具有更高的诊断确定性。 这项回顾性多读者研究分析了包含 F-18-piflufolastat PSMA-PET/CT 与诊断胸部/腹盆腔联合成像的影像FDA 批准 PET 药物后前 6 个月内对前列腺癌患者进行的 CT 检查。六名核放射学读者随机​​接受了有或没有 DxCT 的 PSMA-PET/CT 研究，并被要求报告他们对 PET 上发现的 PSMA 亲和病变的诊断确定性。随后，读者在一段插曲后重新审查同一项研究（如果之前没有提出过 CT，反之亦然），以确定 DxCT 是否改变了他们的诊断评估。评估者间的一致性是根据所有读者阅读的图像子集进行评估的。比较了有和没有 DxCT 的 PSMA-PET/CT 的诊断确定性，并检查了 DxCT 可能增加价值的变量。PET/CT 的读者之间评价者之间具有良好的一致性（总体扫描确定性的芬恩可靠性系数） ：0.85，p < 0.01) 和组合 DxCT-PET/CT (0.59，p < 0.01)。 PET/CT 与组合 DxCT-PET/CT 数据集之间的总体确定性和一致性相似（总体扫描确定性：92% ± 16 与 92% ± 17，p = 0.43），在不同解剖位置添加 DxCT 没有显着优势或临床参数。在解释前列腺癌初始分期所获取的图像时，注意到对组合 DxCT-PET/CT 的轻微偏爱（89% ± 16 与 93% ± 17，p = 0.08）。不同的读者之间可以实现良好的读者间一致性PSMA-PET/CT 的培训水平。此外，同时使用 DxCT 和 PSMA-PET/CT 并不能显着提高大多数适应症的诊断确定性，但可能对初始分期有用。版权所有 © 2024 大学放射科医生协会。由爱思唯尔公司出版。保留所有权利。

To determine whether concurrent contrast-enhanced diagnostic CT (DxCT) confers added diagnostic certainty compared to PSMA-PET/CT alone.This retrospective multi-reader study analyzed imaging comprising combined F-18-piflufolastat PSMA-PET/CT with diagnostic chest/abdominopelvic CT from prostate cancer patients within the first 6 months of FDA-approval of the PET agent. Six nuclear radiology readers were randomly presented with PSMA-PET/CT studies with or without DxCT and asked to report their diagnostic certainty for PSMA-avid lesions found on PET. Subsequently, readers re-reviewed the same study after an interlude (with the CT if not previously presented and vice-versa) to determine if DxCT altered their diagnostic assessment. Inter-rater concordance was assessed on a subset of images read by all readers. Diagnostic certainties for PSMA-PET/CT with and without DxCT were compared, and the variables for which DxCT may add value were examined.Good inter-rater concordance across readers was noted for both PET/CT (Finn's coefficient of reliability for overall scan certainty: 0.85,p < 0.01) and combined DxCT-PET/CT (0.59,p < 0.01). Overall certainty and concordance between PET/CT and combined DxCT-PET/CT datasets were similar (overall scan certainty: 92% ± 16 vs. 92% ± 17,p = 0.43), with no significant advantage for adding DxCT across different anatomic locations or clinical parameters. A slight predilection for combined DxCT-PET/CT was noted when interpreting images acquired for the initial staging of prostate cancer (89% ± 16 vs. 93% ± 17,p = 0.08).Good inter-reader concordance can be achieved across different training levels with PSMA-PET/CT. Furthermore, using DxCT concurrent with PSMA-PET/CT does not significantly improve diagnostic certainty for most indications but may be useful for initial staging.Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.