Background:Lymph node staging of prostate cancer(PCa)is important for planning and monitoring of treatment.^(18)F-prostate specific membrane antigen positron emission tomography/computerized tomography(^(18)F-PSMA PET...Background:Lymph node staging of prostate cancer(PCa)is important for planning and monitoring of treatment.^(18)F-prostate specific membrane antigen positron emission tomography/computerized tomography(^(18)F-PSMA PET/CT)has several advantages over^(68)Ga-PSMA PET/CT,but its diagnostic value requires further investigation.This meta-analysis focused on establishing the diagnostic utility of^(18)F-PSMA PET/CT for lymph node staging in medium/high-risk PCa.Methods:We searched the EMBASE,PubMed,Cochrane library,and Web of Science databases from inception to October 1,2022.Prostate cancer,^(18)F,lymph node,PSMA,and PET/CT were used as search terms and the language was limited to English.We additionally performed a manual search using the reference lists of key articles.Patients and study characteristics were extracted and the QUADAS-2 tool was employed to evaluate the quality of included studies.Sensitivity,specificity,the positive and negative likelihood ratio(PLR and NLR),diagnostic odds ratio(DOR),area under the curve(AUC),and 95%confidence interval(CI)were used to evaluate the diagnostic value of^(18)F-PSMA PET/CT.Stata 17 software was employed for calculation and statistical analyses.Results:A total of eight diagnostic tests including 734 individual samples and 6346 lymph nodes were included in this meta-analysis.At the patient level,the results of each consolidated summary were as follows:sensitivity of 0.57(95%CI 0.39-0.73),specificity of 0.95(95%CI 0.92-0.97),PLR of 11.2(95%CI 6.6-19.0),NLR of 0.46(95%CI 0.31-0.68),DOR of 25(95%CI 11-54),and AUC of 0.94(95%CI 0.92-0.96).At the lesion level,the results of each consolidated summary were as follows:sensitivity of 0.40(95%CI 0.21-0.62),specificity of 0.99(95%CI 0.95-1.00),PLR of 40.0(95%CI 9.1-176.3),NLR of 0.61(95%CI 0.42-0.87),DOR of 66(95%CI 14-311),and AUC of 0.86(95%CI 0.83-0.89).Conclusions:^(18)F-PSMA PET/CT showed moderate sensitivity but high specificity in lymph node staging of medium/high-risk PCa.The diagnostic efficacy was almost equivalent to that reported for^(68)Ga-PSMA PET/CT.Registration:International Prospective Register of Systematic Reviews(PROSPERO),No.CRD42023391101.展开更多
Prostate biopsy is the gold standard for diagnosing prostate cancer(PCa).Prostate targeted biopsy(TB)having a higher rate of detecting clinically significant PCa(csPCa)than traditional systematic biopsy(SB)is supporte...Prostate biopsy is the gold standard for diagnosing prostate cancer(PCa).Prostate targeted biopsy(TB)having a higher rate of detecting clinically significant PCa(csPCa)than traditional systematic biopsy(SB)is supported by high-quality evidence.However,the TB indications and strategies are controversial.The National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences,invited a panel of recognized urology experts in PCa to address these topics at the Panjiayuan Consensus Conference 2022.The conference results on prostate TB are presented herein.The National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences identified 10 key areas of prostate biopsy:(1)selection of imaging examination;(2)indications of TB;(3)transperineal and transrectal prostate biopsy;(4)TB pathways;(5)TB and SB;(6)three techniques of TB;(7)the number of TB cores needed for one lesion;(8)core number for SB;(9)free-hand TB;(10)future development of TB/prostate diagnosis.Thus,a panel of 25 recognized urologists and 2 radiologists from China were invited to attend this conference.The panel voted anonymously on 14 predetermined questions.Voting was based on the panelists'clinical practice and opinion,rather than high-level evidence.The voting outcomes were supported by the panel unequally,and details of the voting results were reported.The voting results can help clinicians to decide on biopsy timing and proper strategies,for which guidelines are sparse.We also focused on the future development of TB and SB,such as the combined pathway of TB and SB,techniques of TB,biopsy cores,free-hand TB,and prostate-specific membrane antigen positron emission tomography/computed tomography.展开更多
The oceans are crucial to human civilization.They provide core support for exploitation and utilization of marine space,resources,and energy.Thus,marine infrastructures are vital to a nation’s economic sustainable de...The oceans are crucial to human civilization.They provide core support for exploitation and utilization of marine space,resources,and energy.Thus,marine infrastructures are vital to a nation’s economic sustainable development.To this end,this article first describes the main challenges in current ocean utilization,and then reviews the China’s ocean engineering progress.As such,six major sectors are evaluated:1)global climate change and marine environment,2)comprehensive utilization of marine space,3)marine transportation infrastructure interconnection,4)ocean clean energy development and maricultural facilities,5)ecological crisis and marine engineering countermeasures,and 6)marine infrastructure operation safety and maintenance.Finally,perspectives on future directions of ocean utilization and marine infrastructure construction in China are provided.展开更多
