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Assessment of Lymph Nodes and Prostate Status Using Early Dynamic Curves with (18)F-Choline PET/CT in Prostate Cancer.

Mathieu C, Ferrer L, Carlier T, Colombié M, Rusu D, Kraeber-Bodéré F, Campion L, Rousseau C - Front Med (Lausanne) (2015)

Bottom Line: SUVmean was corrected for partial volume effect (PVEC) with suitable recovery coefficients.In early dynamic acquisitions, the maximum and mean SUV were significantly higher, respectively, on mCT and GE-LS, in malignant versus benign lesions (p < 0.001, p < 0.001).For patients acquired on mCT, area under the ROC curve showed a trend to better sensitivity and specificity for early acquisitions, compared with late acquisitions (SUVmax AUC 0.92 versus 0.85, respectively).

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, ICO Cancer Center , Saint Herblain , France ; Department of Nuclear Medicine, University Hospital , Nantes , France.

ABSTRACT

Introduction: Dynamic image acquisition with (18)F-Choline [fluorocholine (FCH)] PET/CT in prostate cancer is mostly used to overcome the bladder repletion, which could obstruct the loco-regional analysis. The aim of our study was to analyze early dynamic FCH acquisitions to define pelvic lymph node or prostate pathological status.

Material and methods: Retrospective analysis was performed on 39 patients for initial staging (n = 18), or after initial treatment (n = 21). Patients underwent 10-min dynamic acquisitions centered on the pelvis, after injection of 3-4 MBq/kg of FCH. Whole-body images were acquired about 1 h after injection using a PET/CT GE Discovery LS (GE-LS) or Siemens Biograph mCT (mCT). Maximum and mean SUV according to time were measured on nodal and prostatic lesions. SUVmean was corrected for partial volume effect (PVEC) with suitable recovery coefficients. The status of each lesion was based on histological results or patient follow-up (>6 months). A Mann-Whitney test and ANOVA were used to compare mean and receiver operating characteristic (ROC) curve analysis.

Results: The median PSA was 8.46 ng/mL and the median Gleason score was 3 + 4. Ninety-two lesions (43 lymph nodes and 49 prostate lesions) were analyzed, including 63 malignant lesions. In early dynamic acquisitions, the maximum and mean SUV were significantly higher, respectively, on mCT and GE-LS, in malignant versus benign lesions (p < 0.001, p < 0.001). Mean SUV without PVEC, allowed better discrimination of benign from malignant lesions, in comparison with maximum and mean SUV (with PVEC), for both early and late acquisitions. For patients acquired on mCT, area under the ROC curve showed a trend to better sensitivity and specificity for early acquisitions, compared with late acquisitions (SUVmax AUC 0.92 versus 0.85, respectively).

Conclusion: Assessment of lymph nodes and prostate pathological status with early dynamic imaging using PET/CT FCH allowed prostate cancer detection in situations where proof of malignancy is difficult to obtain.

No MeSH data available.


Related in: MedlinePlus

Receiver operating characteristic curve for distinguishing benign from malignant lesions using SUVmax (A) and SUVmean [(B), without partial volume effect correction] for patients acquired on mCT (n = 71).
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Figure 3: Receiver operating characteristic curve for distinguishing benign from malignant lesions using SUVmax (A) and SUVmean [(B), without partial volume effect correction] for patients acquired on mCT (n = 71).

Mentions: On mCT (n = 71), the optimal SUV threshold that maximized both sensitivity and specificity in early acquisitions was obtained at 8 min post-injection. SUVmax ROC curve analysis showed better area under the curve (AUC) for the early acquisition at 8 min versus late acquisition (Figure 3) (0.92 versus 0.85, respectively). In the early acquisitions, SUVmean displayed the best AUC in comparison with SUVmax and SUVmean with PVEC (0.97 versus 0.92 and 0.91, respectively). The same results were found for late acquisitions with a superiority of SUVmean without PVEC. Optimal threshold and data for SUVmean with and without PVEC are summarized in Table 3.


