BACKGROUND AND PURPOSE: The aim of this work was to determine whether 11C-choline positron emission tomography (PET)-computed tomography (CT) makes a positive contribution to multiparametric magnetic resonance imaging (MRI) for localisation of intraprostatic tumour nodules.
PATIENTS AND METHODS: A total of 73 patients with biopsy-proven intermediate- and high-risk prostate cancer were enrolled in a prospective imaging study consisting of T2-weighted (T2w), dynamic contrast-enhanced (DCE) and diffusion-weighted (DW) MRI and 11C-choline PET-CT before radical prostatectomy. Cancerous regions were delineated on the whole-mount prostatectomy sections and on the different MRI modalities and analysed in 24 segments per patient (3 sections, 8 segments each). To analyse PET-CT images, standardized uptake values (SUV) were calculated per segment.
RESULTS: In total, 1,752 segments were analyzed of which 708 (40.4 %) were found to be malignant. A high specificity (94.7, 93.6 and 92.2 %) but relatively low sensitivity (31.2, 24.9 and 44.1 %) for tumour localisation was obtained with T2w, DCE and DW MRI, respectively. Sensitivity values significantly increased when combining all MRI modalities (57.2 %). For PET-CT, mean SUVmax of malignant octants was significantly higher than mean SUVmax of benign octants (3.68 ± 1.30 vs. 3.12 ± 1.02, p < 0.0001). In terms of accuracy, the benefit of adding PET-CT to (multiparametric) MRI was less than 1 %.
CONCLUSION: The additional value of 11C-choline PET-CT to MRI in localising intraprostatic tumour nodules is limited, especially when multiparametric MRI is used.
Written by:
Van den Bergh L, Isebaert S, Koole M, Oyen R, Joniau S, Lerut E, Deroose CM, De Keyzer F, Van Poppel H, Haustermans K. Are you the author?
Department of Radiation Oncology, University Hospitals Leuven, campus Gasthuisberg, Herestraat 49, 3000, Leuven, Belgium.
Reference: Strahlenther Onkol. 2013 Jun 26. Epub ahead of print.
doi: 10.1007/s00066-013-0359-5
PubMed Abstract
PMID: 23797481
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