The sensitivity of [11C]choline PET/CT to localize prostate cancer depends on the tumor configuration

Nuclear Medicine, Technische Universitaet Muenchen, Ismaninger Str. 22, Muenchen, 81675, Germany.

 

To evaluate the dependency of the sensitivity of [11C]choline-PET/CT for detecting and localising primary prostate cancer (PCa) on tumor configuration in the histologic specimen

Fourty three patients with biopsy proven PCa were included. They underwent radical prostatectomy within 31 days after [11C]choline-PET/CT. The transaxial image slices as well as the histologic specimens were analyzed by comparing the respective slices. SUVmax was calculated in each segment and correlated with histopathology respectively. The tumor configuration in the histologic specimen was grouped as: I=unifocal, II=multifocal, III=rind-like, IV=size< 5mm. Data analysis included the investigation of detection of PCa by SUVmax, the assessment of the influence of potential contributing factors on tumor prediction, and the evaluation if SUV could discriminate cancer tissue from BPH, prostatitis, HGPIN or normal prostate tissue. For statistical analysis general estimation equation models were used.

Tumor configuration in histology was classified as I in 21, as II in 9, as III in 5 and as IV in 8 pts. The prostate segment involved by cancer is identified in 79% of the patients. SUVmax was located in the same side of the prostate in 95% of patients. Tumor configuration was the only factor significantly negatively influencing tumor prediction(p< 0.001). PCa-SUVmax (medianSUVmax=4.9) was not significantly different from BPH-SUV (medianSUVmax=4.5) and prostatitis-SUV (median SUVmax=3.9) p=0.102 and p=0.054 respectively.

The detection and localization of PCa in the prostate with [11C]choline-PET/CT is impaired by tumor configuration. Additionally, in our patient population, PCa tissue could not be distinguished from benign pathologies in the prostate.

Written by:
Souvatzoglou M, Weirich G, Schwarzenboeck S, Maurer T, Schuster T, Bundschuh RA, Eiber M, Herrmann K, Kuebler H, Wester HJ, Hoefler H, Gschwend J, Schwaiger M, Treiber U, Krause BJ.   Are you the author?

Reference: Clin Cancer Res. 2011 Apr 14. Epub ahead of print.
doi: 10.1158/1078-0432.CCR-10-2093

PubMed Abstract
PMID: 21493868

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