Assessment of Lymph Nodes and Prostate Status Using Early Dynamic Curves with (18)F-Choline PET/CT in Prostate Cancer.

Mathieu C, Ferrer L, Carlier T, Colombié M, Rusu D, Kraeber-Bodéré F, Campion L, Rousseau C - Front Med (Lausanne) (2015)

Receiver operating characteristic curve for distinguishing benign from malignant lesions using SUVmax (A) and SUVmean [(B), without partial volume effect correction] for patients acquired on mCT (n = 71).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4563255&req=5

Figure 3: Receiver operating characteristic curve for distinguishing benign from malignant lesions using SUVmax (A) and SUVmean [(B), without partial volume effect correction] for patients acquired on mCT (n = 71).
Mentions: On mCT (n = 71), the optimal SUV threshold that maximized both sensitivity and specificity in early acquisitions was obtained at 8 min post-injection. SUVmax ROC curve analysis showed better area under the curve (AUC) for the early acquisition at 8 min versus late acquisition (Figure 3) (0.92 versus 0.85, respectively). In the early acquisitions, SUVmean displayed the best AUC in comparison with SUVmax and SUVmean with PVEC (0.97 versus 0.92 and 0.91, respectively). The same results were found for late acquisitions with a superiority of SUVmean without PVEC. Optimal threshold and data for SUVmean with and without PVEC are summarized in Table 3.

Bottom Line: SUVmean was corrected for partial volume effect (PVEC) with suitable recovery coefficients.In early dynamic acquisitions, the maximum and mean SUV were significantly higher, respectively, on mCT and GE-LS, in malignant versus benign lesions (p < 0.001, p < 0.001).For patients acquired on mCT, area under the ROC curve showed a trend to better sensitivity and specificity for early acquisitions, compared with late acquisitions (SUVmax AUC 0.92 versus 0.85, respectively).

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, ICO Cancer Center , Saint Herblain , France ; Department of Nuclear Medicine, University Hospital , Nantes , France.

ABSTRACT

Introduction: Dynamic image acquisition with (18)F-Choline [fluorocholine (FCH)] PET/CT in prostate cancer is mostly used to overcome the bladder repletion, which could obstruct the loco-regional analysis. The aim of our study was to analyze early dynamic FCH acquisitions to define pelvic lymph node or prostate pathological status.

Material and methods: Retrospective analysis was performed on 39 patients for initial staging (n = 18), or after initial treatment (n = 21). Patients underwent 10-min dynamic acquisitions centered on the pelvis, after injection of 3-4 MBq/kg of FCH. Whole-body images were acquired about 1 h after injection using a PET/CT GE Discovery LS (GE-LS) or Siemens Biograph mCT (mCT). Maximum and mean SUV according to time were measured on nodal and prostatic lesions. SUVmean was corrected for partial volume effect (PVEC) with suitable recovery coefficients. The status of each lesion was based on histological results or patient follow-up (>6 months). A Mann-Whitney test and ANOVA were used to compare mean and receiver operating characteristic (ROC) curve analysis.

Results: The median PSA was 8.46 ng/mL and the median Gleason score was 3 + 4. Ninety-two lesions (43 lymph nodes and 49 prostate lesions) were analyzed, including 63 malignant lesions. In early dynamic acquisitions, the maximum and mean SUV were significantly higher, respectively, on mCT and GE-LS, in malignant versus benign lesions (p < 0.001, p < 0.001). Mean SUV without PVEC, allowed better discrimination of benign from malignant lesions, in comparison with maximum and mean SUV (with PVEC), for both early and late acquisitions. For patients acquired on mCT, area under the ROC curve showed a trend to better sensitivity and specificity for early acquisitions, compared with late acquisitions (SUVmax AUC 0.92 versus 0.85, respectively).

Conclusion: Assessment of lymph nodes and prostate pathological status with early dynamic imaging using PET/CT FCH allowed prostate cancer detection in situations where proof of malignancy is difficult to obtain.

No MeSH data available.


Related in: MedlinePlus