本研究的目的是探讨 PSMA-RADS 2.0 版在前列腺癌患者肺转移评估中的应用以及 PSMA PET/CT 参数是否提供增量价值。从 2016 年 10 月至 2023 年 7 月，出现肺部混浊的 PC 患者（对接受 Al18F-PSMA-BCH PET/CT 扫描的患者（包括肺转移瘤、肺癌和肺部良性混浊）进行回顾性分析。测量并分析 CT 成像特征，包括最长直径、密度、光滑度、分叶、胸膜回缩和空泡征，以及 PET 参数，包括 SUVmax 和肿瘤背景比。此外，还确定了每位患者的肺部 PSMA-RADS 评分。通过单变量分析和多变量逻辑回归分析确定了肺转移的独立预测因素，并用于构建平行诊断测试。使用接受者操作特征分析评估鉴别诊断性能。回顾性纳入了 96 例患者的 148 例肺部混浊。肺部良性混浊、肺癌和肺转移的数量分别为48例（32.4%）、20例（13.5%）和80例（54.1%）。不同 PSMA-RADS 评分从 2 到 5 的混浊数量分别为 8 个（5.4%）、88 个（59.5%）、7 个（4.7%）和 45 个（30.4%）。 SUVmax和平滑边缘是肺转移的独立预测因子（均P<0.05），这2个参数的平行检验的AUC为0.86（95%置信区间：0.79、0.94；P<0.001）。此外，PSMA-RADS评分从2到5的平行测试的诊断准确性分别为85.7%、79.6%、100%和92.9%。Al18F-PSMA-BCH PET/CT参数有助于区分肺转移瘤PC 患者，并在与 PSMA-RADS 2.0 版集成时提供增量价值。版权所有 © 2024 Wolters Kluwer Health, Inc. 保留所有权利。

The aim of this study was to investigate the application of PSMA-RADS version 2.0 in assessment of pulmonary metastases in patients with prostate cancer and whether PSMA PET/CT parameters provide incremental value.From October 2016 to July 2023, PC patients with pulmonary opacities (including pulmonary metastases, lung cancer, and pulmonary benign opacities) who underwent Al18F-PSMA-BCH PET/CT scans were retrospectively analyzed. CT imaging characteristics, including the longest diameter, density, smoothness, lobulation, pleural retraction, and vacuole sign, as well as PET parameters including SUVmax and tumor-to-background ratio, were measured and analyzed. Additionally, the pulmonary PSMA-RADS score for each patient was determined. Independent predictors of pulmonary metastases were identified through univariate analysis and multivariate logistic regression analysis, which were utilized to construct a parallel diagnostic test. The differential diagnostic performances were evaluated using receiver operating characteristic analysis.A total of 148 pulmonary opacities from 96 patients were retrospectively included. The number of pulmonary benign opacities, lung cancer, and pulmonary metastases were 48 (32.4%), 20 (13.5%), and 80 (54.1%), respectively. The number of opacities across different PSMA-RADS scores from 2 to 5 was 8 (5.4%), 88 (59.5%), 7 (4.7%), and 45 (30.4%). SUVmax and smooth edges were independent predictors of pulmonary metastases (both P < 0.05), and the AUC of the parallel test for these 2 parameters was 0.86 (95% confidence interval: 0.79, 0.94; P < 0.001). Furthermore, the diagnostic accuracy of the parallel test across PSMA-RADS score from 2 to 5 was 85.7%, 79.6%, 100%, and 92.9%, respectively.Al18F-PSMA-BCH PET/CT parameters were helpful in differentiating pulmonary metastases in PC patients and provided incremental value when integrated with PSMA-RADS version 2.0.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.