18 F-Fluoromethylcholine-positron emission tomography/computed tomography for diagnosing bone and lymph node metastases in patients with intermediate- or high-risk prostate cancer

Mike Allan Mortensen*, Mads Hvid Poulsen, Oke Gerke, Jørn Skibsted Jakobsen, Poul Flemming Høilund-Carlsen, Lars Lund

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Background: The use of molecular imaging in staging of prostate cancer (PC) is debated. In patients with newly diagnosed PC we investigated the diagnostic value of 18 F-flouromethylcholine positron emission tomography/computed tomography ( 18 F-FCH-PET/CT) for the detection of bone and lymph node metastases compared to whole-body bone scintigraphy (WBS) with technetium-99-methylene diphosphonate ( 99m Tc-MDP) and results of extended pelvic lymph node dissection, respectively. Materials and methods: Between January 2013 and April 2016, 143 patients, aged 49-83, mean 69, years with newly diagnosed PC and disease characteristics necessitating WBS underwent both WBS and 18 F-FCH-PET/CT using magnetic resonance imaging as standard. Eighty of these patients underwent pelvic lymph node dissection as part of radical prostatectomy or prior to external beam radiation and in these results of 18 F-FCH-PET/CT were compared to histologic findings. Results: Bone metastases were detected in 8/143 patients and sensitivity and specificity of WBS were 37.5% and 85.2% versus 100.0% and 96.3% with 18 F-FCH-PET/CT, P=0.63 and 0.002, respectively. Histologically confirmed metastases to regional lymph nodes were found in 25/80 patients. Suspicious choline uptake on PET/CT in pelvic lymph nodes was found in 35 patients. Sensitivity, specificity, PPV, NPV and accuracy of 18 F-FCH-PET/CT in detection of lymph node metastases were 62.5%, 69.6%, 46.9%, 81.3% and 67.5%, respectively. Conclusions: Findings in this study suggested that 18 F-FCH-PET/CT is a more sensitive and specific method for detection of bone metastases from PC than WBS and could potentially reduce the need for confirmatory imaging if used instead of WBS. However, 18 F-FCH-PET/CT performs sub-optimally in pre-operative staging of lymph node metastases in patients undergoing extended pelvic lymph node dissection.

OriginalsprogEngelsk
TidsskriftProstate International
Vol/bind7
Udgave nummer3
Sider (fra-til)119-123
ISSN2287-8882
DOI
StatusUdgivet - sep. 2019

Fingeraftryk

Prostatic Neoplasms
Lymph Nodes
Radionuclide Imaging
Positron Emission Tomography Computed Tomography
Choline

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@article{aaaac4fec37c4d0d92b1647640177d85,
title = "18 F-Fluoromethylcholine-positron emission tomography/computed tomography for diagnosing bone and lymph node metastases in patients with intermediate- or high-risk prostate cancer",
abstract = "Background: The use of molecular imaging in staging of prostate cancer (PC) is debated. In patients with newly diagnosed PC we investigated the diagnostic value of 18 F-flouromethylcholine positron emission tomography/computed tomography ( 18 F-FCH-PET/CT) for the detection of bone and lymph node metastases compared to whole-body bone scintigraphy (WBS) with technetium-99-methylene diphosphonate ( 99m Tc-MDP) and results of extended pelvic lymph node dissection, respectively. Materials and methods: Between January 2013 and April 2016, 143 patients, aged 49-83, mean 69, years with newly diagnosed PC and disease characteristics necessitating WBS underwent both WBS and 18 F-FCH-PET/CT using magnetic resonance imaging as standard. Eighty of these patients underwent pelvic lymph node dissection as part of radical prostatectomy or prior to external beam radiation and in these results of 18 F-FCH-PET/CT were compared to histologic findings. Results: Bone metastases were detected in 8/143 patients and sensitivity and specificity of WBS were 37.5{\%} and 85.2{\%} versus 100.0{\%} and 96.3{\%} with 18 F-FCH-PET/CT, P=0.63 and 0.002, respectively. Histologically confirmed metastases to regional lymph nodes were found in 25/80 patients. Suspicious choline uptake on PET/CT in pelvic lymph nodes was found in 35 patients. Sensitivity, specificity, PPV, NPV and accuracy of 18 F-FCH-PET/CT in detection of lymph node metastases were 62.5{\%}, 69.6{\%}, 46.9{\%}, 81.3{\%} and 67.5{\%}, respectively. Conclusions: Findings in this study suggested that 18 F-FCH-PET/CT is a more sensitive and specific method for detection of bone metastases from PC than WBS and could potentially reduce the need for confirmatory imaging if used instead of WBS. However, 18 F-FCH-PET/CT performs sub-optimally in pre-operative staging of lymph node metastases in patients undergoing extended pelvic lymph node dissection.",
keywords = "Choline, Diagnostic imaging, Positron emission tomography, Prostatic neoplasms",
author = "Mortensen, {Mike Allan} and Poulsen, {Mads Hvid} and Oke Gerke and Jakobsen, {J{\o}rn Skibsted} and H{\o}ilund-Carlsen, {Poul Flemming} and Lars Lund",
year = "2019",
month = "9",
doi = "10.1016/j.prnil.2019.01.002",
language = "English",
volume = "7",
pages = "119--123",
journal = "Prostate International",
issn = "2287-8882",
publisher = "Elsevier",
number = "3",

