To analyze the consistency between the application of ⁶⁸Ga-PSMA-PET/CT in the diagnosis of pelvic lymph node metastasis (LNM) of prostate cancer and surgical pathology, so as to guide the clinical practice.

The medical records of 44 patients with prostate cancer who completed ⁶⁸Ga-PSMA-PET/CT preoperative 3D laparoscopic radical resection and pelvic lymph node dissection were analyzed retrospectively, and the diagnostic value of ⁶⁸Ga-PSMA-PET/CT for pelvic lymph node metastasis was observed.

The patients median age was 66(60, 69) years, and the initial PSA was 17(11, 30) ng/ml. ⁶⁸Ga-PSMA-PET/CT lymph node was described as 3 types: I, no lymph node metastasis; II, possible lymph node metastasis; III, considering lymph node metastasis. Types I and II were defined as negative, and type III was defined as positive. The LNM positive rate of ⁶⁸Ga-PSMA-PET/CT was 25.00%(11/44), and the pathological LNM positive rate was 13.64%(6/44), of which G₃(1/6) and G₅(5/6). The overall sensitivity of ⁶⁸Ga-PSMA-PET/CT in the diagnosis of LNM was 83.33%(5/6), specificity was 84.21%(32/38), diagnostic coincidence rate was 84.09%(37/44), negative predictive value was 96.97%(32/33), positive predictive value was 45.45%(5/11). The Kappa coefficient consistency test showed that it had a strong degree of consistency with the pathological diagnosis of LNM, Kappa=0.601, P<0.05 (Z=4.109, P<0.001, SEM=0.159, 95%CI: 0.291-0.912).

The application of ⁶⁸Ga-PSMA-PET/CT in the diagnosis of pelvic lymph node metastasis in prostate cancer patients has a strong degree of consistency with the surgical pathology, and its high negative predictive value is of high clinical application value, but it can not replace the status of pelvic lymph node dissection.