基金National High Level Hospital Clinical Research Funding(Nos.BJ-2022-115,BJ-2022-098,BJ-2020-171,BJ-2022-158,and BJ-2022-143)
文摘Background:Lymph node staging of prostate cancer(PCa)is important for planning and monitoring of treatment.^(18)F-prostate specific membrane antigen positron emission tomography/computerized tomography(^(18)F-PSMA PET/CT)has several advantages over^(68)Ga-PSMA PET/CT,but its diagnostic value requires further investigation.This meta-analysis focused on establishing the diagnostic utility of^(18)F-PSMA PET/CT for lymph node staging in medium/high-risk PCa.Methods:We searched the EMBASE,PubMed,Cochrane library,and Web of Science databases from inception to October 1,2022.Prostate cancer,^(18)F,lymph node,PSMA,and PET/CT were used as search terms and the language was limited to English.We additionally performed a manual search using the reference lists of key articles.Patients and study characteristics were extracted and the QUADAS-2 tool was employed to evaluate the quality of included studies.Sensitivity,specificity,the positive and negative likelihood ratio(PLR and NLR),diagnostic odds ratio(DOR),area under the curve(AUC),and 95%confidence interval(CI)were used to evaluate the diagnostic value of^(18)F-PSMA PET/CT.Stata 17 software was employed for calculation and statistical analyses.Results:A total of eight diagnostic tests including 734 individual samples and 6346 lymph nodes were included in this meta-analysis.At the patient level,the results of each consolidated summary were as follows:sensitivity of 0.57(95%CI 0.39-0.73),specificity of 0.95(95%CI 0.92-0.97),PLR of 11.2(95%CI 6.6-19.0),NLR of 0.46(95%CI 0.31-0.68),DOR of 25(95%CI 11-54),and AUC of 0.94(95%CI 0.92-0.96).At the lesion level,the results of each consolidated summary were as follows:sensitivity of 0.40(95%CI 0.21-0.62),specificity of 0.99(95%CI 0.95-1.00),PLR of 40.0(95%CI 9.1-176.3),NLR of 0.61(95%CI 0.42-0.87),DOR of 66(95%CI 14-311),and AUC of 0.86(95%CI 0.83-0.89).Conclusions:^(18)F-PSMA PET/CT showed moderate sensitivity but high specificity in lymph node staging of medium/high-risk PCa.The diagnostic efficacy was almost equivalent to that reported for^(68)Ga-PSMA PET/CT.Registration:International Prospective Register of Systematic Reviews(PROSPERO),No.CRD42023391101.
基金Capital's Funds for Health Improvement and Research,Grant/Award Number:2022-3-40714。
文摘Prostate biopsy is the gold standard for diagnosing prostate cancer(PCa).Prostate targeted biopsy(TB)having a higher rate of detecting clinically significant PCa(csPCa)than traditional systematic biopsy(SB)is supported by high-quality evidence.However,the TB indications and strategies are controversial.The National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences,invited a panel of recognized urology experts in PCa to address these topics at the Panjiayuan Consensus Conference 2022.The conference results on prostate TB are presented herein.The National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences identified 10 key areas of prostate biopsy:(1)selection of imaging examination;(2)indications of TB;(3)transperineal and transrectal prostate biopsy;(4)TB pathways;(5)TB and SB;(6)three techniques of TB;(7)the number of TB cores needed for one lesion;(8)core number for SB;(9)free-hand TB;(10)future development of TB/prostate diagnosis.Thus,a panel of 25 recognized urologists and 2 radiologists from China were invited to attend this conference.The panel voted anonymously on 14 predetermined questions.Voting was based on the panelists'clinical practice and opinion,rather than high-level evidence.The voting outcomes were supported by the panel unequally,and details of the voting results were reported.The voting results can help clinicians to decide on biopsy timing and proper strategies,for which guidelines are sparse.We also focused on the future development of TB and SB,such as the combined pathway of TB and SB,techniques of TB,biopsy cores,free-hand TB,and prostate-specific membrane antigen positron emission tomography/computed tomography.
基金The authors would like to acknowledge the National Natural Science Foundation of China’s Basic Science Center Project(Grant No.52088102)for supporting the research work of this article.
文摘The oceans are crucial to human civilization.They provide core support for exploitation and utilization of marine space,resources,and energy.Thus,marine infrastructures are vital to a nation’s economic sustainable development.To this end,this article first describes the main challenges in current ocean utilization,and then reviews the China’s ocean engineering progress.As such,six major sectors are evaluated:1)global climate change and marine environment,2)comprehensive utilization of marine space,3)marine transportation infrastructure interconnection,4)ocean clean energy development and maricultural facilities,5)ecological crisis and marine engineering countermeasures,and 6)marine infrastructure operation safety and maintenance.Finally,perspectives on future directions of ocean utilization and marine infrastructure construction in China are provided.