}

TY - JOUR

T1 - 18 F-Fluoromethylcholine-positron emission tomography/computed tomography for diagnosing bone and lymph node metastases in patients with intermediate- or high-risk prostate cancer

AU - Mortensen, Mike Allan

AU - Poulsen, Mads Hvid

AU - Gerke, Oke

AU - Jakobsen, Jørn Skibsted

AU - Høilund-Carlsen, Poul Flemming

AU - Lund, Lars

PY - 2019/9

Y1 - 2019/9

N2 - Background: The use of molecular imaging in staging of prostate cancer (PC) is debated. In patients with newly diagnosed PC we investigated the diagnostic value of 18 F-flouromethylcholine positron emission tomography/computed tomography ( 18 F-FCH-PET/CT) for the detection of bone and lymph node metastases compared to whole-body bone scintigraphy (WBS) with technetium-99-methylene diphosphonate ( 99m Tc-MDP) and results of extended pelvic lymph node dissection, respectively. Materials and methods: Between January 2013 and April 2016, 143 patients, aged 49-83, mean 69, years with newly diagnosed PC and disease characteristics necessitating WBS underwent both WBS and 18 F-FCH-PET/CT using magnetic resonance imaging as standard. Eighty of these patients underwent pelvic lymph node dissection as part of radical prostatectomy or prior to external beam radiation and in these results of 18 F-FCH-PET/CT were compared to histologic findings. Results: Bone metastases were detected in 8/143 patients and sensitivity and specificity of WBS were 37.5% and 85.2% versus 100.0% and 96.3% with 18 F-FCH-PET/CT, P=0.63 and 0.002, respectively. Histologically confirmed metastases to regional lymph nodes were found in 25/80 patients. Suspicious choline uptake on PET/CT in pelvic lymph nodes was found in 35 patients. Sensitivity, specificity, PPV, NPV and accuracy of 18 F-FCH-PET/CT in detection of lymph node metastases were 62.5%, 69.6%, 46.9%, 81.3% and 67.5%, respectively. Conclusions: Findings in this study suggested that 18 F-FCH-PET/CT is a more sensitive and specific method for detection of bone metastases from PC than WBS and could potentially reduce the need for confirmatory imaging if used instead of WBS. However, 18 F-FCH-PET/CT performs sub-optimally in pre-operative staging of lymph node metastases in patients undergoing extended pelvic lymph node dissection.

AB - Background: The use of molecular imaging in staging of prostate cancer (PC) is debated. In patients with newly diagnosed PC we investigated the diagnostic value of 18 F-flouromethylcholine positron emission tomography/computed tomography ( 18 F-FCH-PET/CT) for the detection of bone and lymph node metastases compared to whole-body bone scintigraphy (WBS) with technetium-99-methylene diphosphonate ( 99m Tc-MDP) and results of extended pelvic lymph node dissection, respectively. Materials and methods: Between January 2013 and April 2016, 143 patients, aged 49-83, mean 69, years with newly diagnosed PC and disease characteristics necessitating WBS underwent both WBS and 18 F-FCH-PET/CT using magnetic resonance imaging as standard. Eighty of these patients underwent pelvic lymph node dissection as part of radical prostatectomy or prior to external beam radiation and in these results of 18 F-FCH-PET/CT were compared to histologic findings. Results: Bone metastases were detected in 8/143 patients and sensitivity and specificity of WBS were 37.5% and 85.2% versus 100.0% and 96.3% with 18 F-FCH-PET/CT, P=0.63 and 0.002, respectively. Histologically confirmed metastases to regional lymph nodes were found in 25/80 patients. Suspicious choline uptake on PET/CT in pelvic lymph nodes was found in 35 patients. Sensitivity, specificity, PPV, NPV and accuracy of 18 F-FCH-PET/CT in detection of lymph node metastases were 62.5%, 69.6%, 46.9%, 81.3% and 67.5%, respectively. Conclusions: Findings in this study suggested that 18 F-FCH-PET/CT is a more sensitive and specific method for detection of bone metastases from PC than WBS and could potentially reduce the need for confirmatory imaging if used instead of WBS. However, 18 F-FCH-PET/CT performs sub-optimally in pre-operative staging of lymph node metastases in patients undergoing extended pelvic lymph node dissection.

KW - Choline

KW - Diagnostic imaging

KW - Positron emission tomography

KW - Prostatic neoplasms

U2 - 10.1016/j.prnil.2019.01.002

DO - 10.1016/j.prnil.2019.01.002

M3 - Journal article

VL - 7

SP - 119

EP - 123

JO - Prostate International

JF - Prostate International

SN - 2287-8882

IS - 3

ER -