PurposeFor T staging of prostate cancer, transrectal ultrasonography and magnetic resonanceimaging (MRI) are the established imaging studies in many institutions. The use of CTand MRI for N staging is of limited value because of the low sensitivity in the detectionof lymph node metastases. Bone scintigraphy is generally used to exclude the presenceof bone metastases. We aimed to compare the diagnostic accuracies of 18F-CholinePET/CT (FCH) and CI in patients with prostate cancer at initial staging and in case ofsuspicious of biochemical relapse.Methods and MaterialsA retrospective analysis of 74 patients (age: 72±8 years) with histologically provenprostate cancer was performed at our Institution. All patients underwent FCH PET/CT and CI including CT, bone scan, radiography and ultrasonography for staging andrestaging of disease. Histopathology, imaging or clinical follow-up served as the standardof reference. A patient- and a lesion-based analyses were performed.ResultsTwenty-two patients had a Gleason score (Gs) <7, 40 had a Gs # 7 while it was notavailable in 12 subjects. In patients with suspicious of disease relapse, the PSA valueranged between 0.20 and 434 ng/mL (median: 4.6 ng/mL).On a patient base, sensitivity,specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracyfor detecting local and distant metastases were calculated to be 88%, 67%, 77%, 82%,78% compared with 85%, 97%, 97%, 84%, 91% with CI. In case of initial stagingthe accuracy of FCH PET/CT was lower than CI (77% vs. 92%), whereas in case ofbiochemical relapse the sensitivity of FCH PET/CT was slightly higher than CI (89% vs.82%).On a lesion base more lymph node and more bone metastases were detected byusing FCH PET/CT compared with CI. In particular, FCH PET/CT demonstrated lymphnode involvement in three patients and bone lesions in two subjects. Moreover, onepatient showed a diffuse bone medullary involvement.ConclusionFCH PET/CT demonstrates apparent advantages for the restaging of prostate cancer incase of biochemical relapse compared with CI on a patient base. The advantage of PET/CT in depicting lymph node and bone metastasis in one-step should be further studiedin highly-selected subset of patient.
Comparison between conventional imaging (CI) and wholebody 18F-choline (FCH) positron emission tomography/ computed tomography (PET/CT) in patients (pts) with prostate cancer (PCa)
L. Evangelista
;
2013-01-01
Abstract
PurposeFor T staging of prostate cancer, transrectal ultrasonography and magnetic resonanceimaging (MRI) are the established imaging studies in many institutions. The use of CTand MRI for N staging is of limited value because of the low sensitivity in the detectionof lymph node metastases. Bone scintigraphy is generally used to exclude the presenceof bone metastases. We aimed to compare the diagnostic accuracies of 18F-CholinePET/CT (FCH) and CI in patients with prostate cancer at initial staging and in case ofsuspicious of biochemical relapse.Methods and MaterialsA retrospective analysis of 74 patients (age: 72±8 years) with histologically provenprostate cancer was performed at our Institution. All patients underwent FCH PET/CT and CI including CT, bone scan, radiography and ultrasonography for staging andrestaging of disease. Histopathology, imaging or clinical follow-up served as the standardof reference. A patient- and a lesion-based analyses were performed.ResultsTwenty-two patients had a Gleason score (Gs) <7, 40 had a Gs # 7 while it was notavailable in 12 subjects. In patients with suspicious of disease relapse, the PSA valueranged between 0.20 and 434 ng/mL (median: 4.6 ng/mL).On a patient base, sensitivity,specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracyfor detecting local and distant metastases were calculated to be 88%, 67%, 77%, 82%,78% compared with 85%, 97%, 97%, 84%, 91% with CI. In case of initial stagingthe accuracy of FCH PET/CT was lower than CI (77% vs. 92%), whereas in case ofbiochemical relapse the sensitivity of FCH PET/CT was slightly higher than CI (89% vs.82%).On a lesion base more lymph node and more bone metastases were detected byusing FCH PET/CT compared with CI. In particular, FCH PET/CT demonstrated lymphnode involvement in three patients and bone lesions in two subjects. Moreover, onepatient showed a diffuse bone medullary involvement.ConclusionFCH PET/CT demonstrates apparent advantages for the restaging of prostate cancer incase of biochemical relapse compared with CI on a patient base. The advantage of PET/CT in depicting lymph node and bone metastasis in one-step should be further studiedin highly-selected subset of patient.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
